Epidemiological Features of Cutaneous Leishmaniasis in Zliten (North West of Libya)

Cutaneous Leishmaniasis is endemic in north-west of Libya forlong time andit’s spread to other new foci continues to involve new areaslike Taurgha, Sirt and recently, Zliten. Most ofthe patients in north-west of Libya were infected with zoonoticCutaneous Leishmaniasis, which caused by leishmania major, althoughsome cases of anthroponotic cutaneous leishmaniasis caused by leishmania tropica were also reported. Zliten is a coastal city in the north west of Libya;with more than 289000 people; and now isknown to be a new focus since 2016 when the sudden increase of the number of patients with Cutaneous Leishmaniasis had occurred. Aims: This study was performed to observe epidemiological changes about incidence, age of patients, geographical distribution in Zliten city over a period of last 2 year (2017 and 2018).Study Design:Cross-sectional study as retrospective study over time of twoyears, involving all patients, who were presented or referred, to get management of Cutaneous Leishmaniasis, in three accredited outpatient departments for cutaneousleishmania (in Zliten). The data were collected and analyzed in Zliten Teching Hospital.Place and Duration of Study: Outpatient Department of Dermatology and Venereology of Zliten Teaching Hospital between 1stJanuary 2017 and 31stDecember 2018.Methodology: The study included all patients (different gender and from all age groups) withCutaneous Leishmaniasis, who sought medical advicein dermatology reference clinics in Zliten over the period of 2 years (2017 and 2018). The main collected data were age, sex, number of lesions, and affected sites in the body, residency of the patients, year and month of presentation. The analysis ofdata was made with the use of Statistical Package for the Social Sciences (SPSS 25).Results:Eight hundred thirty nine patients were included in this study. The majority of patients came from Zliten and these represented 95.6%, while the most of them came from Majer (south easternpart of Zliten City with more than 25000 people living in it) and represented 45.5% of total patients with CL included in this study, followed by Al-juma (south westernpart of Zliten with around 52000 people), represented (28%) of total patients with CL.Males were found to be more affected, with male to female ratio, 2.4:1. The most affected age group were these less than forty with peak incidence at age group (20 yrs to 30 yrs). The registered patients in 2017 were 397, this number had increasedslightly to be 440 in the following year (2018).The distribution of patients had shown seasonal variations, with steep increase in the number of cases in December, November and January.Conclusion:Cutaneous Leishmaniasis is remained to be amajor health problem in Zliten, affecting a large number of population every year and need further study to determine molecular identification of parasites, and more efforts are needed to control the vector and reservoir.

Distribution and ecological aspects of sand flies (Diptera: Psychodidae) species in Northeastern Iran

Objective: To determine both the distribution and the ecological characteristics of sand flies in Golestan Province, northeast of Iran in 2016. Methods: In this study, 34 villages were selected based on their geographical conditions. Sticky paper traps were used for collecting the sand flies. Sampling was carried out in each of villages from May to November. In each village, 60 traps for indoors and 60 for outdoors were monthly installed. The species of all collected sand flies were determined using approved morphological keys. Pearson coefficient correlation was used to find the relationship between the number of collected Phlebotomus papatasi from different villages and incidence rate of zoonotic cutaneous leishmaniasis as well as the number of positive cases of the disease. The altitude of the studied villages was extracted from digital elevation model of the area using GIS and vegetation cover density index of the province was extracted from Modis satellite imagery and distribution map of sand flies drown up. Results: Overall, 5 428 sand flies were collected and identified, belonging to 18 species. Phlebotomus wenyoni was reported for the first time from the area in this study. The frequency of sand flies in the villages located in northeast of the Golestan province (the plateau area, lower altitude, arid and semi-arid climates, and lower vegetation cover density), were more than other villages in this province. There was a significant correlation between the number of collected Phlebotomus papatasi and incidence rate of the zoonotic cutaneous leishmaniasis cases in different villages (r=0.837, P=0.019) as well as the number of positive cases of the disease (r=0.688, P<0.001). Conclusions: In the northeaster areas of Golestan Province which is known as the endemic foci of zoonotic cutaneous leishmaniasis, the abundance of sand flies were more and the conditions for their growth and development were more appropriate.

Distribution and ecological aspects of sand flies (Diptera: Psychodidae) species in Northeastern Iran

Objective:To determine both the distribution and the ecological characteristics of sand flies in Golestan Province, northeast of Iran in 2016.Methods:In this study, 34 villages were selected based on their geographical conditions. Sticky paper traps were used for collecting the sand flies. Sampling was carried out in each of villages from May to November. In each village, 60 traps for indoors and 60 for outdoors were monthly installed. The species of all collected sand flies were determined using approved morphological keys. Pearson coefficient correlation was used to find the relationship between the number of collected Phlebotomus papatasi from different villages and incidence rate of zoonotic cutaneous leishmaniasis as well as the number of positive cases of the disease. The altitude of the studied villages was extracted from digital elevation model of the area using GIS and vegetation cover density index of the province was extracted from Modis satellite imagery and distribution map of sand flies drown up.Results:Overall, 5 428 sand flies were collected and identified, belonging to 18 species. Phlebotomus wenyoni was reported for the first time from the area in this study. The frequency of sand flies in the villages located in northeast of the Golestan province (the plateau area, lower altitude, arid and semi-arid climates, and lower vegetation cover density), were more than other villages in this province. There was a significant correlation between the number of collected Phlebotomus papatasi and incidence rate of the zoonotic cutaneous leishmaniasis cases in different villages (r=0.837, P=0.019) as well as the number of positive cases of the disease (r=0.688, P<0.001).Conclusions:In the northeaster areas of Golestan Province which is known as the endemic foci of zoonotic cutaneous leishmaniasis, the abundance of sand flies were more and the conditions for their growth and development were more appropriate.

Forecasting the number of zoonotic cutaneous leishmaniasis cases in south of Fars province, Iran using seasonal ARIMA time series method

Objective To predict the trend of cutaneous leishmaniasis and assess the relationship between the disease trend and weather variables in south of Fars province using Seasonal Autoregressive Integrated Moving Average (SARIMA) model. Methods The trend of cutaneous leishmaniasis was predicted using Mini tab software and SARIMA model. Besides, information about the disease and weather conditions was collected monthly based on time series design during January 2010 to March 2016. Moreover, various SARIMA models were assessed and the best one was selected. Then, the model's fitness was evaluated based on normality of the residuals’ distribution, correspondence between the fitted and real amounts, and calculation of Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC). Results The study results indicated that SARIMA model (4,1,4)(0,1,0)

Forecasting the number of zoonotic cutaneous leishmaniasis cases in south of Fars province, Iran using seasonal ARIMA time series method

OBJECTIVE@#To predict the trend of cutaneous leishmaniasis and assess the relationship between the disease trend and weather variables in south of Fars province using Seasonal Autoregressive Integrated Moving Average (SARIMA) model.@*METHODS@#The trend of cutaneous leishmaniasis was predicted using Mini tab software and SARIMA model. Besides, information about the disease and weather conditions was collected monthly based on time series design during January 2010 to March 2016. Moreover, various SARIMA models were assessed and the best one was selected. Then, the model's fitness was evaluated based on normality of the residuals' distribution, correspondence between the fitted and real amounts, and calculation of Akaike Information Criteria (AIC) and Bayesian Information Criteria (BIC).@*RESULTS@#The study results indicated that SARIMA model (4,1,4)(0,1,0) in general and SARIMA model (4,1,4)(0,1,1) in below and above 15 years age groups could appropriately predict the disease trend in the study area. Moreover, temperature with a three-month delay (lag3) increased the disease trend, rainfall with a four-month delay (lag4) decreased the disease trend, and rainfall with a nine-month delay (lag9) increased the disease trend.@*CONCLUSIONS@#Based on the results, leishmaniasis follows a descending trend in the study area in case drought condition continues, SARIMA models can suitably measure the disease trend, and the disease follows a seasonal trend.

The existence of only one haplotype of Leishmania major in the main and potential reservoir hosts of zoonotic cutaneous leishmaniasis using different molecular markers in a focal area in Iran

Introduction Leishmania major is the causative agent of zoonotic cutaneous leishmaniasis (ZCL), and great gerbils are the main reservoir hosts in Iran. Abarkouh in central Iran is an emerging focal point for which the reservoir hosts of ZCL are unclear. This research project was designed to detect any Leishmania parasites in different wild rodent species. Methods All rodents captured in 2011 and 2012 from Abarkouh district were identified based on morphological characteristics and by amplification of the rodent cytochrome b (Cyt b) gene. To detect Leishmania infection in rodents, deoxyribonucleic acid (DNA) of each ear was extracted. Internal transcribed spacer-ribosomal deoxyribonucleic acid (ITS-rDNA), microsatellites, kinetoplast deoxyribonucleic acid (kDNA) and cytochrome b genes of Leishmania parasites were amplified by polymerase chain reaction (PCR). Restriction fragment length polymorphism (RFLP) and sequencing were employed to confirm the Leishmania identification. Results Of 68 captured rodents in the region, 55 Rhombomys opimus were identified and nine Leishmania infections (9/55) were found. In addition, eight Meriones libycus and two Tatera indica were sampled, and one of each was confirmed to be infected. Two Meriones persicus and one Mus musculus were sampled with no infection. Conclusions The results showed that all 11 unambiguously positive Leishmania infections were Leishmania major. Only one haplotype of L. major (GenBank access No. EF413075) was found and at least three rodents R. opimus, M. libycus and T. indica—appear to be the main and potential reservoir hosts in this ZCL focus. The reservoir hosts are variable and versatile in small ZCL focal locations. .