Zoonotic cutaneous leishmaniasis in central Tunisia: spatio temporal dynamics

Abstract

ZCL rates vary across space and time; rural/urban areas and environmental factors may explain part of this variation. In the study region, the Sidi Saâd dam-constructed in the early eighties and identified by previous studies as a major reason for the first outbreak of the disease-seems to be still related to increased ZCL rates. The most likely spatial cluster of high incidence rates contains regions located close to the dam. Our findings of increased incidences in urban areas support the hypothesis of increased incidences in peri-urban environments due to changes in sandfly/rodent living habits over recent years.

Post-earthquake outbreak of cutaneous leishmaniasis in a rural region of southern Iran

“…Another cause of ZCL epidemics is the ecological changes that follow certain types of weather. Periods of rain, for example, may allow the populations of rodent 'reservoir' hosts and sandfly vectors to flourish and expand, increasing transmission of L. major to humans (Ben Salah et al, 2007). A third potential cause of a CL outbreak is the introduction, by infected humans, of leishmanial parasites into a new area where potential vectors (and, in the case of L. major, potential reservoir hosts) are already abundant (Gramiccia and Gradoni, 2005).…”

Epidemiology of Cutaneous Leishmaniasis in Tunisia

“…Between 1998 and 2007, the total number of CL cases reported to health authorities during this period was 57,591. The global yearly incidence of CL is almost 20-30 per 100,000 persons [5].…”

“…In the other hand, M. shawi is the reservoir host of L. major in some parts of Tunisia [5,24]. This rodent has a particular ability to tolerate long period of water deprivation that allow survival in clay and sandy deserts, arid steppes and mountain valleys.…”

“…Prediction of such outbreaks depends on the availability of ecological information and one valuation of development areas before implementation of projects or population movements. Noticeable increase in the number of CL cases has been observed when susceptible population migrate to formerly unsettled areas located near L. major reservoir host biotopes [5].…”

“…Despite this significant effort, and the analysis of transmission dynamics of the disease in other regions, control strategies remain unsatisfactory, as indicated by the number of annual cases [5]. In fact, such actions are demanding and expensive, and consequently are often partially and intermittently performed.…”