Female Phlebotomine Sand Flies Research Articles

Molecular Identification of Host Blood Meal from Phlebotomine Sandflies (Diptera: Psychodidae) from Kerala, India.

Female phlebotomine sandflies serve as vectors for the transmission of Leishmania parasites, perpetuating an enzootic cycle by disseminating between sylvatic and domestic animals. Humans form a part of this cycle because the sandflies search for a blood source required for egg development. The present study aimed to identify the feeding preferences of different sandfly fauna from six districts of Kerala, India, using molecular tools. An entomological survey was conducted during 2021-2023 in Kollam, Kottayam, Thiruvananthapuram, Thrissur, Malappuram, and Palakkad. Both indoor and outdoor habitats were targeted from sandfly collection using different standard tools and methods. Sandflies were identified using standard taxonomic keys, and DNA was extracted from blood meal collected from sandflies. A total of 7366 sandfly specimens were collected during the study period, which belonged to three different genera and 19 species. Blood source was successfully identified from 119 sandflies revealing that the Sergentomyia genus preferably fed on small reptiles and amphibians, whereas Phlebotomus genus was found to mainly feed on mammalian and avian blood. Sergentomyia zeylanica was an exception, as it primarily fed on mammalian blood sources. Interestingly, humans were the second feeding source for Phlebotomus species, which are the proven vectors. Comprehending the feeding patterns of sandflies is crucial, not just for public health but also for obtaining insights into the ecological dynamics between vectors and hosts, ultimately enabling more efficient strategies for disease control and prevention.

An Adult Male with Multiple Skin Lesions

Leishmaniasis, caused by Leishmania spp. and transmitted by infected female phlebotomine sandflies, manifests in various forms. These include visceral, cutaneous, and post-kala-azar dermal leishmaniasis (PKDL). The World Health Organisation (WHO) has officially validated Bangladesh as the first country to eliminate visceral leishmaniasis. However, sustaining this achievement is challenging if PKDL cases remain unchecked because PKDL patients act as human reservoirs. Here, we depict a case of PKDL with mixed skin lesions involving the face and multiple body parts. We hope this will raise a concern among us to be vigilant for such cases and maintain the success of eliminating visceral leishmaniasis. J MEDICINE 2024; 25: 191-192

Canine Leishmaniasis (CanL); a public health threat in Ghana

Canine Leishmaniasis (CanL) is a protozoal disease caused by Leishmania species and transmitted by the female phlebotomine sand fly (which serves as a vector for the parasite) among animals and humans. The disease is of great importance to public health, due to its zoonotic nature, and the role of dogs as the natural reservoir of the disease. An important factor that helps in the continuous perpetuation of the parasite and for that matter the disease is the ability of the infective form of the parasite (metacyclic promastigote) to transform into amastigote in the host cells, and outsmart the host’s immune mechanism. These phenomena among other factors, poses a great risk of spreading the disease to susceptible hosts (humans and animals). Three forms of the disease have been identified, namely; visceral (VL), cutaneous (CL) and mucocutaneous (MCL). Leishmaniasis control has been categorized into direct method, targeted at infectious dogs and indirect method, targeted at the vector. In conclusion, human cutaneous leishmaniasis (HCL) is endemic in certain areas of the country, however, there is no data on cases of canine leishmaniasis in the country. It is recommended that, in discussing strategies to curb human leishmaniasis, stake-holders should factor in the role of dogs and for that reason, canine leishmaniasis (CanL).

Diagnostic accuracy of serological rk-39 test for visceral Leishmaniasis: Systematic review and meta-analysis.

Visceral leishmaniasis (VL), or kala-azar, is a vector-borne tropical disease caused by a group of intracellular hemoflagellate protozoa belonging to the family of Trypanosomatide and the genus Leishmania. The disease is distributed around the world and transmitted via the bite of infected female Phlebotomine sandflies, and there is variation in the diagnostic accuracy. Therefore, this systematic review and meta-analysis aimed to determine the pooled global sensitivity and specificity of the rk-39 test and to evaluate if there is a difference between the different parts of the world. A systematic review and meta-analysis have been conducted on the diagnostic accuracy of dermoscopy. After setting eligibility criteria, literature was searched in four databases and one searching engine. Articles were screened, critically appraised, and extracted independently by two reviewers, and any disagreements were resolved with the involvement of a third person. The quality of the included studies had been assessed by the Quality Assessment of Diagnostic Accuracy Studies (QUADAS 2) tool. Pooled sensitivity and specificity were determined by bivariate random effect analysis. Heterogeneity was assessed by Higgins's I2, and when it was present, mitigation was conducted by using sensitivity analysis. A total of 409 studies were identified, and finally 18 articles were eligible for the review with a total sample size of 5, 253. The bivariate random effect meta-analysis of the 7 diagnostic accuracy studies showed a pooled sensitivity of 0.89 (0.76-0.95) and specificity of 0.86 (0.72-0.94). The +LR was 6.32 (95% CI: 2.85-14.02), the-LR was 0.13 (95% CI: 0.06-0.30), and the diagnostic odds ratio (DOR) was 47.8 (95% CI: 11.3-203.2). Abdel-Latif (2018) was both an outlier and influential for sensitivity, and Walter (2011) was both an outlier and influential for specificity, and removing them from sensitivity and specificity, respectively, was beneficial for reducing the heterogeneity. Rk-39 is found to have highly accurate measures in the diagnosis of visceral leishmaniasis. Both sensitivity and specificity were found to be highly accurate in the diagnosis of leishmaniasis, with a pooled sensitivity of 0.91 (0.88-0.93) and a pooled specificity of 0.89 (0.85-0.91). As we will use secondary data for the systematic review and meta-analysis, ethical concerns are not necessary.

Efficiency of rLb6H recombinant protein from Leishmania (Viannia) braziliensis for the detection of canine visceral leishmaniasis

Introduction: Visceral leishmaniasis (VL) is a serious endemic disease in many tropical and subtropical countries, with a strong incidence in Brazil. The disease is transmitted by the bite of infected female phlebotomine sandflies, with dogs being the main urban reservoirs of the parasite. The diverse clinical profile and the long incubation period are challenges for the diagnosis of canine visceral leishmaniasis (CVL). Recombinant proteins from Leishmania spp. have been studied as antigens that can increase the accuracy of serological tests. Objective: To evaluate the diagnostic performance of the recombinant protein rLb6H, from Leishmania braziliensis, in comparison to the reference antigens rK39 and rK28, from L. donovani, prioritizing the identification of subclinical infected dogs. Material and Methods: Serum IgG reactivity to rLb6H, rK28, and rK39 recombinant proteins was assessed in dogs with previously parasitological confirmation of CVL, subdivided according to their clinical status, using immunoenzymatic assay (ELISA). Diagnostic accuracy of each ELISA was evaluated by receiver operating characteristic (ROC) curve analysis. Results: While all antigens showed a better performance in detecting CVL in symptomatic dogs (SD), detection of CVL in the oligosymptomatic (OD) and asymptomatic (AD) groups was lower, but rLb6H achieved high sensitivity for asymptomatic CVL. Interestingly, the most reactive CVL samples to rK28 were barely detected by rLb6H, while the less reactive to rK28, mostly from the AD group, presented higher reactivity to rLb6H. Conclusion: The recombinant protein rLb6H showed utility in the detection of asymptomatic CVL, displaying a complementary reactivity to rK39 and rK28. Thus, these results suggest that rLb6H could be incorporated into multi-antigen strategies, to increase diagnostic accuracy of CVL.

A case of visceral leishmaniasis

Leishmaniasis is caused by a protozoa parasite, one of more than 20 Leishmania species, transmitted to humans by the bite of infected female phlebotomine sandflies. More than 90 species of mosquitoes have been identified as carriers of the Leishmania parasite. There are 3 main types of the disease: visceral (often called kala-azar, the most severe form of the disease), cutaneous (the most common), and mucocutaneous. Leishmaniasis is caused by the protozoa parasite Leishmania, which is transmitted by the bite of infected mosquitoes. The disease affects the world's poorest people and is associated with malnutrition, displacement, poor housing conditions, weak immune systems, and lack of resources. Leishmaniasis is related to environmental changes such as deforestation, construction of dams and irrigation systems, and urbanization. An estimated 700,000 to 1 million new infections and 20,000 to 30,000 deaths occur each year. Only a small proportion of people infected with Leishmania parasites will eventually develop the disease.

Antiparasitic effect of Farnesol against Leishmania major: A rationale from in vitro and in silico investigations.

Leishmaniasis is a vector-borne parasitic infection caused by the infective bite of female Phlebotomine sandflies. Treatment of leishmaniasis by conventional synthetic compounds is met by challenges pertaining to adverse effects which call for the discovery of newer anti-leishmanial molecules. This study was performed to evaluate the effect and modes of action of a sesquiterpene alcoholic molecule Farnesol on Leishmania major, the causative agent of Zoonotic CL. The cytotoxic effect of Farnesol against L.major promastigotes, amastigotes and macrophages was assessed by MTT test and counting. The IC50 on promastigotes by Farnesol on L.major was also evaluated by flow cytometry. In the findings, promastigotes were reduced at 167μM. The mean numbers of L.major amastigotes in macrophages were significantly decreased on exposure to Farnesol at 172μM. In addition, Farnesol induced significant apoptosis dose-dependent on L.major promastigotes. In silico protein-ligand_binding analyses indicated the effect of Farnesol in perturbation of the ergosterol synthesis pathway of Leishmania with attributes suggesting inhibition of Lanosterol-α-demethylase, the terminal enzyme of ergosterol synthesis machinery. Findings from flow cytometry reveal the role of Farnesol in apoptosis-induced killing in promastigotes. Farnesol was effective at very lower concentrations when compared to Paromomycin. Further studies are crucial to evaluate the therapeutic potential of Farnesol alone or in combination with other conventional drugs in animal models.

Pediatrik Kutanöz Leishmania Olgularının Değerlendirilmesi

Cutaneous Leishmaniasis (CL) is a disease caused by leishmania-type protozoans, which is transmitted by the bite of infected female phlebotomine sandflies and is characterized by ulcerated nodular lesions. Twenty-one pediatric cutaneous leishmania cases followed by pediatric infectious diseases and dermatology were included in the study. The demographic and clinical characteristics of the patients, the local or systemic treatments, and side effects were analyzed retrospectively. 14 (66%) of the patients were female and 7 (34%) were male. The mean age of the cases was 6.4 years. Fifteen of the patients were refugees (seven of the patients were from Iraq, and eight of them were from Syria). Ten of the patients ( 47%) had lesions only on the face, 6 (28%) were both on the face and hand, 4 (20%) were on the lower extremities. Seven patients (34%) had a single lesion, fourteen had multiple lesions and seven had more than four lesions. Amastigote was observed in the microbiological examination of skin scraping samples of 13 patients. Intralesional therapy was given to 15 patients, systemic treatment was given to 6 patients, and 2 patients refused systemic treatment. Five patient was given meglumine antimoniate, one patient was given amphotericin B. In one patient, side effects such as facial swelling, rash, and edema developed after amphotericin b, and the treatment was changed to meglumine antimoniate. Leishmaniasis is a chronic disease caused by flagellate protozoa of the genus Leishmania. especially in endemic countries. CL has become a relatively common condition all over the world due to international travel, migration, and refugees. Cutaneous Leishmania should be considered when there are chronic, painless skin lesions outside of endemic areas.

Survey of phlebotomine sand fly fauna in a public Zoo in Brazil: Species diversity, seasonality, and host variety.

Leishmaniasis is a dynamic disease in which transmission conditions change due to environmental and human behavioral factors. Epidemiological analyses have shown modifications in the spread profile and growing urbanization of the disease, justifying the expansion of endemic areas and increasing number of cases in dogs and humans. In the city of Belo Horizonte, located in the southeastern state of Minas Gerais (Brazil), visceral leishmaniasis (VL) is endemic, with a typical urban transmission pattern, but with different regional prevalence. This study was conducted at the Zoo of the Foundation of Municipal Parks and Zoobotany of Belo Horizonte (FPMZB-BH), located in the Pampulha region, which is among the areas most severely affected by VL. This study aimed to determine the taxonomic diversity of native phlebotomine sand flies (Diptera: Psychodidae), identify climatic variables that potentially affect the phenology of these insects, and determine the blood meal sources for female phlebotomine sand flies. To achieve this, 10 mammal enclosures in the zoo were selected using the presence of possible leishmaniasis reservoirs as a selection criterion, and sampled using light traps between August 2019 and August 2021. A total of 6034 phlebotomine sand flies were collected, indicating nine species, with Lutzomyia longipalpis being the very abundant species (65.35% of the total). Of the 108 engorged phlebotomine collected females, seven samples (6.5%) were positive for blood meals from humans, marsupials, canids, and birds. Relative humidity and rainfall increased the phenology of phlebotomine sand flies, with population increases in the hottest and wettest months. The data obtained will provide guidelines for competent health agencies to implement vector control measures to reduce the risk of leishmaniasis transmission in the FPMZB-BH.

Identification of molecular mechanisms causing skin lesions of cutaneous leishmaniasis using weighted gene coexpression network analysis (WGCNA)

Leishmaniasis is an infectious disease, caused by a protozoan parasite. Its most common form is cutaneous leishmaniasis, which leaves scars on exposed body parts from bites by infected female phlebotomine sandflies. Approximately 50% of cases of cutaneous leishmaniasis fail to respond to standard treatments, creating slow-healing wounds which cause permanent scars on the skin. We performed a joint bioinformatics analysis to identify differentially expressed genes (DEGs) in healthy skin biopsies and Leishmania cutaneous wounds. DEGs and WGCNA modules were analyzed based on the Gene Ontology function, and the Cytoscape software. Among almost 16,600 genes that had significant expression changes on the skin surrounding Leishmania wounds, WGCNA determined that one of the modules, with 456 genes, has the strongest correlation with the size of the wounds. Functional enrichment analysis indicated that this module includes three gene groups with significant expression changes. These produce tissue-damaging cytokines or disrupt the production and activation of collagen, fibrin proteins, and the extracellular matrix, causing skin wounds or preventing them from healing. The hub genes of these groups are OAS1, SERPINH1, and FBLN1 respectively. This information can provide new ways to deal with unwanted and harmful effects of cutaneous leishmaniasis.

Cutaneous Leishmaniasis: A clinicoepidemiological Study in Al Muthanna Governorate/Iraq

Background: Leishmaniasis is an endemic disease in Iraq. There are three types of leishmaniasis; cutaneous, mucocutaneous, and visceral form. Cutaneous leishmaniasis (CL) is the most common type that causes skin sores. In Iraq, CL has 2 presentations, zoonotic cutaneous leishmaniasis which is caused by L. major, and anthroponotic cutaneous leishmaniasis caused by L. Tropica. Leishmaniasis, is transmitted by the bite of infected female phlebotomine sandflies. Objective: We aimed to verify the clinical and epidemiology of cutaneous leishmaniasis in the Al Muthanna governorate. Materials and methods: A prospective cross-sectional descriptive study was carried out in the outpatient dermatological clinic in Al Hussein Teaching Hospital during the period from the 1st of December 2021 to the 1st of April 2022 in Al Muthanna governorate, Iraq. Patients with CL of any age and both sexes were enrolled in the current investigation. Detailed information regarding the age, gender, residence, duration, site, number, and type (wet or dry) of the lesion was recorded for every participant. Results: Two hundred fifty patients were diagnosed clinically as having CL. Males represented 132 (52.8%) patients. The majority of the cases were found in the age group 0-10 (n = 174, 69.6%) patients. Eighty percent (n = 200) of the participants were from rural areas. Most of the cases were presented in less than two months (n = 164, 65.6 %). Most of the lesions affected the face (n = 89, 35.6%), and the least was seen in the upper and lower limbs (n = 9, 3.6 %). The majority of the cases had a single lesion (n = 164, 65.6%) and of the dry type (n = 178, 71.2%). Conclusion: CL is an endemic dermatological disease in the Al Muthanna governorate. Males were outnumbering females. The highest age group affected was 0-10 years. The majority of patients were from rural areas. The majority of the cases presented within two months, involved the face, had a single lesion, and were of a dry type.

The leishmaniases in Kenya: A scoping review.

The leishmaniases are a group of four vector-borne neglected tropical diseases caused by 20 species of protozoan parasites of the genus Leishmania and transmitted through a bite of infected female phlebotomine sandflies. Endemic in over 100 countries, the four types of leishmaniasis-visceral leishmaniasis (VL) (known as kala-azar), cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (MCL), and post-kala-azar dermal leishmaniasis (PKDL)-put 1.6 billion people at risk. In Kenya, the extent of leishmaniasis research has not yet been systematically described. This knowledge is instrumental in identifying existing research gaps and designing appropriate interventions for diagnosis, treatment, and elimination. This study used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology to determine the state of leishmaniases research in Kenya and identify research gaps. We searched seven online databases to identify articles published until January 2022 covering VL, CL, MCL, and/or PKDL in Kenya. A total of 7,486 articles were found, of which 479 underwent full-text screening, and 269 met our eligibility criteria. Most articles covered VL only (n = 141, 52%), were published between 1980 and 1994 (n = 108, 39%), and focused on the theme of "vectors" (n = 92, 34%). The most prevalent study types were "epidemiological research" (n = 88, 33%) tied with "clinical research" (n = 88, 33%), then "basic science research" (n = 49, 18%) and "secondary research" (n = 44, 16%). While some studies still provide useful guidance today, most leishmaniasis research in Kenya needs to be updated and focused on prevention, co-infections, health systems/policy, and general topics, as these themes combined comprised less than 4% of published articles. Our findings also indicate minimal research on MCL (n = 1, <1%) and PKDL (n = 2, 1%). We urge researchers to renew and expand their focus on these neglected diseases in Kenya.

Pediatric lymphatic leishmaniasis: a case report

BackgroundThere are three main forms of leishmaniases: visceral (the most serious form because it is almost always fatal without treatment), cutaneous (the most common, usually causing skin ulcers), and mucocutaneous (affecting mouth, nose, and throat). Leishmaniasis is caused by protozoan parasites, which are transmitted by the bite of infected female phlebotomine sandflies. The disease affects some of the world’s poorest people and is associated with malnutrition, population displacement, poor housing, a weak immune system, and lack of financial resources. An estimated 700,000 to 1 million new cases occur annually. Only a small fraction of those infected by parasites causing leishmaniasis will eventually develop the disease. We report a case of exclusive lymph node involvement in leishmaniasis, presenting as localized lymphadenopathies. The diagnosis of lymphatic leishmaniasis was confirmed by the presence of Leishmania donovani bodies in fine needle aspiration cytology, and positive anti-rK39 antibodies. The bone marrow aspiration was negative for Leishmania donovani bodies. Abdominal ultrasound was done and there was no organomegaly. Furthermore, localized lymphadenopathies may provide a diagnostic challenge by clinically mimicking a lymphoma or other causes of lymphadenopathy. Due to its rarity and its tendency to pose a clinical diagnostic challenge, we decided to report a case of lymphatic leishmaniasis.Case presentationA 12-year-old Amara male patient presented to the University of Gondar comprehensive specialized hospital, Northwestern Ethiopia, with six discrete right lateral cervical lymphadenopathies, the largest measuring 3 × 2 cm2, with no cutaneous lesion. Fine needle aspiration cytology confirmed the diagnosis of leishmaniasis in lymph node, and he was put on sodium stibogluconate (20 mg/kg body weight/day) and paromomycin (15 mg/kg body weight/day) injections, which are given intramuscularly for 17 days. Having completed his medication at the University of Gondar comprehensive specialized hospital, he had a smooth course and was discharged with appointment scheduled for follow-up after 3 months.ConclusionIn the clinical evaluation of a patient with isolated lymphadenopathies, leishmaniasis must be considered as a differential diagnosis in immunocompetent subjects in endemic areas for early diagnostic workup and management.

Antileishmanial Activity of Cinnamic Acid Derivatives against Leishmania infantum

Leishmania infantum is the etiological agent of visceral leishmaniasis (VL) in South America, the Mediterranean basin, and West and Central Asia. The most affected country, Brazil, reported 4297 VL cases in 2017. L. infantum is transmitted by female phlebotomine sand flies during successive blood meals. There are no validated vaccines to prevent the infection and the treatment relies on drugs that often present severe side effects, which justify the efforts to find new antileishmanial drugs. Cinnamic acid derivatives have shown several pharmacological activities, including antiparasitic action. Therefore, in the present study, the biological evaluation of cinnamic acid and thirty-four derivatives against L. infantum is reported. The compounds were prepared by several synthesis methods and characterized by spectroscopic techniques and high-resolution mass spectrometry. The results revealed that compound 32 (N-(4-isopropylbenzyl)cinnamamide) was the most potent antileishmanial agent (IC50 = 33.71 μM) with the highest selectivity index (SI > 42.46), followed by compound 15 (piperonyl cinnamate) with an IC50 = 42.80 μM and SI > 32.86. Compound 32 was slightly less potent and nineteen times more selective for the parasite than amphotericin B (MIC = 3.14 uM; SI = 2.24). In the molecular docking study, the most likely target for the compound in L. infantum was aspartyl aminopeptidase, followed by aldehyde dehydrogenase, mitochondrial. The data obtained show the antileishmanial potential of this class of compounds and may be used in the search for new drug candidates against Leishmania species.

A Challenging Case of Visceral Leishmaniasis

The term leishmaniasis includes multiple clinical syndromes: visceral, cutaneous, and mucosal leishmaniasis, resulting from an infection of macrophages throughout the reticuloendothelial system in the dermis and the naso-oropharyngeal mucosa, respectively. The clinical phenotype is mainly driven by the leishmania biologic characteristics and, ultimately, also by the host immune status. The disease is endemic in focal areas in the tropics, subtropics, and southern Europe, transmitted by the bite of female phlebotomine sandflies. Sandflies regurgitate the parasite’s flagellated promastigote stage into the host’s skin; promastigotes bind to receptors on macrophages are phagocytized and transformed within phagolysosomes into non-flagellated amastigotes which replicate and infect additional macrophages. Amastigotes ingested by sandflies transform back into infective promastigotes. Depending on the host’s innate and acquired immune status, systemic and visceral leishmaniasis can be characterized by irregular fever, weight loss, enlargement of the spleen and liver, and anaemia. We present a 42 year-old man with long-lasting type 1 autoimmune hepatitis under immunosuppressive treatment. In January 2017, the patient started to experience low-grade unresponsiveness to empiric antibiotic therapy. The patient developed severe anemia and progressive multilineage cytopenia accompanied by increased levels of inflammatory markers. FDG-PET revealed increased glucose uptake in the liver, spleen, and the whole bone marrow. The subsequently performed bone marrow biopsy evidenced Leishmania amastigotes inside macrophages, confirmed by serological positivity to anti-Leishmania antibody. Immunosuppressive therapy was suspended and replaced by treatment with amphotericin B at 4 mg/kg/day from day 1 to day 5, followed by a single infusion on days 10, 17, 24, 31, and 38. The bone marrow smear after treatment still evidenced few Leishmania amastigotes; in consideration of the patient’s immunosuppression status, two further doses of amphotericin B on days 45 and 52 were employed, leading to infection resolution. In real-life, as exemplified in this case, administering two additional doses of amphotericin B (concerning the guidelines) offered an additional therapeutic opportunity for a patient under long-term immunosuppressive treatment.

Synthesis, Characterization and Pharmacological Evaluation of Chalcones and Its Derivatives for Antileishmanial Activity

Medicinal chemistry is almost always geared toward drug discovery and development. The focus on development of new synthetic drug compounds has resulted in the incorporation of many other disciplines, such as biochemistry, combinatorial chemistry, chemical biology, phytochemistry, pharmacology, enzymology, pharmacognosy, statistics, physical chemistry and molecular biology into medicinal chemistry. In this view medicinal chemists are also trying to speed up drug discovery process for finding the lead molecule [1]. The compounds with chalcone as backbone have been reported to possess varied biological and pharmacological activities, including antimicrobial, anti-inflammatory, analgesic, cytotoxic, antitumor, antimalarial, antitubercular, antiviral, anti-HIV, antiulcerative, antileishmanial activities. Leishmaniasis is a vector-borne disease caused by protozoan parasites of the genus Leishmania. It is transmitted through the bite of female phlebotomine sandflies and can range from mild self-healing cutaneous lesions to lethal visceral leishmaniasis. Lic A (1), efficiently inhibited the proliferation of Leishmania donovani and Leishmania major promastigotes and amastigotes in vitro by inhibiting fumarate reductase (Chen et al. 1993), a selective target present in the parasite mitochondria. The Lic C (113) inhibited the growth of the L. major parasite to the same extent as Lic A (1) (Nielson et al. 1995).

Leishmaniosis caused by Leishmania infantum in ferrets: Update review

Leishmaniosis in domestic ferrets (Mustela putorius furo) is a disease caused by Leishmania infantum, a parasite transmitted through the bite of an infected female phlebotomine sand fly. Among vertebrates, the dog is the primary domestic reservoir of the parasite; however, other domestic animals can be implicated such as cats. The first description of a clinical case of leishmaniosis in domestic ferrets was reported recently. As a result, new knowledge has been published including empirically based treatment protocols, confirmatory techniques to detect the presence of the parasite infection and seasonal variation in the antibodies against Leishmania in apparently healthy domestic ferrets. The most common clinical signs observed are enlargement of peripheral lymph nodes and skin lesions such as papular and/or ulcerative dermatitis. Additionally, the most frequent laboratory alterations seen are hyperproteinaemia with hyperglobulinaemia and biochemical analytes alterations depending on the affected tissue. Two different therapeutic protocols have been described to treat domestic ferrets with leishmaniosis: meglumine antimoniate plus allopurinol protocol or miltefosine plus allopurinol protocol. These treatment protocols seemed to be able to control the Leishmania infection, although the presence of xanthinuria could be detected. The susceptibility of domestic ferrets to Leishmania infantum, the clinical picture, treatment of infected animals and prevention are poorly understood, due to the scarcity of recent description in the literature. Different proposed diagnostic algorithms have been included for domestic ferrets with suspected leishmaniosis, clinically healthy domestic ferrets and animals as blood donors. In this sense, the present review provides updated data on scientific knowledge of leishmaniosis in ferrets.

Amplicon-based next-generation sequencing reveals the co-existence of multiple Leishmania species in patients with visceral leishmaniasis

Visceral leishmaniasis (VL) is a mammalian protozoal disease propagated in the Americas by female phlebotomine sandflies, mainly caused by Leishmania infantum. However, in recent years, cases of VL caused by different Leishmania species, such as L. amazonensis and L. colombiensis, have been reported in the continent. This study used an amplicon-based next-generation sequencing approach to identify VL aetiologic species using high-depth sequencing targeting a region on the Heat Shock Protein 70 gene. In this first approach, six samples from five patients diagnosed with VL were selected and analysed to identify DNA of Leishmania spp. All samples harboured DNA of L. infantum; five samples were found to be co-infected with other Leishmania spp. or with Trypanosoma cruzi, and just one sample was mono-infected with L. infantum. This study demonstrates the usefulness of this methodology to identify trypanosomatid co-infections in clinical samples, which presents an interesting study panorama considering their biological, clinical and epidemiological implications.

Cutaneous leishmaniasis in protected environmental areas in the Eastern Amazon: the case of São Félix do Xingu, Pará, Brazil

Cutaneous Leishmaniasis is a disease transmitted to men and animals by infected female phlebotomine sandflies and is considered a great environmental and public health problem in the Amazon region. Thus, the study aimed to analyze the spatial distribution of this disease in São Félix do Xingu, in the state of Pará, Brazil, and its relationship with epidemiological and environmental variables, in the period from 2012 to 2016. The data used were from the Information System of the Pará State Secretariat of Health, the National Institute for Space Research and the Brazilian Institute of Geography and Statistics. The statistical and spatial analysis of the variables were done using non-parametric chi-square statistical test, kernel interpolation technique and the Bivariate Global Moran Index. The municipality had 183 confirmed cases, non-homogeneously distributed in 5 administrative districts. The individuals most affected were adult males with brown skin, an elementary level of education and rural area residents. In the case series, a direct relationship was observed between the increase of the number of cases and deforestation in the study area. The spatial analysis showed different types of land use and cover related to case clusters in the municipality. Additionally, there was a presence of cases in protected areas and a great epidemiological silence in indigenous lands. Thus, this disease is a large and complex public health problem in the municipality, related to social and environmental risk factors.

Live attenuated Leishmania major p27 gene knockout as a novel vaccine candidate: A study on safety, protective immunity and efficacy against canine leishmaniasis caused by Leishmania infantum

Canine leishmaniasis (CanL) is an important parasitic e disease caused by Leishmania infantum and is transmitted by female phlebotomine sand flies primarily between canines and secondarily to humans. Recently, we showed that immunization with Leishmania major p27 gene knockout (Lmp27−/−) as a live attenuated vaccine was safe, induced immunogenicity, and protected against the development cutaneous and visceral leishmaniasis in mice. The p27 protein is a component of the COX protein complex which is responsible for ATP production. In this study, we analyzed the Lmp27−/− candidate vaccine potential with this regard to the safety and induction of immunogenicity and protection against CanL. Variables such a clinical manifestation, anti-Leishmania antibodies using direct agglutination test (DAT), lymphocyte proliferation, delayed-type hypersensitivity (DTH), bone marrow aspiration (BMA) and parasite burden using parasitological and molecular examinations were measured. The results demonstrated that the Lmp27−/− vaccinated group showed no clinical signs after inoculation with Lmp27−/− mutant during a 12-month follow-up, and had significantly higher T-cell responses (Lymphocyte proliferation and DTH), lower seroconversion and parasite burdens following a challenge inoculation with L. infantum after 6-mounth. In conclusion, vaccination with Lmp27−/− parasites would be safe and provide significant immunoprotectivity and efficacy against infection with wild type (WT) L. infantum.