Occurrence of Leishmania infantum cutaneous leishmaniasis in central Tunisia

Abstract

Cutaneous leishmaniasis (CL) due to Leishmania infantum occurs sporadically in Tunisia where its distribution is confined to the northern parts of the country. However, during the past decade there have been occasional repeated reports of cases from areas in central Tunisia, known to be free of CL. Epidemiological, clinical and parasitological data regarding these patients were collected and analysed. Data were very suggestive of the sporadic form of CL due to L. infantum. The parasites contained within the lesions of some of the patients were characterised by two different previously described PCR assays, each having different resolutive powers. The first assay, which amplified complete kDNA minicircles, showed a fragment size characteristic of the L. donovani complex; whilst the second consisted of a PCR-RFLP analysis targeting the gp63 coding sequences that confirmed assignment of the parasites to L. infantum species while illustrating its differences from the reference isolate. These findings confirm the aetiology of CL in the concerned areas in central Tunisia and suggest that L. infantum CL might be more prevalent and widespread than previously thought, or possibly emerging in these areas.

Cutaneous Leishmaniasis in the Nalut District, Libyan Arab Jamahiriya: A Clinico-epidemiologic Study andLeishmaniaSpecies Identification

“…4C). The mean age of those infected with L. tropica was significantly higher than of those with L. infantum (P , 0.01), known to mainly affect young children (BenSaid et al, 2006;Pace et al, 2011). In patients with L. tropica, 80 (50.0%) were 0-20 yr of age, 41 (25.6%) were 21-40 yr of age, 27 (16.9%) were 41-60 yr of age, and 12 (7.5%) were 61-80 yr of age (Table I).…”

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

“…Similar trends were described in SCL which, up to 1980, was very rarely reported south to the Tunisian ridge ("dorsale"). From the early 1980s, and up to date, SCL has continuously been reported from central and southern parts of the country (Aoun et al, 2000(Aoun et al, , 2008Ben Saïd et al, 2006;Kallel et al, 2005Kallel et al, , 2008a. ZCL was first reported on the end of the 19 th century causing large outbreaks in Gafsa and neighbouring areas.…”

Irrigation in the arid regions of Tunisia impacts the abundance and apparent density of sand fly vectors of Leishmania infantum

“…Likewise, canine visceral leishmaniasis (CVL), until 1988, was limited to the northern Tunisian Ridge but is now endemic in the governorate of Sidi Bouzid, located in the center of Tunisia (Diwani et al 2008, Keddous 1988). Evidence of the extension of HVL and SCL as well as CVL toward the center and the south of the country was shown based on earlier epidemiological studies (Ben Salah et al 2000, Ayadi et al 1991, Besbes et al 1994, Ben Said et al 2006, Diwani et al 2008). However, recent entomological surveys suggest that the extension of HVL, SCL, and CVL is due to geographical expansion of P. perniciosus and P. perfiliewi toward the center of Tunisia (Zhioua et al 2007).…”

“…However, from 1982 to 1991, more than 200 cases of HVL were reported from areas located in arid central and southern Tunisia (Ben Salah et al 2000, Ayadi et al 1991, Besbes et al 1994). Sporadic cutaneous leishmaniasis was previously limited to the northern Tunisia (Ben Rachid et al 1983) but in 2006 (Ben Said et al 2006) the spread of SCL towards central Tunisia was documented. Likewise, canine visceral leishmaniasis (CVL), until 1988, was limited to the northern Tunisian Ridge but is now endemic in the governorate of Sidi Bouzid, located in the center of Tunisia (Diwani et al 2008, Keddous 1988).…”