A zoonotic focus of cutaneous leishmaniasis due to Leishmania tropica af Utut, Rift Valley Province, Kenya

Abstract

Several foci of cutaneous leishmaniasis have been identified in central Kenya and the Rift Valley. One of these was the Utut focus of Leishmania tropica on the floor of the Rift Valley between Gilgil and Elementaita, where intense transmission was detected. High infection and scar rates were detected among illegal charcoal burners in a previously uninhabited forest reserve on a lava flow containing numerous caves and rock crevices inhabited by sandflies and mammals which included hyraxes. Multiple lesions, predominantly in the head region, were common. 33% of cases occurred in people who had been less than one year in the area. Although most lesions healed within one or 2 years, some large, recrudescing lesions lasted several years.

Spread ofLeishmania killickito Central and South-West Tunisia

“…As described in south-eastern foci, anthroponotic transmission is very unlikely since the number of CL cases is too small and their distribution in space too sporadic to constitute an adequate reservoir. The rock hyraxes which were suggested as reservoir hosts in Kenya (Sang et al, 1994) aren't present in Tunisia. Whether the wild rodents Ctenodactylus gondii found in the mountainous areas of Aïn Jloula and Metlaoui play a role in the cycle of CL remains to be determined.…”

“…Two ten-year-old girls had particular clinical presentations. The first one presented recurrent reactivation of her face lesion with formation of satellite lesions at the periphery of the scar, a feature which is described with lesions caused by L. tropica in Kenya, a species identified as L. killicki (Sang et al, 1992 ;Sang et al, 1994) (Fig. 4).…”

Speculations on the origin and evolution of the genus Leishmania

“…More recently foci of L. tropica have been identified in Kenya (Mebratu et al 1992) and L. tropica is not known to be zoonotic anywhere else but Africa in its distribution (Sang et al 1994). Man is believed to have originated in Africa and it is reasonable to consider that anthroponotic parasites such as members of the L. tropica and (L. donovani) complex which have evolved with him may also have originated there.…”

Retrospective Analysis of Leishmaniasis in Central Tunisia: An Update on Emerging Epidemiological Trends

“…Some findings argue for its zoonotic origin as the disease is hypoendemic and frequently reported in rural populations. In addition, L. killicki in Kenya was isolated from hyracoides (Sang et al, 1994). However, CCL has also been reported from urban areas and from regions where L. major ZCL is highly prevalent and additional CCL cases were probably misdiagnosed.…”

“…CCL was first reported in 1957 and nearly nothing was known about the disease before this date. In 1979, an outbreak involving 47 individuals arose in Tataouine; and the epidemiological investigation, which included the isoenzymatic typing of strains isolated from the patients, led to the identification of the parasite as the MON 8 zymodeme of L. tropica, named L. killicki, a species previously described in Kenya, Namibia, Yemen and, more recently in Algeria and Libya (Harrat et al, 2009;Rioux et al, 1986;Sang et al, 1994). Surprisingly, over the last decade, cases of CCL were reported in patients originating from areas where this form has never been previously reported, the first case being in a child from Meknassy in Sidi Bouzid governorate .…”