Cases Of Leishmaniasis Research Articles

Time series analysis of cutaneous leishmaniasis incidence in Shahroud based on ARIMA model

BackgroundLeishmaniasis is a zoonotic disease and Iran is one of the ten countries with has the highest estimated cases of leishmaniasis. This study aimed to determine the time trend of cutaneous leishmaniasis (CL) incidence using the ARIMA model in Shahroud County, Semnan, Iran.MethodsIn this study, 725 patients with leishmaniasis were selected in the Health Centers of Shahroud during 2009–2020. Demographic characteristics including; history of traveling, history of leishmaniasis, co-morbidity of other family members, history of treatment, underlying disease, and diagnostic measures were collected using the patients’ information listed in the Health Ministry portal. The Box-Jenkins approach was applied to fit the SARIMA model for CL incidence from 2009 to 2020. All statistical analyses were done by using Minitab software version 14.ResultsThe mean age of patients was 28.2 ± 21.3 years. The highest and lowest annual incidence of leishmaniasis were in 2018 and 2017, respectively. The average ten-year incidence was 132 per 100,000 population. The highest and lowest incidence of the disease were 592 and 195 for 100,000 population in the years 2011 and 2017, respectively. The best model was SARIMA (3,1,1) (0,1,2)4 (AIC: 324.3, BIC: 317.7 and RMSE: 0.167).ConclusionsThis study suggested that time series models would be useful tools for predicting cutaneous leishmaniasis incidence trends; therefore, the SARIMA model could be used in planning public health programs. It will predict the course of the disease in the coming years and run the solutions to reduce the cases of the disease.

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.

Comparison of Injection Meglumine Antimoniate with a Combination of Injection Meglumine Antimoniate and Carbon Dioxide Fractional Ablative Laser in Treatment of Cutaneous Leshmaniasis

Aim: To see the efficacy of meglumine antimoniate alone in comparison with combination of meglumine antimoniate and CO2 ablative laser among patients with cutaneous leishmaniasis. Study design: Quasi-experimental study. Place and duration of study: Department of Dermatology, Pakistan Emirates Military Hospital, Rawalpindi from 9th July 2020 to 8th January 2021. Methodology: Sixty patients (30 in each group) diagnosed cases of cutaneous leishmaniasis by skin biopsy or slit skin smear were enrolled. In group A; intramuscular injection of meglumine antimoniate (dose 20 mg/kg daily) was administered for 28 days and group B was treated with intramuscular meglumine antimoniate injection along with fractional C02 ablative laser. Standard digital photography was done before start of treatment and then every 2 weeks. Results: Efficacy of meglumine antimoniate alone was observed in 60% of patients while it was 86.7% when combined with fractional CO2 ablative laser. Better outcome was observed when such patients were treated with both meglumine antimoniate and fractional CO2 laser. Efficacy was measured after 6 x weeks in all patients of both groups. Clinical Implication: Hence CO2 lasers are latest modality of treatment with minimal side effects and can be used in treatment of patients with cutaneous leishmaniasis. Conclusion: Efficacy of meglumine antimoniate plus fractional CO2 laser found to be higher as compared to meglumine antimonate alone in treating cutaneous leishmaniasis. Keywords: Cutaneous leishmaniasis, CO2 fractional ablative laser, Meglumine antimoniate, Slit skin smear

Leishmaniases in a tropical area of Brazil: a spatio-temporal analysis.

Leishmaniases are a group of tropical and neglected diseases caused by the protozoa of the genus Leishmania which are transmitted by insect sandflies. Despite of the major efforts undertaken at global level for the control of these diseases, a recent spreading to non-endemic areas been observed. In this study we analyzed the spatio-temporal distribution of Visceral Leishmaniasis (VL) and Tegumentary Leishmaniasis (TL) cases notified in a tropical region of Brazil. A retrospective evaluation was carried out using secondary data (e.g., demographics, origin, age and area of occurrence) of human patients obtained from 2009 to 2019. Choropleth maps with levels of color intensity represented the spatial distribution of VL and TL cases. Overall, 116 (10.5 ± 8.5) cases of leishmaniases were registered in the study area during the whole period. Of those, 61 (5.5 ± 5.5) and 55 (5 ± 4.3) were diagnosed as VL and TL, respectively. VL cases were recorded in 61.9% (13/21) and TL cases in 42.8% (9/21) of the municipalities. Most of the cases were predominantly notified in men from rural areas, and specifically for TL with an age range of 30-59years old. These findings will be useful to drive strategies of control (e.g., vector control, dog surveillance and notification of suspected cases) against these neglect diseases, preventing the spreading to non-endemic areas.

Molecular detection of Leishmania and blood meal analysis in sand flies from Corumbá, Mato Grosso do Sul, Brazil

In this study, we investigated the presence of Leishmania in sand flies collected from a peridomestic area in Corumbá, Mato Grosso do Sul, after an autochthonous case of cutaneous leishmaniasis was confirmed. A total of 1,542 sand flies belonging to seven species were collected, with Lu. cruzi being the most prevalent (94.3%). We detected the presence of DNA from Le. infantum (7 pools) and Le. braziliensis (3 pools) by sequencing the ITS1 amplicon in ten pools, all of which were composed of engorged (3) and non-engorged (7) females of Lu. cruzi. We collected 24 engorged females, with Homo sapiens being the most common blood meal source (91.6%), followed by Dasyprocta azarae and Canis lupus familiaris (4.2% each). To our knowledge, this is the first molecular evidence of Le. braziliensis in wild-caught Lu. cruzi in Brazil, suggesting its potential role as a vector for this parasite.

Ecological interactions of sand flies, hosts, and Leishmania panamensis in an endemic area of cutaneous leishmaniasis in Colombia.

The transmission dynamics of leishmaniasis are complex. There is also a lack of information about the ecological relationships between the vector/host/parasite at a more local and specific level. The Andean region concentrates more than 50% of Colombia's cutaneous leishmaniasis (CL) cases. The study of the ecological interactions of sand flies through the identification of blood sources has provided information on the female's opportunistic behavior, feeding on various hosts. Therefore, this study aimed to determine sand flies' ecological interactions with Leishmania parasites and their blood sources in an endemic area of CL. A total of 4,621 sand flies were collected, comprising 20 species, in which the most abundant were Nyssomyia yuilli yuilli (55.4%), Psychodopygus ayrozai (14.5%) and Ps. panamensis (13.4%). Sequences of 12S gene fragment were analyzed using the BLASTn search tool. Blood-meal source identification was successfully performed for 47 sand flies, detecting seven vertebrate species, human and armadillo being the most frequent. Leishmania DNA was amplified in four female pools, constituted by Ny. yuilli yuilli and Ps. ayrozai, and the identification through RFLP detected Leishmania (Viannia) panamensis in the positive pools. The interactions between the sand fly species, local mammalian fauna and the Leishmania parasite in this active focus of CL, provide evidence of the potential role of two different species in the maintenance of the parasite transmission, important information for the understanding of the ecoepidemiology and transmission dynamics of the disease in Andean endemic areas. However its necessary further evaluations of the vector and host competence in the transmission and maintenance of Leishmania spp, in these complex and diverse areas.

Occurrence of Leishmaniasis in Iberian Wolves in Northwestern Spain

Canine leishmaniasis is an important vector-borne protozoan disease in dogs that is responsible for serious deterioration in their health. In the Iberian Peninsula, as in most countries surrounding the Mediterranean Sea, canine leishmaniasis is caused by Leishmania infantum (zymodeme MON-1), a digenetic trypanosomatid that harbors in the parasitophorous vacuoles of host macrophages, causing severe lesions that can lead to death if the animals do not receive adequate treatment. Canine leishmaniasis is highly prevalent in Spain, especially in the Mediterranean coastal regions (Levante, Andalusia and the Balearic Islands), where the population of domestic dogs is very high. However, the presence of this disease has been spreading to other rural and sparsely populated latitudes, and cases of leishmaniasis have been reported for years in wildlife in northwestern Spain. This work describes for the first time the presence of wolves that tested positive for leishmaniasis in the vicinity of the Sierra de la Culebra (Zamora province, northwestern Spain), a protected sanctuary of this canid species, using PCR amplification of L. infantum DNA from different non-invasive samples such as buccal mucosa and those from both ears and hair. In addition to live animals (21), samples from carcasses of mainly roadkill animals (18) were also included and analyzed using the same technique, obtaining a positivity rate of 18 of the 39 wolves sampled (46.1%) regardless of their origin.

Entomological Exploration of Sand Flies in Human Communities Affected by Cutaneous and Visceral Leishmaniasis in El Hajeb Province, Morocco.

Sand flies are the exclusive vectors of leishmaniasis. This group of parasitic diseases is a serious public health problem in Morocco. The aim of this study was to investigate the sand fly fauna, mainly the species composition, biodiversity, and seasonal activity of sand flies in El Hajeb in central Morocco. A total of six stations (Aït Naaman, Aït Rbaa, Aït Brahim, Ain Taoujdate, Sidi Mbarek, and Aït Oufella) were studied, five of which had recently recorded cases of leishmaniasis. Sand fly bimonthly captures were carried out using a sticky paper trap in different biotopes from March to December 2019. A total of 14590 adult sand flies were collected. The activity of the sand fly started in April and declined in November. The periods of high abundance were July, September, and November. Morphological identification of sand flies shows the presence of twelve species: Phlebotomus papatasi, P. longicuspis, P. perniciosus, P. sergenti, P. bergeroti, P. alexandri, P. dreyfussi, P. ariasi, Sergentomyia fallax, S. minuta, S. schwetzi, and S. antennata. The analysis showed that species belonging to the genus Phlebotomus were the most dominant (93.3%) and the risk periods were spread during the summer and autumn seasons. The present study provides for the first time information on the species of sand flies in El Hajeb. It, therefore, provides decision makers with an important tool to conduct vector control actions during peak periods in order to limit the transmission of leishmaniasis. A preprint was made available by the research square in the following link: "https://assets.researchsquare.com/files/rs-1409330/v1/dfef7013-0327-4a54-897f-214924a2d950.pdf?c=1646838874."

Visceral leishmaniasis in Xinjiang Uygur Autonomous Region during the COVID-19 pandemic: a case report

To perform an epidemiological investigation on a case of visceral leishmaniasis reported from Shule County, Kashi Prefecture, Xinjiang Uygur Autonomous Region in 2021, so as to provide insights into differential diagnosis of visceral leishmaniasis during the COVID-19 pandemic. The epidemiological history of this case was collected, and the case was diagnosed for Leishmania infection with the immunochromatographic (rK39) strip test, bone marrow smear microscopy and PCR assay. The patient had typical clinical symptoms of leishmaniasis, including irregular fever, hepatosplenomeg- aly, low serum albumin and elevated globulin. Bone marrow smear microscopy identified L. donovani amastigotes, and both rK39 strip test and PCR assay were positive, while the case was tested negative for SARS-CoV-2. COVID-19 was therefore excluded and visceral leishmaniasis was diagnosed. Standard full-dose treatment with sodium stibogluconate was given, and no Leishmania was found on blood smears during the reexamination. No recurrence was found during the followup after discharge for hospital. During the COVID-19 pandemic, it is recommended to increase the perception of differential diagnosis of visceral leishmaniasis among first-contact doctors, and reinforce the capability of differential diagnosis and health education of visceral leishmaniasis among medical and healthcare institutions at all levels, to prevent missed diagnosis and misdiagnosis of visceral leishmaniasis.

Development of Leishmania Species Strains with Constitutive Expression of eGFP.

Protozoan parasites of the genus Leishmania cause leishmaniasis, a disease with variable clinical manifestations that affects millions of people worldwide. Infection with L. donovani can result in fatal visceral disease. In Panama, Colombia, and Costa Rica, L. panamensis is responsible for most of the reported cases of cutaneous and mucocutaneous leishmaniasis. Studying a large number of drug candidates with the methodologies available to date is quite difficult, given that they are very laborious for evaluating the activity of compounds against intracellular forms of the parasite or for performing in vivo assays. In this work, we describe the generation of L. panamensis and L. donovani strains with constitutive expression of the gene that encodes for an enhanced green fluorescent protein (eGFP) integrated into the locus that encodes for 18S rRNA (ssu). The gene encoding eGFP was obtained from a commercial vector and amplified by polymerase chain reaction (PCR) to enrich it and add restriction sites for the BglII and KpnI enzymes. The eGFP amplicon was isolated by agarose gel purification, digested with the enzymes BglII and KpnI, and ligated into the Leishmania expression vector pLEXSY-sat2.1 previously digested with the same set of enzymes. The expression vector with the cloned gene was propagated in E. coli, purified, and the presence of the insert was verified by colony PCR. The purified plasmid was linearized and used to transfect L. donovani and L. panamensis parasites. The integration of the gene was verified by PCR. The expression of the eGFP gene was evaluated by flow cytometry. Fluorescent parasites were cloned by limiting dilution, and clones with the highest fluorescence intensity were selected using flow cytometry.

Asymptomatic Leishmania donovani infection and associated factors among blood donors attending at Metema district Blood Bank, Northwest Ethiopia: a cross- sectional study

BackgroundEthiopia is one of the top 10 countries in the world where 90% visceral leishmaniasis cases are reported. Metema-Humera lowlands are the most important foci in Ethiopia. Blood transfusion in visceral leishmaniasis endemic foci in Ethiopia does not consider screening of visceral leishmaniasis during blood donation. The aim of this study is therefore, was to assess asymptomatic Leishmania donovani infection and associated factors among blood donors attending at Metema district Blood Bank, Northwest Ethiopia.MethodsA Health facility based cross-sectional study was conducted at Metema Blood Bank from February to March 2020. A total of 205 blood donors were eligible and participated in this study. Structured questionnaire were used to collect data on socio-demographic characteristics and perceived risk factors associated with asymptomatic visceral leishmaniasis among blood donors. Blood donors were screened using both rK39 and direct agglutination tests based on the manufactures’ instructions. Data were analyzed using SPSS version 20.0. Chi-square test was used to assess associations of Leishmania donovani infection with predisposing factors. Associations were considered statstically significant on P-value < 0.05 at 95% confidence level.ResultsOf the total 205 participants, 32(15.6%) were positive for asymptomatic Leishmania donovani infection at least by one of the diagnostic tests used. Eight (3.9%) and 30(14.6%) of the participants` were positive by the rK39 and direct agglutination tests, respectively. Six (2.9%) donors were tested positive by both diagnostic tests. Family history of visceral leishmaniasis (X²=11.334, P = 0.003) and having neighbors with history of visceral leishmaniasis (X²=5.923, P = 0.015) were significantly associated with asymptomatic Leishmania donovani infection among blood donors.ConclusionsThe prevalence of asymptomatic Leishmania donovani infection was 15.6%. Asymptomatic visceral leishmaniasis was significantly associated with donors’ family and neighbors’ history of infection. Therefore, laboratory screening of blood donors for visceral leishmaniasis in endemic areas will be mandatory. Moreover, this study will give base line information for future study in the country.

Cutaneous leishmaniasis in Burkina Faso: Epidemiological evolution of a vector-borne disease locally called “Ouaga 2000 disease”: a minireview

In Burkina Faso, the first case of cutaneous Leishmaniasis (CL) dates from 1960 and a few cases were reported in the following years. The objective of this review was to collect and analyze available data on CLin Burkina Faso to improve case management and control of disease transmission. A review of the literature was carried out using the PubMed, Google Scholar and Hinari databases. Publications dealing with the epidemiological aspects of CL, the parasite species involved, vectors and potential reservoir hosts, as well as drugs used in the treatment of CLwere searched. From 1960 to 1961, Burkina Faso recorded 13 cases of CL. From 2000 to 2005, an average of more than 1500 CLcases were recorded in Ouagadougou. In 2016 authors reported the results of the investigation of a second epidemic focus in Larama, Bassins region. More recently, in 2021, an investigation was carried out in a focus in the Centre-Nord region, bringing the number of CL focus to three in Burkina Faso. Leishmania major is the main species identified. In the wild area in the Ouagadougou focus, rodents Mastomys, Cricetomys, etc. have been described as the potential reservoir hosts, while in the domestic area, the animal reservoir would be the dog. In the focus of Ouagadougou, Phlebotomus duboscqi has been suspected since the 1960s as the possible vector of CL. The diagnosis is essentially microscopic. The first-line treatment meglumine antimoniate (Glucantime) accounted for only 65.9% of prescriptions. According to studies, the relapse rate after the first treatment with pentavalent antimony is about 37%. Despite the neglected disease status given to CL, there is therefore a need to strengthen the fight against this parasitosis by improving access to diagnosis and treatment, vector control and investigations to discover possible new endemic foci.

Clinicopathological characteristics of cutaneous and mucocutaneous leishmaniasis in patients treated with TNF-α inhibitors.

The increasing use of biologics in the treatment of inflammatory diseases has led to more cases of leishmaniasis in patients subjected to iatrogenic immunosuppression. The main objective was to describe the characteristics of the patients with cutaneous (CL) or mucocutaneous (MCL) leishmaniasis who were receiving a biological therapy at the time of diagnosis. A multicenter retrospective study was design based on a cohort of patients diagnosed with CL or MCL. All patients who were being treated with biologicals were included. For each case, two matched non-exposed patients were included for comparison. 38 patients were diagnosed with CL or MCL while being treated with tumor necrosis factor alpha (TNF-α) inhibitors. Leishmaniasis presented more frequently as a plaque (58.3%) with a larger median lesion size (2.5cm), ulceration (92.1%), and required a greater median number of intralesional meglumine antimoniate infiltrations (3 doses) (P <0.05) than in non-exposed patients. We found no systemic involvement in patients being treated with anti-TNF-α. We did not find differences regarding the treatment characteristics whether biologic therapy was modified or not. Although management should be individualized, maintenance of biologic therapy does not seem to interfere with treatment of CL or MCL.

Ecological Notes and New Records of Sand Flies1 from General Zuazua, Nuevo León, Mexico

Phlebotominae sand flies are the main vectors of several species of Leishmania parasites that are the etiological agents of leishmaniasis. The disease is endemic to southeastern Mexico, and many studies focused on the area. Cases of leishmaniasis also occur in other Mexican states such as Coahuila, Nuevo León, and Tamaulipas in the northeastern region bordering the United States of America (USA). Cutaneous leishmaniasis was reported intermittently in the State of Nuevo León through the years. Few records of sand fly species exist for the State of Nuevo León, and many municipalities have not been sampled despite potential importance of the disease at certain localities. The main objective of the work was to trap sand flies at the Municipality of General Zuazua, Nuevo León where urbanization occurred rapidly in recent years. A semi-urban location was selected to catch sand fly species using CDC light traps from 6 August through 26 September 2020. In total, 137 specimens in four genera and five species were collected during nine sampling events. Lutzomyia diabolica (Hall, 1936) was dominant at 90.5% of the total collected. Abundance of sand fly species peaked at Sampling Event 5 (34.3%) and differed significantly between sampling events and trap locations at six sites. Using Taylor´s power law, spatial distribution of sand flies was aggregated at the study site. Environmental variables such as air temperature, soil temperature, relative humidity, dew point, and wind speed were not significantly related to abundance of sand flies. The five sand fly species in the study -- Dampfomyia anthophora (Addis, 1945), Micropygomyia apache (Young and Perkins, 1984), Micropygomyia californica (Fairchild and Hertig, 1957), Psathyromyia texana (Dampf, 1938), and Lutzomyia diabolica were new records for the Municipality of General Zuazua, Nuevo León. Although the taxonomic status of M. californica is debatable, the species was recorded for the first time in México. The five species can be added to previous records, for a total of 10 species in the State of Nuevo León. Brief discussion of medical importance of each sand fly species to transmit Leishmania spp. is provided for the region.

Seroprevalence of Visceral Leishmaniasis in Children Up To 12 Years Old of Rural Areas from Kermanshah Province, Western Part of Iran.

After the earthquake in 2017 a few new cases of visceral leishmaniasis (VL) were reported from SarPol-e-Zahab district of Kermanshah Province, western part of Iran. This study was conducted to determine the seroprevalence in Kermanshah Province. This descriptive cross-sectional study was conducted on children up to 12 years of age from SarPol-e-Zahab County, Kermanshah Province, western part of Iran in 2021. For each individual, a questionnaire including age, sex, clinical features, history of the disease, and contact with canines as reservoir hosts of VL were completed, separately. To determine VL seroprevalence, blood samples were collected from the children and after centrifugation, the sera samples were separated and tested using Direct Agglutination Test (DAT) for detection of anti-L. infantum antibodies. Statistical analyses were performed using SPSS16. Totally, 13 persons were seropositive; 7 samples with titer 1:800, 3 samples had 1:1600, 2 samples had 1:3200 and 1 sample had 1:6400. None of the seropositive cases had a history of kala-azar. There was no significant difference between males and females at titers of anti-Leishmania specific antibodies. L. infantum infection is being circulated with low prevalence in children up to 12 years old from SarPol-e-Zahab County but it is necessary that the surveillance system is regularly monitored among physicians and public health managers in the studied areas.

Emerging infectious diseases and migration: a case of leishmaniasis in northern Mexico

Emerging infectious diseases and migration: a case of leishmaniasis in northern Mexico

Exposure to and infection by Leishmania infantum among domestic dogs in an area of the Cerrado biome, Maranhão, Brazil

Visceral Leishmaniasis is a serious public health problem and dogs are considered to be the main source of infection in urban areas. In Brazil, this disease is present in all regions, but with high concentration of cases in the Northeast, and the state of Maranhão is considered to be an endemic region. The aim of this study was to conduct an epidemiological, spatial, molecular and serological survey on Leishmania infantum among domestic dogs in the municipality of Belágua, Maranhão. Blood samples were collected from dogs and questionnaires were applied to their owners to obtain epidemiological data and risk factors relating to this zoonosis in the region. The coordinates of the dogs' homes were obtained to produce a disease risk map. Serological diagnoses were made using the indirect immunofluorescence reaction (IFAT) and the dual-path platform chromatographic immunoassay test (DPP®) (Bio-Manguinhos/FIOCRUZ, Brazil). A molecular investigation was undertaken using the polymerase chain reaction (PCR). Georeferencing was performed using the global positioning system (GPS) and cases of canine visceral leishmaniasis in the municipality were spatially represented and analyzed using QGIS version 3.16.6 (QGIS Development Team, 2021). A total of 205 blood samples were collected, of which 122 (59.51%) were seroreactive for L. infantum through IFAT, while the DPP test showed 84 reactive samples (40.97%). IFAT and DPP detected 16 positive animals simultaneously. One sample that was seroreactive through IFAT was also positive through PCR. In the clinical evaluation, it was observed that among the seropositive dogs, 112 (91.80%) were symptomatic and 10 (8.20%) were asymptomatic. In the spatial analysis, the Kernel density estimator enabled determination of the place at greatest risk of occurrence of the disease. The areas with the highest concentrations of cases were in districts with large quantities of precarious housing and lack of basic sanitation. This was the first report on the occurrence of L. infantum among dogs in the municipality of Belágua. The results show that canine visceral leishmaniasis is well dispersed in this municipality, thus putting at risk the human population.

Clinicoepidemiological Study of Cutaneous Leishmaniasis: A Hospital Based Study

Introduction: Cutaneous leishmaniasis is a tropical disease transmitted by the bite of an intracellular parasite infected sandfly. Visceral leishmaniasis is common in Nepal. However, cutaneous leishmaniasis remains rare with only limited number of cases documented in Nepal. Objectives: To describe the clinical and epidemiological distribution of cutaneous leishmaniasis in Karnali province of Nepal. Materials and Methods: All cases clinically diagnosed from direct microscopic Giemsa-stain smears, histopathology or fine needle aspiration cytology as cutaneous leishmaniasis were enrolled in the study for one year. Demographic data and clinical details were recorded on a printed proforma. Statistical analysis was done using STATA/SE version 15.0 for MacBook. Results: Only 46 cases with age ranging from 2 to 75 years were included in the study. Mean age was 23±2.45 years. Majority of cases below 20 years (47.83%) were infected. Male to female ratio was 0.70:1. Mean duration of the disease was 4.96±0.47 months. Single lesions (73.91%) were mostly present. Single lesions were particularly presented on the face (73.53%). Cutaneous leishmaniasis (95.65%) outnumbered mucocutaneous one on lips (4.35%). Ulcerative-papulonodular type lesions (58.70%) were mostly presented in the cases. Kalikot district (56.52%) had the majority of cutaneous leishmaniasis cases in Karnali province. Majority of the cases presented during the months of February, March, April, August, November, and December (65.22%). Conclusion: The study concluded that the increase in cutaneous leishmaniasis is alarming in the Kalikot district of Karnali province in Nepal. The result of this study would continue contributing to the existing data in the literature and encourage early diagnosis and treatment of cutaneous leishmaniasis.

Epidemiological survey of human and canine visceral leishmaniasis cases in the municipality of São Luís in the period from 2019 to 2020

The objective was to describe the epidemiological profile of visceral leishmaniasis (VL) in the municipality of São Luís, Maranhão. To this end, a descriptive study was carried out from 2019 to 2020, using secondary data obtained from the Information System of Notifiable Diseases and provided by the São Luís Zoonoses Surveillance Unit. General and clinical characteristics of the disease were analyzed in cases registered in humans and dogs. The results showed that 78 cases of VL in humans were reported, with the following profile: male (74.36%), mixed race (73.08%), 20 to 29 and 40 to 49 years old (35.90%), incomplete elementary school education (37.18%), urban area (44.87%). Most were new cases (84.62%), with co-infection with the HIV virus (41.03%) and with evolution towards cure (82.50%). Among the dogs, 401 cases were reported, 49.63% male, without defined breed (56.86%), age between 1 and 3 years (38.15%). Most dogs were symptomatic (90.27%), with a prevalence of skin lesions (39.90%) and weight loss (15.96%). It is concluded that VL has a frequent occurrence in the city of São Luís, therefore it is necessary to intensify sanitary measures in particular the education of the local population to reach the desired effect.

Avaliação da acurácia da informação em sites sobre leishmaniose visceral: uma estratégia de enfrentamento da desordem informacional

ABSTRACT New Information and Communication Technologies are increasingly present in the daily lives of people and institutions globally. The information they convey may need to be updated, complete, correct, or deliberately untrue. We live in a context of information mayhem. Health-related information like this can harm individuals and society. Some alternatives have been put forward to address this issue. This article discusses how online health information quality assessment and website certification can serve in confronting information disorder. It presents a methodology for assessing the accuracy of online information following the updated and scientifically proven information from evidence-based medicine. It analyzes the case of visceral leishmaniasis: one of the most prevalent neglected diseases in the world. Following this method, a tool with indicators was built, and the websites of international non-governmental organizations and the Ministries of Health of Brazil and India were evaluated. The results show that all the evaluated websites obtained at most 50% compliance with the indicators used.