Cutaneous Leishmaniasis in North Africa: a review

Abstract

In North African countries, cutaneous leishmaniasis transmission has been increasing since the 1980s, with a significant increase in the incidence of cases and a spread of the geographical distribution. The disease currently represents a major public health problem with a productivity gap and an impediment for development, which results in dramatic socioeconomic and psycho-sanitary impacts. The incidence is more than thousands of cases every year in Algeria, Libya, Morocco, and Tunisia. In Egypt, only a few dozen cases per year are reported, mainly in the Sinai Peninsula. Three Leishmania species, associated with distinct eco-epidemiological and clinical patterns, are involved, namely Leishmania infantum, L. major, and L. tropica. However, L. major is by far the most frequent in Algeria, Libya, and Tunisia, with more than 90% of the registered cases. It is mainly encountered in rural areas under semi-arid, arid and Saharan climates. Leishmania tropica is more prevalent in Morocco, reaching 30–40% of isolates in some districts. Much data is still missing concerning the risk factors of the infection and the lesion development, as well as vector and reservoir ecology and behavior. The knowledge of such parameters, following multidisciplinary and integrated approaches, is crucial for better management and control of the disease, that also faces a lack of resources and efficient control measures.

Epidemiology of Cutaneous Leishmaniasis in Tunisia

“…To date, ZCL represents the dominant Tunisian CL form in terms of burden of disease, and it is mainly distributed over the central and southern arid and semiarid regions of the country, where is responsible for seasonal epidemics and regional outbreaks [4].…”

“…In fact, such actions are demanding and expensive, and consequently are often partially and intermittently performed. As such, it was therefore not possible to reduce the temporal and spatial spread of the disease [4]. Thereby, the national strategy for Leishmaniasis prevention and control has mainly focused on passive case detection and free diagnosis and treatment rather than on the reservoir and sandfly control.…”

“…Disease prevention and control are difficult because of the complexity of CL epizoology, and the few options available for effective vector control [4]. Furthermore, ZCL dynamic is influenced by environmental, demographic and human behavioral factors.…”

In Vitro Investigation of Antibacterial and Antileishmanial Activities of Gum-Resin of Boswellia Serrata Using (0.5%) Dmso Solution as an Alternative Solvent for Extraction

“…[15] Leishmania tropica is a species of flagellate parasites that infects humans and cause cutaneous leishmaniasis. [16] Leishmania donovani is a species of intracellular parasites belonging to the genus Leishmania, a group of haemoflagellate that cause visceral leishmaniasis or kalazar. [17] The objectives of this study is to investigate the in vitro Boswellia serrata aqueous crude extract antimicrobial effect against Staphylococcus aureus and Escherischia coli bacteria and antileishmanial activity against promastigotes of Leishmania tropica and Leishmania donovani using(0.05%) DMSO aqueous solution.…”

Clinicopathological presentation of cutaneous leishmaniasis and its diagnostic algorithm

“…The promastigotes are ingested by tissue macrophages where they transform and proliferate as amastigotes. The disease is variably distributed throughout the world and is termed as Old World and New World cutaneous leishmaniasis ( Figure 1) [1][2][3][4].…”