Chagas disease in Spain.

El notable incremento de la inmigración de procedencia Latinoamericana habido en España durante el último lustro, con especial impacto en la población de procedencia boliviana, ha convertido a la enfermedad de Chagas, o tripanosomiasis americana, en un problema de Salud Pública en nuestro país. En el momento actual residen en España casi dos millones y medio de personas oriundas de países endémicos para esta enfermedad que, en ausencia del insecto vector, puede transmitirse por transfusión de sangre, transplantes de tejidos o por vía vertical. En el trabajo se revisa la situación epidemiológica y del conocimiento de esta parasitosis actuales en EspañaThe notable increase in immigration from Latin-American countries to Spain during the last five years, particularly people from Bolivia, has converted Chagas disease or American trypanosomiasis, into a public health problem in Spain. The number of people from countries in which Chagas disease is endemic now living in Spain is estimated to be near two and half million. In the absence of vector species responsible for transmission, the disease may be transmitted by blood transfusion and tissue transplants as well as by vertical transmission. This work reviews the current knowledge and epidemiological situation of this parasitosis in Spain

Is leishmaniosis spreading to northern areas of the Iberian Peninsula? The examples of Lleida (NE Spain) and Andorra

Podeu consultar el llibre complet a: http://hdl.handle.net/2445/46988The entomological and canine leishmaniosis surveys carried out in the northwest of Catalonia and in Andorra in the context of the European project Emerging Diseases in a changing European eNvironment (EDEN) are summarized. The aim of the study was to obtain data on the presence of leishmaniosis in these areas and the spatial distribution of their vectors

Agressivité du Simulium du complexe ornatum (Diptera, Simuliidae) en Catalogne (Espagne). Premiere mention

A l'heure actuelle, en Espagne, même si des Simulies sont incriminées chez l'homme, dans des lésions dues à des insectes hématophages, le lien direct entre ces piqûres et une espèce donnee de Simulie n'avait pas encore été éetabli pour ce pays. Une invasion récente (1993) de ces insectes dans la région de l'Alt Penedès, au nord-est de la province de Tarragone, permet aujourd'hui de combler cette lacune

Is leishmaniasis endemic on the island of Minorca (Spain)?. A human visceral case after living 13 years in Minorca

Ecoepidemiologica studies performed in Minorca (Balearic Islands) seem to show that leishmaniasis is not endemic in this island, even in the presence of the vector. All cases of leishmaniasis in man or dog diagnosed in the island seem to come from other Spanish regions. A recent case of human visceral leishmaniasis in a man who had not left Minorca for 13 years calls into question this assumption or the time that Leishmania may persist asymptomatic in the host

First cases of gynandromorphism in Phlebotomus perniciosus Newstead, 1911 (Diptera, Psychodidae, Phlebotominae)

Two gynandromorphic specimens of Phlebotomus perniciosus Newstead, 1911 are described and illustrated for the first time The specimens were collected in the Northeast of the Iberian Peninsula (Spain)

Application of microsatellite genotyping to the study of a restricted Leishmania infantum focus: different genotype compositions in isolates from dogs and sand flies

Leishmania infantum polymorphism was studied by DNA microsatellite analysis of 110 L. infantum stocks (94 from dogs, 15 from sand flies, and 1 from a human visceral case) from a rural leishmaniasis-endemic area (Priorat) in northeastern Spain. Three microsatellites of the eight present in three fragments (internal transcribed spacer, Lm4, and Lm2) of L. infantum nuclear DNA are polymorphic inside the focus, resulting in 17 genotypes. Isolates from dogs and sand flies had different allelic compositions and shared only four genotypes. Microsatellite analysis is useful for L. infantum genotyping and epidemiologic tracking. Its application with strains from dogs and vectors in an area endemic for leishmaniasis shows the heterogeneous distribution of L. infantum in hosts living in sympatric conditions

Factors influencing the presence of sand flies in Majorca (Balearic Islands, Spain) with special reference to Phlebotomus pernicious, vector of Leishmania infantum

Background: Although the Mediterranean island of Majorca is an endemic area of leishmaniosis, there is a lack of up-to-date data on its sand fly fauna, the last report dating from 1989. The aim of the present study was to provide information on the current sand fly distribution, the potential environmental factors favoring the presence of Phlebotomus perniciosus and which areas are at risk of leishmaniosis. Methods: In July 2008 sand fly captures were carried out in Majorca with sticky castor oil interception traps. The capture stations were distributed in 77 grids (5x5 km2) covering the entire island. A total of 1,882 sticky traps were set among 111 stations. The characteristics of the stations were recorded and maps were designed using ArcGIS 9.2 software. The statistical analysis was carried out using a bivariate and multivariate logistic regression model. Results: The sand fly fauna of Majorca is composed of 4 species: Phlebotomus perniciosus, P sergenti, P. papatasi and Sergentomyia minuta. P. perniciosus, responsible for Leishmania infantum transmission, was captured throughout the island (frequency 69.4 %), from 6 to 772 m above sea level. Through logistic regression we estimated the probability of P. perniciosus presence at each sampling site as a function of environmental and meteorological factors. Although in the initial univariate analyses the probability of P. perniciosus presence appeared to be associated with a wide variety of factors, in the multivariate logistic regression model only altitude, settlement, aspect, drainage hole construction, adjacent flora and the proximity of a sheep farm were retained as positive predictors of the distribution of this species. Conclusions: P. perniciosus was present throughout the island, and thereby the risk of leishmaniosis transmission. The probability of finding P. perniciosus was higher at altitudes ranging from 51 to 150 m.a.s.l., with adjacent garrigue shrub vegetation, at the edge of or between settlements, and in proximity to a sheep farm

Importance of individual analysis of environmental and climatic factors affecting the density of Leishmania vectors living in the same geographical area: the example of Phlebotomus ariasi and P. perniciosus in northeast Spain.

The aim of the present study was to determine the role of specific environmental and climatic factors affecting the distribution and density of Phlebotomus ariasi and P. perniciosus, the proven vectors for Leishmania infantum in Spain. An entomological study was carried out in July 2006 in the province of Lleida with sticky traps set in their diurnal resting places at altitudes ranging from 86 to 1,755 m above the mean sea level (339 sites were sampled). Bivariate analysis revealed that factors such as altitude, bioclimatic zone, temperature, precipitation, sampling site (site relative to settlement, site situation, site category), wall vegetation, particular environment (in this case a natural park), general environment, adjacent natural vegetation and land cover were significantly associated with sand fly densities. The multivariate model for P. perniciosus revealed that its density was affected by site and land cover. Specifically, paved driveways correlated negatively with vector density (Incidence Risk Ratio (IRR): 0.41) and arable land cover correlated positively (IRR: 4.59). In the case of P. ariasi, a significant correlation was observed with the altitude and bioclimatic zone, with density increasing at >800 m above the mean sea level (IRR: 3.40) and decreasing in the meso-Mediterranean bioclimatic zone (IRR: 0.08). Both species were mostly found in agricultural and forest areas far from domestic environments. However, the two species correlated differently with altitude, bio-climate, vegetation, temperature and precipitation, which emphasises the importance of their individual analysis in studies regarding risk of leishmaniasis transmission

Leishmania infantum DNA detection in urine from patients with visceral leishmaniasis and after treatment control.

A urine-polymerase chain reaction (PCR) assay was validated for diagnosis of human visceral leishmaniosis (VL), taking advantage of the accessibility of urine samples. Leishmania infantum DNA presence was examined in 17 urine samples from 17 patients with VL during a clinical episode and in 55 urine samples from 17 patients with VL monitored after treatment at different intervals. Fifty-nine urine samples from 59 controls with no history of VL were also studied. The urine-PCR test was positive in 15/17 samples obtained during the episode (sensitivity, 88%). None of the controls tested were urine-PCR positive (specificity, 100%). During the monitoring period, 25% of the samples gave a positive urine-PCR. Results were compared with other diagnostic methods, such as urine antigen detection and peripheral blood-PCR and culture, with good concordance during the clinical episode and differences in the follow-up period. This study suggests that urine-PCR is sensitive for diagnosis and may be useful to monitor treatment efficac

Value of culture and nested polymerase chain raction of blood in the prediction of relapses in patients co-infected with Leishmania and human immunodeficiency virus

The use of culture and a nested polymerase chain reaction (PCR) of blood in predicting the probability of relapse was evaluated in 20 patients co-infected with Leishmania and human immunodeficiency virus (HIV). Fourteen of 20 patients relapsed, with 24 clinical relapses diagnosed. During clinical relapse, the parasite was detected by culture in 21 of 24 blood samples and by nested PCR in 23 of 24 blood samples. After treatment and during asymptomatic periods, the parasite was detected by culture in 18 (19.1%) of 94 blood samples and by nested PCR in 58 (61.7%) of 94 blood samples. For positive blood cultures, the Kaplan-Meier probability estimates for relapse at 6, 12, 18, and 24 months were 44%, 68%, 76%, and 76%, respectively, while for positive nested PCRs, the estimates were 20%, 33%, 45%, and 50%, respectively. For negative blood cultures, relapse probabilities for the same time points were 7%, 12%, 12%, and 12%, while for negative nested PCRs, these probabilities were 8%, 14%, 21%, and 26%. Nested PCR-positive results in asymptomatic periods indicated presence of the parasite, but not necessarily relapse. However, the presence of viable parasites during post-treatment follow-up increased the probability of relapse and showed that culture positivity could be a good relapse marker