Spread of Leishmania killicki to central and south-west Tunisa

International audienceTwenty cutaneous leishmaniasis (CL) cases were notified from December 2001 to February 2002, in a small village in the district of Oueslatia (governorate of Kairouan, central Tunisia) which is an endemic focus of infantile visceral leishmaniasis due to Leishmania (L.) infantum and that hod never been concerned previously by CL. The parasite typing of two isolates obtained from two children that have never left the region has identified L. killicki. This species hod only been reported previously in a limited focus of Tunisian Southeast. In October 2002, an epidemiological survey with isoenzym characterization of the parasite led in a well-known focus of zoonotic cutaneous leishmaniasis of South-West Tunisia also revealed the presence of L. killicki. These results suggest the spread of this species and stress the need of further investigations for a better control of CL in Tunisia

First Molecular Epidemiological Study of Cutaneous Leishmaniasis in Libya

Cutaneous leishmaniasis (CL) is caused by protozoan parasites of the genus Leishmania. The disease is characterized by the formation of chronic skin lesions followed by permanent scars and deformation of the infected area. It is distributed in many tropical and subtropical countries with more than 2 million cases every year. During the past few years CL has emerged as a major public health problem in Libya. So far, diagnosis was based on clinical symptoms and microscopic observation of parasites. Disease outbreaks were not investigated and the causative leishmanial species of CL were not identified so far. Our study indicates the presence of two coexisting species: Leishmania major and Leishmania tropica. These results are crucial in order to provide accurate treatment, precise prognosis and appropriate public health control measures. The recent armed conflict in Libya that ended with the Gadhafi regime collapse on October 2011 has affected all aspects of the life in the country. In this study we discussed multiple risk factors that could be associated with this conflict and present major challenges that should be considered by local and national health authorities for evaluating the CL burden and highlighting priority actions for disease control

Culex pipiens, an Experimental Efficient Vector of West Nile and Rift Valley Fever Viruses in the Maghreb Region

West Nile fever (WNF) and Rift Valley fever (RVF) are emerging diseases causing epidemics outside their natural range of distribution. West Nile virus (WNV) circulates widely and harmlessly in the old world among birds as amplifying hosts, and horses and humans as accidental dead-end hosts. Rift Valley fever virus (RVFV) re-emerges periodically in Africa causing massive outbreaks. In the Maghreb, eco-climatic and entomologic conditions are favourable for WNV and RVFV emergence. Both viruses are transmitted by mosquitoes belonging to the Culex pipiens complex. We evaluated the ability of different populations of Cx. pipiens from North Africa to transmit WNV and the avirulent RVFV Clone 13 strain. Mosquitoes collected in Algeria, Morocco, and Tunisia during the summer 2010 were experimentally infected with WNV and RVFV Clone 13 strain at titers of 107.8 and 108.5 plaque forming units/mL, respectively. Disseminated infection and transmission rates were estimated 14–21 days following the exposure to the infectious blood-meal. We show that 14 days after exposure to WNV, all mosquito st developed a high disseminated infection and were able to excrete infectious saliva. However, only 69.2% of mosquito strains developed a disseminated infection with RVFV Clone 13 strain, and among them, 77.8% were able to deliver virus through saliva. Thus, Cx. pipiens from the Maghreb are efficient experimental vectors to transmit WNV and to a lesser extent, RVFV Clone 13 strain. The epidemiologic importance of our findings should be considered in the light of other parameters related to mosquito ecology and biology

Neglected Tropical Diseases of the Middle East and North Africa: Review of Their Prevalence, Distribution, and Opportunities for Control

The neglected tropical diseases (NTDs) are highly endemic but patchily distributed among the 20 countries and almost 400 million people of the Middle East and North Africa (MENA) region, and disproportionately affect an estimated 65 million people living on less than US$2 per day. Egypt has the largest number of people living in poverty of any MENA nation, while Yemen has the highest prevalence of people living in poverty. These two nations stand out for having suffered the highest rates of many NTDs, including the soil-transmitted nematode infections, filarial infections, schistosomiasis, fascioliasis, leprosy, and trachoma, although they should be recognized for recent measures aimed at NTD control. Leishmaniasis, especially cutaneous leishmaniasis, is endemic in Syria, Iran, Iraq, Libya, Morocco, and elsewhere in the region. Both zoonotic (Leishmania major) and anthroponotic (Leishmania tropica) forms are endemic in MENA in rural arid regions and urban regions, respectively. Other endemic zoonotic NTDs include cystic echinococcosis, fascioliasis, and brucellosis. Dengue is endemic in Saudi Arabia, where Rift Valley fever and Alkhurma hemorrhagic fever have also emerged. Great strides have been made towards elimination of several endemic NTDs, including lymphatic filariasis in Egypt and Yemen; schistosomiasis in Iran, Morocco, and Oman; and trachoma in Morocco, Algeria, Iran, Libya, Oman, Saudi Arabia, Tunisia, and the United Arab Emirates. A particularly noteworthy achievement is the long battle waged against schistosomiasis in Egypt, where prevalence has been brought down by regular praziquantel treatment. Conflict and human and animal migrations are key social determinants in preventing the control or elimination of NTDs in the MENA, while local political will, strengthened international and intersectoral cooperative efforts for surveillance, mass drug administration, and vaccination are essential for elimination

Spread of Leishmania killicki to Central and South-West Tunisia

Twenty cutaneous leishmaniasis (CL) cases were notified from December 2001 to February 2002, in a small village in the district of Oueslatia (governorate of Kairouan, central Tunisia) which is an endemic focus of infantile visceral leishmaniasis due to Leishmania (L.) infantum and that had never been concerned previously by CL. The parasite typing of two isolates obtained from two children that have never left the region has identified L. killicki. This species had only been reported previously in a limited focus of Tunisian Southeast. In October 2002, an epidemiological survey with isoenzym characterization of the parasite led in a well-known focus of zoonotic cutaneous leishmaniasis of South-West Tunisia also revealed the presence of L. killicki. These results suggest the spread of this species and stress the need of further investigations for a better control of CL in Tunisia

Profil particulier des zymodèmes de Leishmania infantum causant la leishmaniose viscérale en Tunisie

Archives des Bulletins de la Société de Pathologie Exotique - SPE (http://www.pathexo.fr/1845-bulletin.html?id_bull=94&id_volume=232&L=1)International audienceThe isoenzymatic typing of 16 stocks of Leishmania, isolated from Tunisian visceral leishmaniasis (VL) cases, revealed that all strains belonged to Leishmania (L.) infantum species. Although zymodeme MON-1 was predictably the most frequent (9 cases), it came as a surprise that L. infantum MON-24 was responsible of about third of cases. This latter zymodeme, while previously reported in Tunisia, Algeria and Spain, was assumed to be a dermotropic and the few cases of VL that it caused occurred always in HIV infected patients. L. infantum MON-80, occasionally reported during both cutaneous and VL of immunocompetent infants was identified in 2 patients. This report confirms that in addition to the more common L. infantum MON-1, zymodeme MON-24 has a substantial role in generating VL in immunocompetent infants in Tunisia.Le typage iso-enzymatique de 16 souches de leishmanies isolées chez des enfants tunisiens atteints de leishmaniose viscérale (LV) a révélé qu'en plus du classique Leishmania (L.) infantum MON-1, identifié chez 9 patients, le zymodème L. infantum MON-24 a été trouvé dans 5 cas. Bien que ce zymodème ait déjà été incriminé dans la genèse de quelques cas de LV infantile en Algérie, en Tunisie et en Espagne, une proportion aussi élevée, 31,2%, était inattendue. En effet, L. infantum MON-24 a été jusque-là considéré comme plutôt dermotrope et les quelques cas de LV qui lui sont rapportés sont survenus le plus souvent chez des individus immunodéprimés infectés par le VIH.Par ailleurs, L. infantum MON-80, déjà signalé au cours de formes aussi bien cutanées que viscérales, a été identifié chez 2 patients

First field evidence infection of Culex perexiguus by West Nile virus in Sahara Oasis of Algeria

Background & objectives: West Nile virus (WNV) is considered one of the most widely distributed arboviruses in the world which is transmitted by several mosquito species including the Culex genus. Culex pipiens is the major vector of this virus in Europe and USA whereas in African countries, other species such as Cx. perexiguus is considered as an important vector. This paper aimed to study the mosquito species involved in WNV transmission in Aougrout, one of the highly populated Oasis of Timimoun Province in Algeria where human WNV neuroinvasive diseases are prevalent. Methods: CDC light-traps were installed in animal and human shelters for three nights. Collected mosquitoes were pooled and real-time PCR was performed to detect and identify WNV lineages 1 and 2 in the samples. Results: CDC light-traps collected 270 mosquitoes belonging to three genera. Culex genus was predominant with Cx. perexiguus as main species followed by Aedes and Anopheles genus. A total of 33 pools were tested; one pool containing Cx. perexiguus was found positive for WNV lineage 1. Interpretation & conclusion: This study reports for the first time a WNV natural infection of Culex perexiguus in the study region indicating that species other than Cx. pipiens should be taken into consideration in WNV surveillance, especially in specific environments like Saharan Oasis ecosystem