Risk factors for cutaneous leishmaniasis in Cukurova region, Turkey

a b s t r a c t We conducted a case-control study to evaluate risk factors for cutaneous leishmaniasis caused by Leishmania infantum outbreaks in villages in the Cukurova region, South Anatolia, Turkey. 282 respondents from eight villages were interviewed using structured questionnaires. Epidemiological and clinical characteristics, personal protection and knowledge of leishmania were analyzed. Young people, aged from 5-19 years, were found to be the most endangered group of villagers. The concurrent presence of both lesions and scars in nine persons may indicate repeated infections. Sleeping without bed nets, ownership of a dog and cattle ownership (living close to a barn and storage of dried dung according univariate analyses) were associated with a significantly increased risk of leishmania infection. Non-impregnated bed nets provided only partial protection, but their use decreased the risk approximately 1.6 times. Further research on the role of dogs in the transmission cycle and the effect of suitable interventions are needed to design the best strategy for disease control. Results suggest that personal protection should be increased, particularly among outdoor sleepers, with insecticide-treated bed nets suggested as the best choice

Revision of the species composition and distribution of Turkish sand flies using DNA barcodes

WOS: 000483025000002PubMed ID: 31439012Background Currently, knowledge regarding the phlebotomine sand fly (Diptera: Psychodidae) fauna of Turkey is restricted to regions with endemic leishmaniasis. However, rapidly changing environmental and social conditions highlight concerns on the possible future expansion of sand fly-borne diseases in Turkey, promoting risk assessment through biosurveillance activities in non-endemic regions. Traditional morphological approaches are complicated by extensive cryptic speciation in sand flies, thus integrated studies utilizing DNA markers are becoming increasingly important for correct sand fly identification. This study contributes to the knowledge of the sand fly fauna in understudied regions of Turkey, and provides an extensive DNA barcode reference library of expertly identified Turkish sand fly species for the first time. Methods Fly sampling was conducted at 101 locations from 29 provinces, covering all three biogeographical regions of Turkey. Specimens were morphologically identified using available keys. Cytochrome c oxidase I (cox1) barcode sequences were analyzed both for morphologically distinct species and those specimens with cryptic identity. A taxon identity tree was obtained using Neighbor Joining (NJ) analysis. Species boundaries among closely related taxa evaluated using ABGD, Maximum Likelihood (ML) and haplotype network analyses. Sand fly richness of all three biogeographical regions were compared using nonparametric species richness estimators. Results A total of 729 barcode sequences (including representatives of all previously reported subgenera) were obtained from a total of 9642 sand fly specimens collected in Turkey. Specimens belonging to the same species or species complex clustered together in the NJ tree, regardless of their geographical origin. The species delimitation methods revealed the existence of 33 MOTUs, increasing the previously reported 28 recorded sand fly species by 17.8%. The richest sand fly diversity was determined in Anatolia, followed by the Mediterranean, and then the Black Sea regions of the country. Conclusions A comprehensive cox1 reference library is provided for the sand fly species of Turkey, including the proposed novel taxa discovered herein. Our results have epidemiological significance exposing extensive distributions of proven and suspected sand fly vectors in Turkey, including those areas currently regarded as non-endemic for sand fly-borne disease.Scientific and Technological Research Council of TurkeyTurkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [SBAG: 114S999]; Armed Forces Health Surveillance Board, Global Emerging Infections Surveillance and Response System (AFHSBGEIS), USA; US ArmyUnited States Department of Defense [W911QY-16-C-0160, P0034_18_WR]; Hacettepe University Scientific Research UnitHacettepe University [01001601001]This study was funded by The Scientific and Technological Research Council of Turkey (SBAG: 114S999) and the Armed Forces Health Surveillance Board, Global Emerging Infections Surveillance and Response System (AFHSBGEIS), USA; FY18 Award P0034_18_WR (PI: Y-ML) under US Army subcontract W911QY-16-C-0160 to Hacettepe University). The research was supported by Hacettepe University Scientific Research Unit (01001601001). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The material to be published reflects the views of the authors and should not be construed to represent those of the US Department of the Army or the US Department of Defense

Effects of environmental factors and storage conditions on the performance of Olyset(A (R)) Plus against sand flies in WHO cone bioassays

WOS: 000374573000008PubMed ID: 27076511Leishmaniasis, visceral and cutaneous, is seen in Turkey and has both public and veterinary importance. So far, four Leishmania species and their vectors have been detected in Turkey. Vector control is essential in endemic areas and several personal protection methods are available including long-lasting insecticidal nets (LLINs). In this study, we aimed to measure the effects of usage and storage conditions on LLINs in a village-scale study. Olyset(A (R)) Plus bed nets were set up in different climatic conditions (rain, exposed to sunlight and humidity) and collected after 6 months. The effectiveness of bed nets were tested by WHO's cone test method using wild-caught sand flies. Bed nets, which were placed directly exposed to sunlight (A1, A2) showed lower (17.2%) knock down effect compared to bed nets placed indoors (A3, B1). Twenty-four hour mortality was 100% for the five study groups (A2, A3, B1, C1, C2) whereas group A1 was found to have a lower mortality rate (44.4%). Bed nets need to avoid direct exposure to sunlight. When used and stored in appropriate conditions (cool, well-ventilated place away from sunlight) they can be used as an effective vector control tool in endemic areas.EUEuropean Union (EU) [FP7-261504 EDENext]; Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [112T270]This work was supported by the EU [grant number FP7-261504 EDENext] and is catalogued by the EDENext Steering Committee as EDENext440 (http://www.edenext.eu). This study is partially supported by The Scientific and Technological Research Council of Turkey (TUBITAK) Project No: 112T270

The Maximum likelihood phylogenetic analysis of the phlebovirus nucleocapsid protein sequences.

<p>The Genbank accession numbers of all the phleboviruses included in the analysis can be found in <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0004519#pntd.0004519.s002" target="_blank">S2 Table</a>.</p

Assessment of diagnostic doses for widely used synthetic pyrethroids (Deltamethrin & Permethrin) in an endemic focus of leishmaniasis in Turkey

WOS: 000384846700007PubMed ID: 27688146Background: Leishmania is a group of parasitic flagellated protozoons, which are transmitted by female sand flies and produces health problems in humans and also in wild and domestic animals. So far, 25 Phlebotomus and 4 Sergentomyia species were recorded in Turkey including proven or possible vectors of Leishmania spp. As no single insecticide susceptibility test was conducted targeting the sand flies in Turkey, we aimed to determine the diagnostic dose against two commonly used synthetic pyrethroids (deltamethrin and permethrin) in a hyperendemic area for leishmaniasis. Methods: Sand flies were collected from villages of Adana in 2-4 September 2013 using Centers for Disease Control and Prevention (CDC) light traps and transferred to the laboratory. The World Health Organisation tube test method was conducted using self-prepared filter papers with different concentrations. In order to determine the diagnostic dose, lethal doses (LD) were calculated by EPA Probit Analysis. Sand flies used in the experiments were dissected, mounted and identified. Results: For the lowest (0.025 %) and highest dose of permethrin (0.5 %), the mortality rate was recorded as 52.6 % and 100 % by the end of 24-h period and the diagnostic dose was recorded as 0.36 %. The mortality rate for lowest (0.0025 %) and highest (0.05 %) doses of deltamethrin was recorded as 54.8 % and 100 %. The diagnostic dose of deltamethrin was determined as 0.9 %. Conclusion: An insecticide susceptibility study was conducted in Turkey for the first time and effective doses were determined by calculating the LDs. According to presented results, the wild population of sand flies collected from a hyper-endemic region of Adana Province is still susceptible to deltamethrin and permethrin.Armed Forces Health Surveillance Center, Global Emerging Infections Surveillance and Response System (AFHSC-GEIS), United States; National Research Council (NRC); EUEuropean Union (EU) [FP7-261504 EDENext]This study was partially supported by The Armed Forces Health Surveillance Center, Global Emerging Infections Surveillance and Response System (AFHSC-GEIS), United States (with Yvonne Marie-Linton as the principal investigator). This manuscript was prepared whilst YML held a National Research Council (NRC) Research Associateship Award at the Walter Reed Army Institute of Research. This research was performed in part under a Memorandum of Understanding between the Walter Reed Army Institute of Research and the Smithsonian Institution, with institutional support provided by both organizations. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The material to be published reflects the views of the authors and should not be construed to represent those of the US Department of the Army or the US Department of Defense.; This work was partially supported by EU grant FP7-261504 EDENext and is catalogued by the EDENext Steering Committee as EDENext451 (http://www.ede-next.eu). The contents of this publication are the sole responsibility of the authors and do not necessarily reflect the views of the European Commission