Leishmaniasis

Boelaert, Marleen; Sundar, Shyam

doi:10.1016/b978-0-7020-5101-2.00048-0

Cited by 31 publications

(31 citation statements)

References 156 publications

(109 reference statements)

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“…The organisms are transmitted by approximately 70 species of hematophagous sand flies in the Phlebotomus and Lutzomyia genera. 1 In the New World (Western hemisphere), Lutzomyia sand flies feed on and transmit Leishmania between various mammalian reservoirs, including wood rats, cotton rats, other rodents, opossums, and armadillos. [2][3][4][5][6][7][8] In the United States, leishmaniasis has also been documented in domesticated cats and dogs ( Table 1).…”

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confidence: 99%

“…[2][3][4][5][6][7][8][9][10][11][12] Leishmania species are classified as Old World or New World depending on the geographic region in which they primarily occur. Leishmania speciation helps to define the clinical subtype of disease (eTable in the Supplement) 1,11,13 and, therefore, expected severity, prognosis, and required treatment. In humans, leishmaniasis comprises a spectrum of disease with 3 major clinical subtypes: cutaneous, mucocutaneous, and visceral.…”

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Incidence of Endemic Human Cutaneous Leishmaniasis in the United States

2018

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IMPORTANCE Leishmaniasis is recognized as an endemic human disease in Africa, the Middle East, Asia, and South America. Yet despite case reports of endemic human leishmaniasis in the United States, and well-documented occurrences of disease in various animal vectors and reservoirs, the endemicity of leishmaniasis in North America has not yet been established. Moreover, leishmaniasis is not a federally reportable disease in the United States. Clinical awareness of endemic disease therefore remains low, with North American physicians considering leishmaniasis a tropical disease. OBJECTIVE To assess the endemicity of human leishmaniasis in the United States. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional multicenter observational study reviewed cases of human leishmaniasis occurring in the United States from 2007 through 2017. Previously diagnosed, deidentified cases of leishmaniasis were reported by the institutions of the authors and acknowledged contributors, as well as the Texas Department of State Health Services. Cases of leishmaniasis were identified by searching by disease name (leishmaniasis) or International Classification of Diseases, 9th and 10th Revisions diagnosis codes in the respective laboratory information systems. EXPOSURES Via examination of deidentified demographics, cases of leishmaniasis were classified as one of the following: (1) documentation of no history of travel outside of the United States within 10 years; (2) positive history of travel outside of the United States within 10 years; or (3) unknown or no documentation of travel history. MAIN OUTCOMES AND MEASURES Cases of leishmaniasis were considered endemic if identified in patients with documentation of no travel history outside of the United States within 10 years. RESULTS Of the 69 novel cases of human cutaneous leishmaniasis identified in this study, 41 (59%) were endemic; the median age at diagnosis was 61 years (range, 3-89 years), and 28 (68%) of the endemic cases occurred in female patients. Twenty-two (32%) cases had documentation of Leishmania speciation performed by polymerase chain reaction, and in 100% of these cases the infectious organism was identified as Leishmania mexicana. CONCLUSIONS AND RELEVANCE Human cutaneous leishmaniasis is endemic in the United States, and, at least regionally, is acquired endemically more frequently than it is via travel. Our data argue in favor of making leishmaniasis a federally reportable disease and may have substantial implications on North American public health initiatives, with climate models predicting the number of citizens exposed to leishmaniasis will double by 2080.

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Incidence of Endemic Human Cutaneous Leishmaniasis in the United States

2018

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“…Unlike miltefosine, this drug is administered by intramuscular injections. A full course comprises daily injections (11 mg/kg/day) for 21 days [14,15]. Although paromomycin is an aminoglycoside, it does not exhibit much ototoxicity or nephrotoxicity.…”

Section: Paromomycinmentioning

confidence: 99%

Visceral Leishmaniasis

Bhattacharya¹,

Ghosal²,

Ganguly³

et al. 2018

Leishmaniases as Re-Emerging Diseases

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Clinically, leishmaniasis is of three types-visceral leishmaniasis (VL) or kala-azar, cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis (MCL). Post-kala-azar dermal leishmaniasis (PKDL) is considered as a complication of VL. VL is characterized by fever, anemia and splenomegaly in a VL-endemic area (malaria excluded). A subject with such symptoms should be subjected to an rK39 strip test. Confirmation of diagnosis is made by demonstration of the parasite (Leishmania donovani) from samples obtained by aspiration of bone marrow or iliac crest puncture. Miltefosine, stibogluconate, amphotericin B, liposomal amphotericin B and paromomycin are effective available anti-leishmaniasis drugs. Vector (Phleblotomus argentipes) control for reduction of transmission and early diagnosis and complete treatment are essential elements of case management. There is no effective vaccine against VL. This review on VL aims at providing state-art knowledge on epidemiology, diagnosis and case-management and vaccine development.

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“…These protozoa comprise approximately 53 species with an ongoing debated taxonomical structure. Currently 31 species are parasites of mammals and at least 21 Leishmania species are known to cause disease in humans [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…infantum described in [ 3 – 5 ]. Depending on the parasite species and the immune system of the host, the disease can cause different clinical forms ranging from localized self-limiting and self-healing cutaneous lesions – cutaneous leishmaniasis (CL) – to visceralizing infections – i.e., visceral leishmaniasis (VL), which is fatal if left untreated [ 2 ]. Depending on the Leishmania species , the disease can be zoonotic or anthroponotic.…”

Section: Introductionmentioning

confidence: 99%

A pilot study on fingerprinting Leishmania species from the Old World using Fourier transform infrared spectroscopy

et al. 2017

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Leishmania species are protozoan parasites and the causative agents of leishmaniasis, a vector borne disease that imposes a large health burden on individuals living mainly in tropical and subtropical regions. Different Leishmania species are responsible for the distinct clinical patterns, such as cutaneous, mucocutaneous, and visceral leishmaniasis, with the latter being potentially fatal if left untreated. For this reason, it is important to perform correct species identification and differentiation. Fourier transform infrared spectroscopy (FTIR) is an analytical spectroscopic technique increasingly being used as a potential tool for identification of microorganisms for diagnostic purposes. By employing mid-infrared (MIR) spectral data, it is not only possible to assess the chemical structures but also to achieve differentiation supported by multivariate statistic analysis. This work comprises a pilot study on differentiation of Leishmania species of the Old World (L. major, L. tropica, L. infantum, and L. donovani) as well as hybrids of distinct species by using vibrational spectroscopic fingerprints. Films of intact Leishmania parasites and their deoxyribonucleic acid (DNA) were characterized comparatively with respect to their biochemical nature and MIR spectral patterns. The strains’ hyperspectral datasets were multivariately examined by means of variance-based principal components analysis (PCA) and distance-based hierarchical cluster analysis (HCA). With the implementation of MIR spectral datasets we show that a phenotypic differentiation of Leishmania at species and intra-species level is feasible. Thus, FTIR spectroscopy can be further exploited for building up spectral databases of Leishmania parasites in view of high-throughput analysis of clinical specimens. Graphical abstractFor Leishmania species discrimination, sample films of intact parasites and their extracted DNA were analyzed by FTIR micro-spectroscopy. Hyperspectral datasets that comprise mid-infrared fingerprints were submitted to multivariate analysis tools such as principal components analysis (PCA) and hierarchical cluster analysis (HCA). Electronic supplementary materialThe online version of this article (10.1007/s00216-017-0655-5) contains supplementary material, which is available to authorized users.

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Leishmaniasis

Cited by 31 publications

References 156 publications

Incidence of Endemic Human Cutaneous Leishmaniasis in the United States

Incidence of Endemic Human Cutaneous Leishmaniasis in the United States

Visceral Leishmaniasis

A pilot study on fingerprinting Leishmania species from the Old World using Fourier transform infrared spectroscopy

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