Leishmaniasis in Northern Morocco: Predominance of Leishmania infantum Compared to Leishmania tropica

Abstract

In Morocco, Leishmania infantum species is the main causative agents of visceral leishmaniasis (VL). However, cutaneous leishmaniasis (CL) due to L. infantum has been reported sporadically. Moreover, the recent geographical expansion of L. infantum in the Mediterranean subregion leads us to suggest whether the nonsporadic cases of CL due to this species are present. In this context, this review is written to establish a retrospective study of cutaneous and visceral leishmaniasis in northern Morocco between 1997 and 2018 and also to conduct a molecular study to identify the circulating species responsible for the recent cases of leishmaniases in this region. Data concerning leishmaniases cases were collected from the Epidemiology and Disease Control Directorate from 1997 to 2018. Human samples obtained from peripheral laboratories were examined using PCR-ITS1 method. The ITS1 products were subjected to digestion with the restriction endonuclease Mn1-I. Between 1997 and 2018, a total of 1,255 cases of cutaneous and visceral leishmaniasis were recorded in Tangier-Tetouan-Al Hoceima Region, i.e., 1.56% of the reported cases in Morocco (1,255/80,299). Concerning the geographical study covering the period 2007-2018, 79.5% (105/132) of the sectors were affected by leishmaniases. The molecular results showed that Humans were found to be infected with the L. infantum species with a high infection rate compared to L. tropica infection. Moreover, molecular characterization using ITS1 PCR-RFLP showed that the density of L. infantum was significantly higher (n = 68/81; 84%) than that of L. tropica (n = 13/81; 16%) (P-value 9.894e-10). While regarding visceral leishmaniasis, L. infantum was the only species responsible of this form. These findings of this study showed the emergence of L. infantum in Morocco and suggest that this species might be more prevalent than previously thought. Furthermore, the molecular determination of L. infantum will be helpful for control strategies by taking into consideration the reservoir of this species.

The Cutaneous Leishmaniasis and the Sand Fly: Knowledge and Beliefs of the Population in Central Morocco (El Hajeb)

“…erefore, the circulating species identified in the north is L. infantum; in the centre, it was L. tropica, while in the south the two species of L. major and L. tropica are responsible for the cases of cutaneous leishmaniasis [4]. Transmission is mainly anthroponotic in cases of L. tropica and zoonotic in cases of L. infantum and L. major [5][6][7][8][9].…”

“…At present, most of the work that was done on CL in Morocco focuses on the eco-epidemiological and parasitological aspects of the disease [7,9,[11][12][13]. However, no studies were made to describe the sociocultural aspects of the disease.…”

Risk Factors Associated with Leishmaniasis in the Most Affected Provinces byLeishmania infantumin Morocco

“…In addition to these epidemiological studies, measures to control this pathology must take into account the parasite cycle since each species of the Leishmania genus has its own sandfly species and its own reservoir, and each focus is characterized by the species which circulates as well as the risk factors likely to influence its development. However, molecular investigations recently carried out in these provinces showed the coexistence of L. tropica besides L. infantum with a predominance of the latter species [ 19 , 20 ].…”

Canine Leishmaniasis in Morocco: A Descriptive Prospective Clinical Study

“…Dogs constitute the main domestic reservoir for human visceral leishmaniasis (VL) caused by L. infantum and play a key role in the transmission to humans [ 9 ]. Studies carried out on cutaneous leishmaniasis (CL) in the Maghreb countries isolated L. infantum from dogs too, suggesting them as a possible reservoir of this disease as well [ 10 ].…”