Current epidemiological, clinical and parasitological data concerning cutaneous lesishmaniasis in Tunisia

ABSTRACT

In order to update the geographical distribution of the three noso-geographical of cutaneous leishmaniasis [CL] occurring in Tunisia, namely the sporadic [SLCL zoonotic [ZCL] and chronic [CCL] forms, and to review their main pattern, a involving 244 cases, was carried out. Most of patients were infected in the Central and Southern parts of the country 74.2% and suffered of ZCL in 64.8% of cases. The three forms were registered in zones considered so far as preserved thus confirming their geographical spread. Sexes were equally affected [sex ratio 1.02]. The patients were predominantly children and young] adults aged 24.6 years on average. ZCL lesions were mainly multiples [54.1%] localised in the limbs [81.5%] while those of SCL were rather isolated [91%, p<001] and affected the face [84.3%, p<0,00l]. Two clinical presentations prevailed the classical ulcerous presentation with scabs in ZCL [72%] and the erythematous presentation in SCL [55,9%, p=0.002]. A negative correlation was found between the number and duration of the lesions on presentation [r=0, 22; p<0,00l]. The iso-enzymatic identification of 105 isolated strains confirmed that L. major was the most prevalent species [60.9%] followed by L. infantum [27.6%] and L. killicki [11.4%]. Within L. infantum complex, zymodeme MON-24 was prevailing [75,9%]. CL remains an emergent disease in Tunisia with an incidence and a geographicol spread continuously on the increase. Recent environmental changes, auspicious to Phlebotomine vectors and rodents reservoirs, had probably contributed to that situation