scholarly journals Leishmaniasis recidivans in Ethiopia: cutaneous and mucocutaneous features

2017 ◽  
Vol 11 (01) ◽  
pp. 106-110 ◽  
Author(s):  
Federica Dassoni ◽  
Frehiwot Daba ◽  
Bernard Naafs ◽  
Aldo Morrone
Keyword(s):  
Cutaneous Leishmaniasis ◽  
New World ◽  
Leishmania Braziliensis ◽  
Leishmania Tropica ◽  
Clinical Form ◽  
Leishmania Aethiopica ◽  
Mucosal Involvement ◽  
Leishmania Panamensis ◽  
First Time ◽  
Leishmania Guyanensis

Cutaneous leishmaniasis (CL) is endemic in Ethiopia. An unusual clinical form of this disease is leishmaniasis recidivans (LR), a prolonged, relapsing form of cutaneous leishmaniasis resembling tuberculosis of the skin that may persist for many years with a chronic and relapsing course. This rare variant has been shown to be caused by Leishmania tropica species in the Old World and by Leishmania braziliensis, Leishmania amazonensis, Leishmania panamensis, and Leishmania guyanensis in the New World, as reported in various studies. To our knowledge, there are no reports from Ethiopia, and mucocutaneous involvement of LR has not been described to date. This was a retrospective analysis of the patients seen at the Italian Dermatological Center in Mekelle on the Tigrean highlands over a three-year period (2008–2011). Seven patients with typical clinical features of LR were seen. Two of them presented with signs of mucosal involvement. To date, Leishmania aethiopica is shown to be the only species causing CL that is endemic in the Ethiopian highlands. Therefore, it had to be assumed that the lesions in these patients were caused by this species. The aims of this communication are to report, for the first time, the presence of LR, most likely due to Leishmania aethiopica, in Ethiopia, and to report mucosal involvement in this rare clinical form of CL.

A putative Leishmania panamensis/Leishmania braziliensis hybrid is a causative agent of human cutaneous leishmaniasis in Nicaragua

Parasitology ◽  
1994 ◽  
Vol 109 (4) ◽  
pp. 435-442 ◽  
Author(s):  
A. A. Belli ◽  
M. A. Miles ◽  
J. M. Kelly
Keyword(s):  
Strong Evidence ◽  
New World ◽  
Northern Region ◽  
Leishmania Braziliensis ◽  
Human Leishmaniasis ◽  
Leishmania Panamensis ◽  
Genotypic Characteristics ◽  
Epidemiological Significance ◽  
Human Cutaneous Leishmaniasis ◽  
Putative Hybrids

SUMMARYAs part of a survey of human leishmaniasis in Nicaragua we examined phenotypic and genotypic characteristics of 40 Leishmania isolates. We identified 3 distinct parasites associated with cutaneous disease in this area; Leishmania panamensis (40% of cases), Leishmania braziliensis (33%), and a strain which exhibits the heterozygous isoenzyme and DNA fingerprinting patterns expected of a L. panamensis/L. braziliensis hybrid (27%). There was complete correlation between the isoenzyme and DNA data for each of the putative hybrids examined. All of the ‘hybrids’ were obtained from foci in the northern region of the country where L. panamensis and L. braziliensis occur sympatrically. These observations provide strong evidence for sexual reproduction in New World Leishmania populations and suggest that it is of taxonomic and epidemiological significance.

scholarly journals Miltefosine for the treatment of cutaneous leishmaniasis—A pilot study from Ethiopia

2021 ◽  
Vol 15 (5) ◽  
pp. e0009460
Author(s):  
Saskia van Henten ◽  
Annisa Befekadu Tesfaye ◽  
Seid Getahun Abdela ◽  
Feleke Tilahun ◽  
Helina Fikre ◽  
...  
Keyword(s):  
Side Effects ◽  
Cutaneous Leishmaniasis ◽  
Systemic Treatment ◽  
Initial Response ◽  
Tablet Form ◽  
Leishmania Aethiopica ◽  
Mucosal Involvement ◽  
Observational Cohort ◽  
Good Improvement ◽  
Favorable Side Effect Profile

Background Cutaneous leishmaniasis (CL) in Ethiopia, caused by Leishmania aethiopica, is often severe and hard to treat compared to CL caused by other species elsewhere. Miltefosine is the only oral anti-leishmanial drug, with a favorable side-effect profile compared to routinely available sodium stibogluconate (SSG), but evidence about its use for L. aethiopica is lacking. Methodology and principal findings In an observational cohort study, treatment outcomes, safety and adherence among CL patients who required systemic treatment and received miltefosine for 28 days in Boru Meda Hospital and University of Gondar Hospital were studied. Patient cure was defined as 100% flattening for non-ulcerated lesions and 100% flattening and 100% re-epithelization for ulcerated lesions. Outcomes were documented for day 28, 90 and 180, both per site, and pooled, adjusting for site as a fixed effect with effect coding. Among 94 included patients (32 in Gondar, 62 in Boru Meda), median lesion duration was 12 months, median size six cm, and mucosal involvement (46.8%) and diffuse (30.9%) lesions were common. Adherence to miltefosine was good, and side-effects were tolerable. Initial outcomes at day 28 were promising, with 68.8% and 94.0% of patients having good improvement or cure in Gondar and Boru Meda respectively. In Boru Meda, outcomes were good with 72.7% and 72.9% cure at day 90 and day 180 respectively. In Gondar, results were less promising, with only 12.5% and 26.7% cure at day 90 and day 180, although confidence intervals were wide. In pooled estimates, 48.7% of patients reached cure at day 180, and 32.3% relapsed. Outcomes were better in Boru Meda Hospital, for smaller lesions and for mucosal lesions. Conclusions/Significance Based on miltefosine’s good initial response, tolerable side-effects, tablet-form, we propose to include miltefosine for future clinical trials using extended treatment schedules, combination therapy, or targeting specific subgroups. Trial registration ClinicalTrials.gov NCT04004754.

scholarly journals Presence of Psychodopygus wellcomei (Diptera: Psychodidae), a proven vector of Leishmania braziliensis braziliensis, in Ceara State

1983 ◽  
Vol 78 (2) ◽  
pp. 235-236 ◽  
Author(s):  
P. D. Ready ◽  
A. L. Ribeiro ◽  
R. Lainson ◽  
J. E. de Alencar ◽  
J. J. Shaw
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Amazon Basin ◽  
Leishmania Braziliensis ◽  
First Time

Psychodopygus wellcomei, a proven vector of (muco-)cutaneous leishmaniasis, has been found for the first time outside of the Amazon Basin, in Ceará State. Parasitological and entomological evidence suggests that the Leishmania braziliensis braziliensis/Ps. wellcomei zoonosis is widespread on the Brazilian Shield.

scholarly journals Indirect immunofluorescence test in new world Leishmaniasis: serological and clinical relation-ship

1988 ◽  
Vol 83 (3) ◽  
pp. 347-355 ◽  
Author(s):  
Sergio C. F. Mendonça ◽  
Wilson J. S. Souza ◽  
Marise P. Nunes ◽  
Mauro C. A. Marzochi ◽  
Sergio G. Coutinho
Keyword(s):  
Visceral Leishmaniasis ◽  
Cutaneous Leishmaniasis ◽  
Indirect Immunofluorescence ◽  
Healthy Subjects ◽  
Endemic Area ◽  
New World ◽  
Leishmania Braziliensis ◽  
Immunofluorescence Test ◽  
Control Groups ◽  
Indirect Immunofluorescence Test

The indirect immunofluorescence test (IF) for anti-Leishmania antibodies (IgC and IgM) was performed with sera form the following groups of individuals: 214 cutaneous leishmaniasis patients, 28 healthy subjects with positive Montenegro's skin test (MST), 29 healthy subjects with negativeMST and 16 visceral leishmaniasis patients. The first four groups came from a suburban area of Rio de Janeiro (Jacarepaguá) where cutaneous leishmaniasis caused by Leishmania braziliensis braziliensis is endemic. It was observed that IF-IgM titers were significantly higher amongst the cutaneous leishmaniasis patients with less than four months of disease as compared to those with longer periods and that IF-IgG titers were significantly higher in patients with multiple lesions as compared to those with single lesions. The visceral leishmaniasis patients had IF-IgG titers significantly higher than those from cutaneous leishmaniasis patients. A group of 28 individuals selected amongst the 214 cutaneous leishmaniasis patients had their IF-titers (IgG and IgM) compared to those of the two control groups of healthy subjects from the endemic area, respectively with positive and negative MST. Significantly higher titers of IF-IgG and IF-IgM were found in the group with active disease. The same group of patients showed IF-IgG titers significantly lower at the end of the antimonial therapy than those observed during this tratment.

scholarly journals Identificación molecular de aislamientos clínicos de Leishmania spp. procedentes de Colombia con base en el gen hsp70

Biomédica ◽  
2016 ◽  
Vol 36 ◽  
Author(s):  
Ana M. Montalvo ◽  
Jorge Fraga ◽  
Ivón Montano ◽  
Lianet Monzote ◽  
Gert Van der Auwera ◽  
...  
Keyword(s):  
Leishmania Braziliensis ◽  
Leishmania Panamensis ◽  
Leishmania Spp ◽  
Leishmania Guyanensis

<p><strong>Introducción.</strong> La leishmaniasis es una enfermedad de alta prevalencia en Colombia, donde al menos seis especies diferentes pueden causar una variada presentación clínica en el humano. La tipificación de la especie es importante no solo desde el punto de vista epidemiológico, sino en el diagnóstico, dado que el tratamiento y el esquema de tratamiento pueden variar dependiendo de la especie identificada. Para la identificación se han utilizado distintas alternativas metodológicas, con variable poder discriminatorio.</p><p><strong>Objetivo.</strong> Realizar la identificación molecular de especies de <em>Leishmania spp.</em> mediante<strong> </strong>la amplificación molecular de un fragmento del gen <em>hsp</em>70.</p><p><strong>Materiales y métodos.</strong> Se realizó la amplificación molecular de un fragmento del gen <em>hsp</em>70: PCR-<em>hsp</em>70 (siglas en inglés) seguida del análisis del tamaño de los fragmentos de restricción (RFLP siglas en inglés), a 81 aislamientos clínicos de <em>Leishmania spp.</em>, provenientes de pacientes con enfermedad cutánea y mucocutánea, en los cuales se identificaron las especies presentes.</p><p><strong>Resultados.</strong> Se obtuvo un único producto de amplificación para el total de muestras analizadas. La restricción enzimática permitió identificar 70 aislamientos con un patrón de bandas correspondiente a <em>Leishmania braziliensis, </em>que incluye<em> </em>dos patrones diferentes (62 y 8 aislamientos respectivamente); 9 aislamientos compatibles con <em>Leishmania panamensis</em> y 2 con <em>Leishmania guyanensis</em>. El origen geográfico de los aislamientos concuerda con reportes anteriores sobre la distribución de las especies correspondientes.</p><p><strong>Conclusiones.</strong> La técnica de PCR-<em>hsp</em>70/RFLP utilizada es útil para identificar especies de <em>Leishmania</em> aisladas de muestras clínicas de Colombia que puede ser aplicable también al estudio de cepas provenientes de vectores y reservorios con importancia epidemiológica.</p>

scholarly journals Efficacy and Tolerability of Miltefosine in the Treatment of Cutaneous Leishmaniasis

2020 ◽  
Author(s):  
JeanAnne M Ware ◽  
Elise M O’Connell ◽  
Thomas Brown ◽  
Lauren Wetzler ◽  
Kawsar R Talaat ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cutaneous Leishmaniasis ◽  
Leishmania Major ◽  
Standard Of Care ◽  
Leishmania Species ◽  
Response To Treatment ◽  
Prior History ◽  
Leishmania Braziliensis ◽  
Alternative Treatment Option ◽  
Leishmania Panamensis

Abstract Background Cutaneous leishmaniasis (CL) is a neglected tropical disease causing an estimated 1 million new cases annually. While antimonial compounds are the standard of care worldwide, they are associated with significant adverse effects. Miltefosine, an oral medication, is United States (US) Food and Drug Administration approved to treat CL caused by Leishmania braziliensis, Leishmania guyanensis, and Leishmania panamensis. Evidence of efficacy in other species and side-effect profiles in CL has been limited. Methods Twenty-six patients with CL were treated with miltefosine at the US National Institutes of Health. Species included L. braziliensis (n = 7), L. panamensis (n = 5), Leishmania mexicana (n = 1), Leishmania infantum (n = 3), Leishmania aethiopica (n = 4), Leishmania tropica (n = 2), Leishmania major (n = 1), and unspeciated (n = 3). Demographic and clinic characteristics of the participants, response to treatment, and associated adverse events were analyzed. Results Treatment with miltefosine resulted in cure in 77 % (20/26) of cases, with cures among all species. Common adverse events included nausea/vomiting (97%) and lack of appetite (54%). Clinical management or dose reduction was required in a third of cases. Gout occurred in 3 individuals with a prior history of gout. Most laboratory abnormalities, including elevated creatinine and aminotransferases, were mild and normalized after treatment. Conclusions Our data suggest that miltefosine has good but imperfect efficacy to a wide variety of Leishmania species. While side effects were common and mostly mild to moderate, some resulted in discontinuation of therapy. Due to oral administration, broad efficacy, and manageable toxicities, miltefosine is a viable alternative treatment option for CL, though cost and lack of local availability may limit its widespread use.

scholarly journals Vaccination with L. infantum chagasi Nucleosomal Histones Confers Protection against New World Cutaneous Leishmaniasis Caused by Leishmania braziliensis

PLoS ONE ◽  
2012 ◽  
Vol 7 (12) ◽  
pp. e52296 ◽  
Author(s):  
Marcia W. Carneiro ◽  
Diego M. Santos ◽  
Kiyoshi F. Fukutani ◽  
Jorge Clarencio ◽  
Jose Carlos Miranda ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
New World ◽  
Leishmania Braziliensis

scholarly journals Failure of Liposomal-amphotericin B Treatment for New World Cutaneous Leishmaniasis due to Leishmania braziliensis

2020 ◽  
Vol 59 (9) ◽  
pp. 1227-1230
Author(s):  
Atsushi Kosaka ◽  
Naoya Sakamoto ◽  
Mayu Hikone ◽  
Kazuo Imai ◽  
Masayuki Ota ◽  
...  
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Amphotericin B ◽  
Liposomal Amphotericin ◽  
New World ◽  
Liposomal Amphotericin B ◽  
Leishmania Braziliensis

scholarly journals NEW PRIMERS FOR DETECTION OF Leishmania infantum USING POLYMERASE CHAIN REACTION

2015 ◽  
Vol 57 (5) ◽  
pp. 377-383 ◽  
Author(s):  
Kézia Peres GUALDA ◽  
Lílian Mathias MARCUSSI ◽  
Herintha Coeto NEITZKE-ABREU ◽  
Sandra Mara Alessi ARISTIDES ◽  
Maria Valdrinez Campana LONARDONI ◽  
...  
Keyword(s):  
Polymerase Chain Reaction ◽  
Leishmania Infantum ◽  
Leishmania Major ◽  
High Sensitivity ◽  
Leishmania Braziliensis ◽  
Chain Reaction ◽  
Serological Tests ◽  
Leishmania Panamensis ◽  
Polymerase Chain ◽  
Leishmania Guyanensis

SUMMARY Leishmania infantum causes visceral leishmaniasis (VL) in the New World. The diagnosis of VL is confirmed by parasitological and serological tests, which are not always sensitive or specific. Our aim was to design new primers to perform a Polymerase Chain Reaction (PCR) for detecting L. infantum. Sequences of the minicircle kinetoplast DNA (kDNA) were obtained from GenBank, and the FLC2/RLC2 primers were designed. Samples of DNA from L. infantum, Leishmania amazonensis, Leishmania braziliensis, Leishmania guyanensis, Leishmania naiffi, Leishmania lainsoni, Leishmania panamensis, Leishmania major and Trypanosoma cruzi were used to standardize the PCR. PCR with FLC2/RLC2 primers amplified a fragment of 230 bp and the detection limit was 0.2 fg of L. infantum DNA. Of the parasite species assayed, only L. infantum DNA was amplified. After sequencing, the fragment was aligned to GenBank sequences, and showed (99%) homology with L. infantum. In the analysis of blood samples and lesion biopsy from a dog clinically suspected to have VL, the PCR detected DNA from L. infantum. In biopsy lesions from humans and dogs with cutaneous leishmaniasis, the PCR was negative. The PCR with FLC2/RLC2 primers showed high sensitivity and specificity, and constitutes a promising technique for the diagnosis of VL.

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