Cutaneous leishmaniasis in northwestern Saudi Arabia: identification of sand fly fauna and parasites

Abstract

BackgroundCutaneous leishmaniasis (CL) is a vector-borne disease transmitted by the bite of an infected sand fly. This disease is highly prevalent in Saudi Arabia where Leishmania major and L. tropica are the etiological agents. In the region of Hail, northwestern of Saudi Arabia, the incidence is about 183 cases/year. However, the epidemiology of the disease in this area is not well understood. Thus, an epidemiological survey was conducted in 2015–2016 to identify the circulating parasite and the sand fly fauna in the region of Hail. Skin lesion scrapings were collected from suspected patients with CL.MethodsThe diagnosis was made by microscopic examination of Giemsa-stained smear and PCR. The parasite was identified by PCR and sequencing of the single copy putative translation initiation factor alpha subunit gene. Sand fly specimens were collected and identified morphologically. Total DNA was extracted from the abdomen of female specimens and Leishmania DNA was detected by PCR.ResultsAmong the 57 examined patients, 37 were positive for CL. The identification of the parasite has revealed the single species Leishmania major. The 384 sand flies were collected belonged to two genera (Phlebotomus and Sergentomyia), six sub-genera and six species. Phlebotomus papatasi, Ph. kazeruni and Sergentomyia clydei were the dominant species. Leishmania DNA was detected in two females of Ph. papatasi two of Ph. kazeruni and one specimen of Sergentomyia clydei.Conclusions Leishmania major is confirmed to be the etiological agent of cutaneous leishmaniasis in northwestern Saudi Arabia. The molecular detection of Leishmania DNA in Ph. papatasi and Ph. kazeruni supports the potential role of these two species in the transmission of Leishmania. Further epidemiological studies are needed to prove their role and to evaluate the burden of CL in the study region.

The Geographical Distribution of Cutaneous Leishmaniasis Causative Agents in Iran and Its Neighboring Countries, A Review

“…Saudi Arabia is another important focus of CL (89), with most cases occurring in southwest, central, and eastern parts of the country. L. tropica is mainly endemic in Aseer province in the southwest (90) while L. major is reported from Hail, Al-Hasa, Eastern, and the Riyadh provinces (91,92).…”

Molecular characterization of Leishmania species from stray dogs and patients in Saudi Arabia

“…However, L. tropica infection has been herein molecularly diagnosed for the rst time in humans and dogs in the central part of the Saudi Arabia since it was previously reported in the west and southern west of Saudi Arabia in association with the distribution of the sand y species (i.e., distribution of Phlebotomus sergenti), which is a proper vector for that species [27]. Conversely, L. major is more prevalent throughout the country and can be found in the open deserts regions of Saudi Arabia [2,28]. Previous studies in Saudi Arabia have reported the natural infection of L. major in dogs using enzymatic biochemical methods [29,30], though no clinical information was available, nor serology or molecular con rmation were performed.…”

“…Of the 25 species of Phlebotomus (P) reported in Saudi Arabia only ve (i.e., P. papatasi, P. sergenti, P. bergeroti, P. kazeruni, and P. arabicus) have been incriminated as vectors of CL [27,28,33,34]. Of these, P. papatasi is the major, and most predominant vector species for L. major [28,33], while P. sergenti is the natural vector species for L. tropica [27]. Presence of P. papatasi and P. sergenti in Al-Qaseem province suggests that they could have a potential role in the transmission of human and canine leishmaniasis.…”

Molecular characterization of Leishmania species from stray dogs and patients in Saudi Arabia

“…Of these, Ph. papatasi is the main and most predominant vector species for L. major [28,33], while Ph. sergenti is the natural vector species for L. tropica [27].…”