Regional genetic differentiation of Phlebotomus sergenti in three Moroccan foci of cutaneous leishmaniasis caused by Leishmania tropica.

Phlebotomus sergenti was identified morphologically in samples from three Moroccan foci of leishmaniasis caused by Leishmania tropica in the provinces of Azilal, Essaouira and Taza. Three primary mitochondrial DNA lineages were identified, and they could be markers for regionally distributed cryptic species. Greater mitochondrial diversity in Azilal indicated that this central province could have been the origin of dispersal of P. sergenti or the zone of secondary contact. All except one of the 21 mitochondrial haplotypes showed a marked regional distribution, and this indicates that vector control would not always be followed by rapid, long-distance reinvasion. Only mitochondrial haplotype SER18 was a putative marker for long-distance dispersal, for which there is no evidence of human assistance.

[Leishmania tropica cutaneous leishmaniasis in an emerging focus in North Morocco: new clinical forms]. / Leishmaniose cutanée à Leishmania tropica dans un foyer émergent au nord du Maroc: nouvelles formes cliniques.

INTRODUCTION: Leishmania tropica cutaneous leishmaniasis is usually described as dry, small and self-healing lesions, mainly located on the face and occurring in stable endemic foci. In 1989, similar aspects were observed in a rural hypoendemic focus in center Morocco where about 60 cases were diagnosed. In contrast, an epidemic urban focus in Taza-North Morocco--was identified in 1995 with peculiar clinical aspects. Our objectives is to describe these clinical characteristics. PATIENTS AND METHODS: From October 1995 to November 1996, 132 cases were diagnosed from this new focus during a monthly active survey. Age, sex, duration of lesions, clinical aspects and therapeutic regimen were detailed for each patient. RESULTS: Among the patients, 56.8 p. 100 were women. Mean age was 24.6 +/- 21.5 years (range: 8 months to 85 years). The mean duration of lesions was 6.9 +/- 6.5 months and 91.4 p. 100 evoluted for less than one year. Impetiginized, ulcerocrusted and noduloulcerative forms were predominant (61 p. 100). Furthermore, severe, vegetant inflammatory and multiple lesions were observed in infants and elderly patients. Limbs were involved in 30 p. 100 of cases. Eighty-six patients were treated with intralesional glucantime regimen and cured in 72 p. 100 of cases. Intramuscular treatment by glucantime was required in case of multiple lesions and failure of local therapy. DISCUSSION: In this study, the high frequency of severe lesions in infants and elderly patients suggests that the introduction of the parasite occurred recently in this area. The brief duration of lesions confirms the acute character for cutaneous leishmaniasis related to L. tropica in this epidemic focus. The host immune status associated with parasite intrinsic factors probably plays a role in these perculiar clinical manifestations.

Immune response against Leishmania antigens in dogs naturally and experimentally infected with Leishmania infantum.

Cell-mediated and humoral immune response in naturally and experimentally infected dogs was studied using crude and pure antigens. Both types of infections induced severe signs of visceral disease, but the symptoms observed in natural infections were more pronounced than in experimental infections. In addition, asymptomatic infections were not observed in experimentally infected animals. Disease evolution in laboratory infections was rapid and an increase in antibody titer to crude parasite antigen was correlated with the appearance and aggravation of clinical symptoms. Peripheral blood lymphocyte proliferation to crude antigen and pure gp63 was observed early following experimental infection, but was abolished once the infected dogs began to exhibit clinical signs. A similar pattern was observed in naturally infected dogs. Serum from all patent dogs showed high antibody titers to rK39 in enzyme-linked immunosorbent assays (ELISA), and reacted by western blotting with several antigens, 12 to 120 KDa, including gp63 and gp70. In the case of asymptomatic dogs. antibody titers to crude antigen were low and only a few antigens were identified by western blotting. None of the pure proteins examined, gp63, gp70, and rK39 were recognized by western blotting or ELISA. However, asymptomatic dogs exhibited specific lymphocyte proliferation to both crude antigen and the potential vaccine candidate gp63.

Short report: Leishmania tropica: etiologic agent of a case of canine visceral leishmaniasis in northern Morocco.

The domestic dog has been previously demonstrated to be the reservoir of Leishmania infantum, the etiologic agent of human visceral leishmaniasis around the Mediterranean Basin. It can also be infected with L. tropica, the etiologic agent of anthroponotic cutaneous leishmaniasis in Morocco. We report a canine L. tropica visceral infection for the first time in Morocco.

Epidemiology of human visceral leishmaniasis in Taounate, a northern province of Morocco.

We report the preliminary results of an epidemiological survey carried out in the locality of Ouled Hcein, province of Taounate (North Morocco) around one visceral leishmaniasis infant case. The strain isolated from the child was characterized by three methods as Leishmania infantum and its isoenzyme pattern was indistinguishable from zymodeme MON-1. The human survey in the locality of origin of the index case did not show any additional case and the serology was negative for the whole people sampled. The canine survey showed that the highest seroprevalence of the canine disease was found in the locality of Ouled Hcein (27.1%) when compared to 4 surrounding localities. The entomological survey showed that amongst the demonstrated L. infantum vectors around the Mediterranean Basin, Phlebotomus longicuspis was the predominant species. Furthermore, the survey led to the identification of one female of P. ariasi naturally infected with L. infantum, so this species should be at least one of the vectors of this parasite in this area. Thus, this study confirms that the transmission cycle of L. infantum in North Morocco is similar to the cycle found in the remaining Mediterranean area.

Cutaneous leishmaniasis: an emerging epidemic focus of Leishmania tropica in north Morocco.

Cutaneous leishmaniasis in Morocco occurs mainly in the south and is caused by Leishmania major and L. tropica. In 1995, for the first time, 4 autochthonous cases were confirmed by smear and/or culture from the province of Taza in north Morocco. An active survey revealed 128 more cases. The number had increased gradually since 1994. Most of the cases (86%) came from the suburbs of the city of Taza. All cultured and typed parasites were characterized as L. tropica MON-102. A leishmanin skin test survey among a random sample of the exposed population showed an overall positivity rate of 19.9%, with no correlation with age or gender. The spatial distribution of the cases and skin test positivity, their occurrence in all age groups, the highly variable clinical picture, the severity and large size of lesions in older patients, the slow recovery of some treated patients, and the isoenzymic monomorphism of the parasite, all suggested that cutaneous leishmaniasis caused by L. tropica is an emerging disease in Taza.

[Toxoplasmosis and rubella in Moroccan women. Results of a serological survey]. / La toxoplasmose et la rubéole chez la femme marocaine. Résultats d'une enquête sérologique.

A prospective sero-immunological enquiry of the rubella and toxoplasmosis immune status of 200 pregnant women in Casablanca (Morocco) revealed that 66,5% are immune to rubella and 51,5% are immune to toxoplasmosis. A study of the relation between the immune status and age shows that serum conversion takes place most frequently between the ages of 21 and 25. 7 women had high levels of anti-toxoplasmosis antibodies. The authors compare their results with those obtained in other regions of Morocco and in other countries. They also present a range of epidemiological and technical correlations. They conclude that the prevention of congenital toxoplasmosis and rubella must be integrated into a national programme of mother-and-child protection, notably by means of obligatory prenatal serological tests and the continued monitoring of those women who are not immune.