Retrospective Analysis of Leishmaniasis in Sicily (Italy) from 2013 to 2021: One-Health Impact and Future Control Strategies

Abstract

Leishmaniasis is an important vector-borne disease that represents a serious public health problem, including in Sicily (Italy), which is considered an endemic area. We collected canine, feline and human data from 2013 to 2021 in Sicily, while entomological surveys were conducted only in 2013 and 2021. Overall, 23,794/74,349 (34.4%) of dogs and 274/4774 (11.8%) of cats were positive in one or more diagnostic tests. A total of 467 cases of human Leishmaniasis were reported, with 71% showing cutaneous and 29% visceral involvement. The provinces with the largest number of patients were Agrigento (45.4%) and Palermo (37%). In 2013, Phlebotomus perfiliewi was the dominant sandfly species in Sicily (68.7%), followed by Phlebotomus perniciosus (17.2%) and Sergentomya minuta (14%). In 2021, Phlebotomus perfiliewi was confirmed as the most common species (61.6%), followed by Phlebotomus perniciosus (33.1%) and Sergentomya minuta (4.7%). Of particular interest was the identification of Phlebotomus papatasi (0.41%) in Agrigento. Our retrospective study can inform health authorities for the development of appropriate screening, treatment and control strategies to reduce Leishmania incidence rate. This study examined the present state of Leishmaniasis control, surveillance, and prevention in Sicily, but also highlighted deficiencies that could be addressed through the application of One-Health principles.

FeliLeish: An Update on Feline Leishmaniosis and Factors Associated with Infection in Different Feline Populations from Italy

“…Our study confirmed the highest prevalence of FeL in the Sicily region in southern Italy, as reported by recent published studies [9,45,52]. This region has the highest endemicity for animal leishmaniosis and highest incidence of human infection among the Italian regions [5,45].…”

“…Our study confirmed the highest prevalence of FeL in the Sicily region in southern Italy, as reported by recent published studies [9,45,52]. This region has the highest endemicity for animal leishmaniosis and highest incidence of human infection among the Italian regions [5,45]. Originating from the Sicily region was a risk factor for seropositivity for antibodies against L. infantum, but not for qPCR positivity.…”

“…In the last 20 years, sand fly vectors as well as human and canine Leishmania infections have been detected in northern Italy, traditionally classified as a cold area unsuitable for sand fly survival [42,43]. Today, human and animal leishmaniosis is endemic throughout the Italian peninsula, showing an increasing gradient from north to south and showing the highest incidence in Sicily [44,45]. Bruno et al [45] used a One Health approach, integrating human and animal data, to assess and map the risk of endemic transmission of Leishmania in Sicily, and found positive associations between human cases, infected reservoir hosts and vector spatial distribution.…”

High-resolution melting (HRM)-based detection of polymorphisms in the malic enzyme and glucose-6-phosphate isomerase genes for Leishmania infantum genotyping

“…Regarding samples from Pantelleria Island, it should be noted that this island is characterized by ideal conditions to study leishmaniasis in a defined population of animals and in a circumscribed and central territory of the Mediterranean basin. Previous studies reported a Leishmaniasis prevalence of 27% in the dog population of the island, which is in line with the average prevalence in the Sicily region, indicative of an active circulation of the parasite in the island [ 12 , 42 ]. In this area, only 23.5% of canine clinical isolates/samples were associated with the G1 genotype while 70.6% were identified as the G6 genotype (390T/1831A).…”

Neglected Tropical Diseases in Italy: introducing IN-NTD, the Italian network for NTDs

“…The study by Moirano et al showed, during an 8-year period (2009–2016), 1126 cases of VL with a crude incidence rate (IR) of 2.43 cases per 10 6 person-years with 2 age peaks: the first in the age groups of 0–4 years (IR 7.63 cases) and the second in the age group of 65–74 years (IR: 2.79 cases) (Moirano et al ., 2022 ). The highest IR (16 cases per 10 6 person-years) was reported in the Agrigento province of Sicily; these data agree with a retrospective study of leishmaniasis conducted in Sicily from 2013 to 2021 that showed that the largest number of cases of human and canine leishmaniasis were from Agrigento (45.4 and 41.5%, respectively) (Bruno et al ., 2022 ; Moirano et al ., 2022 ). The changing epidemiologic landscape for leishmaniasis in Italy with the recognition of new endemic foci is further confirmed by the upsurge (observed since 2012) in VL and CL cases diagnosed in the Emilia-Romagna region (Varani et al ., 2013 ; Gaspari et al ., 2022 ).…”