Cutaneous parasitism in patients with American visceral leishmaniasis in an endemic area

Moura, Carla Riama Lopes de Pádua; Costa, Carlos Henrique Nery; Moura, Rafael de Deus; Braga, Aline Reis Ferro; Silva, Vladimir Costa; Costa, Dorcas Lamounier

doi:10.1590/0037-8682-0446-2019

Cited by 3 publications

(3 citation statements)

References 18 publications

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“…Patched presence of parasites in the skin of experimentally infected mice determines that the skin is not a homogenous system, opening PLOS NEGLECTED TROPICAL DISEASES a new dimension of the problem [21]. In addition, the proportion of VL patients harboring parasites in healthy skin is relatively low as recently published [23]. In this paper none of the 22 patients with VL (7 of them being HIV-coinfected) showed parasites through histopathology or immunochemistry, excluding one among the 7 coinfected.…”

Section: Discussionmentioning

confidence: 62%

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Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context

Molina¹,

Jiménez²,

García‐Martínez³

et al. 2020

PLoS Negl Trop Dis

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Background In the Mediterranean basin, Leishmania infantum is the causative agent of visceral leishmaniasis (VL), a zoonosis in which the dog is the primary domestic reservoir, although wildlife may have a leading role in the sylvatic cycle of the disease in some areas. Infections without disease are very frequent. There is limited information regarding the role that VL patients and asymptomatic infected individuals could be playing in the transmission of L. infantum. Xenodiagnosis of leishmaniasis has been used in this descriptive study to explore the role of symptomatic and asymptomatic infected individuals as reservoirs in a recent focus of leishmaniasis in southwestern Madrid, Spain. Methodology and main findings Asymptomatic blood donors (n = 24), immunocompetent patients who were untreated (n = 12) or treated (n = 11) for visceral leishmaniasis (VL), and immunocompromised patients with VL (n = 3) were enrolled in the study. Their infectivity to Phlebotomus perniciosus was studied by indirect xenodiagnosis on peripheral blood samples. Quantitative polymerase chain reaction of blood samples from immunocompetent patients untreated for VL and immunocompromised untreated, treated and under secondary prophylaxis for VL was performed. Antibodies against Leishmania were studied by indirect fluorescent antibody and rK39-immunochromatographic tests. A lymphoproliferative assay with a soluble Leishmania antigen was used to screen for leishmaniasis infection in the healthy population. Sixty-two xenodiagnostic tests were carried out and 5,080 sand flies were dissected. Positive xenodiagnosis was recorded in four patients, with different sand fly infection rates: 1 immunosuppressed HIV / L. infantum coinfected asymptomatic patient, 1 immunosuppressed patient PLOS NEGLECTED TROPICAL DISEASES

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Section: Discussionmentioning

confidence: 62%

“…A total of 899 female sand flies were dissected. The rK39-ICT performed the same day that the IXDs were carried out was positive in 9 out of 11 (81.8%) patients (13,(15)(16)(17)(18)(19)(20)(21)23).…”

Section: Patients Treated For Vlmentioning

confidence: 91%

Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context

Molina¹,

Jiménez²,

García‐Martínez³

et al. 2020

PLoS Negl Trop Dis

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“…longipalpis [40]. A study of VL patients coinfected with L. infantum/HIV found significant cutaneous parasitism in non-lesional skin of one patient, but none of the other patients had detectable skin parasites by immunohistochemistry [41]. Immunosuppressed individuals may develop significantly high parasite levels in peripheral blood, allowing this tissue to serve as an important viable parasite source for vector transmission.…”

Section: Discussionmentioning

confidence: 99%

Leishmania infantum xenodiagnosis from vertically infected dogs reveals significant skin tropism

et al. 2021

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Background Dogs are the primary reservoir for human visceral leishmaniasis due to Leishmania infantum. Phlebotomine sand flies maintain zoonotic transmission of parasites between dogs and humans. A subset of dogs is infected transplacentally during gestation, but at what stage of the clinical spectrum vertically infected dogs contribute to the infected sand fly pool is unknown. Methodology/Principal findings We examined infectiousness of dogs vertically infected with L. infantum from multiple clinical states to the vector Lutzomyia longipalpis using xenodiagnosis and found that vertically infected dogs were infectious to sand flies at differing rates. Dogs with mild to moderate disease showed significantly higher transmission to the vector than dogs with subclinical or severe disease. We documented a substantial parasite burden in the skin of vertically infected dogs by RT-qPCR, despite these dogs not having received intradermal parasites via sand flies. There was a highly significant correlation between skin parasite burden at the feeding site and sand fly parasite uptake. This suggests dogs with high skin parasite burden contribute the most to the infected sand fly pool. Although skin parasite load and parasitemia correlated with one another, the average parasite number detected in skin was significantly higher compared to blood in matched subjects. Thus, dermal resident parasites were infectious to sand flies from dogs without detectable parasitemia. Conclusions/Significance Together, our data implicate skin parasite burden and earlier clinical status as stronger indicators of outward transmission potential than blood parasite burden. Our studies of a population of dogs without vector transmission highlights the need to consider canine vertical transmission in surveillance and prevention strategies.

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Overview on Epidemiology of Leishmaniasis in Iraq

Al-Hayali¹,

alkattan²

2021

RJS

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Leishmaniasis continues to be a significant public health issue and socioeconomic obstacle in Iraq. The various species of leishmania are transmitted by the bite of sandflies belonging to genus phlebtomus, where high temperatures might prolong the breeding season for this fly species. The current review proved that the infection in the southern regions of Iraq is more than in the northern regions. The incidence of leishmaniasis has increased and expanded to most Iraqi governorates, the reason may be due to the population growth, urbanization, pronounced poverty and lack of public health awareness. Furthermore, leishmaniasis is a zoonotic disease with a rodent, cats and dog's reservoir that poses a problem to human health. Leishmaniasis has spread in Iraq from the 1950s until now, additionally, wars forced migration of Iraqi people from their province to other places. All these have encouraged an increase in the infected rate with leishmaniasis in areas previously uninfected.

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Cutaneous parasitism in patients with American visceral leishmaniasis in an endemic area

Cited by 3 publications

References 18 publications

Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context

Role of asymptomatic and symptomatic humans as reservoirs of visceral leishmaniasis in a Mediterranean context

Leishmania infantum xenodiagnosis from vertically infected dogs reveals significant skin tropism

Overview on Epidemiology of Leishmaniasis in Iraq

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