Its-1 Dna Sequence Confirmation of Leishmania Major as a Cause of Cutaneous Leishmaniasis From an Outbreak Focus in the Ho District, Southeastern Ghana

Abstract

We report first-time definitive evidence of human cutaneous leishmaniasis (CL) resulting from L. major infections in Ghana. The evidence is in the form of PCR testing and DNA sequence analysis of skin sample biopsies from residents of the Ho District in the forested Volta Region of southeastern Ghana (Figure 1). The moist semi-deciduous forest of this region of Ghana is atypical for CL. Although two sand fly species with known or suspected potential to transmit L. major were present in communities where human cases of CL originated, they were found in such small numbers that their role in the transmission of CL is uncertain.

First Detection of Leishmania tropica DNA and Trypanosoma Species in Sergentomyia Sand Flies (Diptera: Psychodidae) from an Outbreak Area of Cutaneous Leishmaniasis in Ghana

“…L. tropica is recognized as a very heterogeneous species of Leishmania and intra-specific microheterogeneity has been readily demonstrated [29]. The lack of information on the existence of L. tropica in human in this focus might be largely due to the small numbers of human specimens investigated [11], [12] and difficulties in distinguishing between L. major and L. tropica . The emergence of human CL due to L. tropica as an increasingly important public health problem is now being reported in many foci in Africa such as Libya, Kenya, Egypt and Morocco [30]–[33].…”

“…This suspicion is strengthened when the same sand fly is found infected with the same leishmanial parasite as that found in man in the same place [28]. Phylogenetic analysis of the leishmanial ribosomal internal transcribed spacer 1 region indicates that the sequences from L. major DNA determined from S. ingrami align most closely with a human isolate from Ghana (MHOM/GH/2004/HO-004) [11]. Thus, based on the documented anthropophilic nature of S. ingrami (Boakye et al, unpublished results), [26], its abundance and the detection of L. major DNA within this sand fly as the same Leishmania species found in man from the same CL focus, suggests that S. ingrami is a possible vector of L. major transmission in the study area.…”

Leishmaniasis in northern and western Africa: a review

“…Between 1999 and 2002, the Ghana Health Service recorded 2,426 suspected cases of CL in the Ho, Hohoe, and Kpando Districts (2,348, 2, and 76 cases, respectively). In 2003, the number of suspected cases rose to 6,450 (6,185,174, and 91 in the same respective districts) with 116 villages affected (Fryauff et al 2006). A limited survey of towns in the Ho district during 2002 identified suspected CL lesions in 12.2-32.3% of local school children.…”

“…Although the CL belt mentioned cuts across the northern part of Ghana, the disease has not been reported in the country until recently, in 1999, when some chronic ulcers diagnosed as cutaneous leishmaniasis were observed in the Ho District of the Volta Region . Recently, the first definitive evidence of human CL resulting from L. major infections in Ghana was reported in Ho District (Fryauff et al 2006). On the other hand in Ouagadougou, the capital city of Burkina Faso, 1,845 people were diagnosed with CL between 1996 and 1999 (Traoré et al 2001).…”

“…Although the study considered P. duboscqi as the primary suspected vector of CL, the species was near the least abundant of 17 different sand fly species that were collected and comprised only 0.1% of the total catch. One other suspect sand fly species, P. rodhaini, was captured for the first time in Ghana, but at similarly low numbers (0.3%), insufficient to yield a profile of seasonal abundance (Fryauff et al 2006). …”