First Report of Leishmania tropica from a Classical Focus of L. major in North-Sinai, Egypt

Abstract

Cutaneous leishmaniasis (CL) is prevalent in the Egyptian Sinai Peninsula and previous research has consistently documented the etiologic agent to be Leishmania major. We report the first isolation of Leishmania tropica from human cases of CL in a Northern Sinai community bordering Palestine. Parasite culturing, real-time polymerase chain reaction (PCR), gene sequencing, and restriction fragment length polymorphism (RFLP) analyses indicate CL cases in this community were caused by either L. major or L. tropica (three cases each). Two wild-caught rodents (Gerbillus pyramidum floweri) were infected with L. tropica. Phlebotomus papatasi sand flies were found harboring L. major, however only non-infected individuals of Phlebotomus sergenti, a vector for L. tropica, were caught. Patients with L. tropica had not traveled from the region in over a year, suggesting these cases are autochthonous. This scenario is consistent with an incursion of L. tropica from bordering countries and raises concerns about expansion of this parasite further into Egypt.

Leishmaniasis transmission: distribution and coarse-resolution ecology of two vectors and two parasites in Egypt

“…To compare ecological niches among the species, taking into account the mobility constraint area described above, we calculated Hellinger's I index in R for all pairwise combinations of the four species, to test the null hypothesis of niche similarity between pairs against a 'background' of Egypt, as described above. We excluded L. tropica from comparisons owing to low sample sizes for this parasite in Egypt: it has been reported only once in one of the most remote areas, on the EgyptianPalestinian border 1 . We generated points randomly from across the accessible area equal to numbers of real occurrence data available for each species, with 100 replicate samples.…”

“…The sandfly species most commonly recorded was P. papatasi (N = 121) followed by P. sergenti (N = 26). Records of L. major were obtained from 19 localities, all in northern Sinai; only three records were available for L. tropica, all from El Barth, a community on the EgyptPalestine border 1 , thus constituting a single unique occurrence.…”

“…L. major is responsible for zoonotic cutaneous leishmaniasis (ZCL) transmission in several countries of North Africa, whereas L. tropica is responsible for anthroponotic cutaneous leishmaniasis (ACL) transmission across the Old World 2,3 . Although several reservoirs are associated with CL transmission in different regions, vectors for these parasites are well characterized across the Middle East and Africa: specifically, Phlebotomus papatasi appears to be the potential vector for ZCL and P. sergenti for ACL 1,[4][5][6] .…”

“…Two parasites are responsible for CL circulation in Egypt: Leishmania major and Leishmania tropica 1 . L. major is responsible for zoonotic cutaneous leishmaniasis (ZCL) transmission in several countries of North Africa, whereas L. tropica is responsible for anthroponotic cutaneous leishmaniasis (ACL) transmission across the Old World 2,3 .…”

Global health

“…Visceral leishmaniasis, a chronic disease leading to irreversible damage to inner organs which is caused by protozoal parasites transmitted by sandflies of the genus Phlebotomus is found predominantly along the Mediterranean coast (El Sawaf et al 1984;Killick-Kendrick 1999). While Leishmania major has been present in the country for a long time, infections caused by Leishmania tropica were diagnosed for the first time in 2009 (Shehata et al 2009). Moreover, mosquitoes of the genera Culex, Anopheles and Aedes may transmit several arboviral infections, including (potentially hemorrhagic) fevers such as dengue fever, chikungunya fever, sindbis fever (named after its first occurrence in a village 30 km north of Cairo), Rift Valley fever and West Nile fever.…”