Cutaneous Leishmaniasis in Algeria; Highlight on the Focus of M’Sila

Abstract

Algeria ranks second after Afghanistan for the incidence of cutaneous leishmaniasis (CL) worldwide. Here, we report a 34-years retrospective analysis of CL in Algeria and focused on the most affected region, the M’Sila province. All 66 cutaneous isolates corresponded to Leishmania (L.) major. Our study of the sandfly and rodent fauna further highlighted the high density of Phlebotomus papatasi and additional phlebotomine species of medical importance, not previously identified in M’Sila. Wild rodents belonging to nine species were trapped in M’Sila, and Psammomys obesus and Meriones shawi were found infected by L. major. In addition, Leishmania infantum was isolated from two visceral leishmaniasis cases, one dog and its proven vectors (P. perniciosus, P. longicuspis, and P. perfiliewi) inventoried during the survey. The high incidence of CL in the M’Sila province is likely a consequence of the increase in minimum temperatures recorded that constitutes suitable conditions for establishing a high endemicity and leads to an explosive rise in leishmaniases cases in this region. A thorough investigation of the underlying risk factors is urgently needed to detect new cases earlier. All these would improve the preparedness to fight the disease.

Trends of Cutaneous Leishmaniasis, Western Ethiopia: retrospective study

“…Our study revealed that males were more affected by CL than females which agree with different studies [10][11][12][13][14][15][16][17]. However, our finding is analogized with the studies reported from Algeria, Istanbul, Turkey, and Larstan, South of Iran that excess in the frequency of CL cases among females than males [18][19][20]. In contrast to this, the studies conducted in rural communities in Tigray, northern Ethiopia, Silti woreda, Ethiopia, and Pakistan reported no gender difference in the frequency of CL cases [21][22][23].…”

Imaging Leishmania major Antigens in Experimentally Infected Macrophages and Dermal Scrapings from Cutaneous Leishmaniasis Lesions in Tunisia

“…In North African countries, the burden of the disease is high and three Leishmania species, associated to distinct eco-epidemiological patterns, namely L. infantum, L. major and L. tropica, are involved in Leishmania transmission [3][4][5]. However, L. major is by far the most frequent species, with more than 90% of registered cases in Algeria and Tunisia [5,6].…”

“…Cutaneous leishmaniasis caused by L. major, also known as zoonotic or rural zoonotic cutaneous leishmaniasis (ZCL), is a major public health problem in the North African region, including Tunisia, with thousands of cases occurring each year [5,6]. It is distributed in the arid and Saharan bioclimatic stages, where it follows an epidemic pattern with seasonal occurrence of cases [5,6]. Typical ZCL lesions evolve from papules to nodules to ulcerative lesions, with a central depression and a raised, indurate border [5].…”

“…They are typically multiple and located on limbs and tend to be exudative or "wet", large and complicated by superficial and secondary bacterial infections [5]. Most cases do not cause any clinical diagnostic difficulties, diagnosis often being suspected during epidemics on evocative clinical presentations in patients living in or coming from endemic areas [5][6][7]. However, occasionally patients present with unusual morphological forms of CL, which initially may elude diagnosis [8].…”

“…However, while these techniques are highly specific for diagnosing leishmaniasis, they are not sensitive enough [11,12]. Thus, the percent success for microscopic detection of Leishmania amastigotes in stained dermal scrapings varies depending on the number of parasites present and microscopist expertise, and is estimated around 60-80% for CL caused by L. major [6,10]. Likewise, culture on NNN medium is a less sensitive technique, which is moreover limited by the nonexceptional bacterial and fungal contamination [11,12].…”