The effects of natural disasters on leishmaniases frequency: A global systematic review and meta-analysis.

OBJECTIVES: Natural disasters (NDs) may increase the outbreaks and transmissions of vector-borne diseases such as cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL). However, the relationship between leishmaniases and NDs has not yet been clearly established. Here, we systematically reviewed all reported articles in this field to answer whether NDs increase the frequency of leishmaniases. METHODS: All the related articles published during January 2000 till January 2020 were reviewed. Moreover, all NDs and the associated leishmaniases frequencies reports in 17 leishmaniases endemic countries were searched to find any ND-leishmaniases relationship. RESULTS: After the initial screening, 39 articles on ND-leishmaniases were selected and systematically reviewed. These articles showed different frequencies of CL in the endemic areas before and after NDs in some regions of Pakistan and Iran and in case of VL in Brazil, Ethiopia, and Sudan. After thorough deliberation, four studies for CL-ND and five studies for VL-ND relationships were selected for meta-analysis. The results showed increases in the leishmaniases incidences after NDs, although not robustly. CONCLUSION: The lack of a strong leishmaniases-ND relationship could be attributed to the local compilations of such data in scattered regions of the endemic countries. Therefore, currently a substantial knowledge gap on leishmaniases-ND relationship is apparent.

Description of an outbreak of human trichinellosis in an area of Argentina historically regarded as Trichinella-free: the importance of surveillance studies.

Trichinellosis is an important food-borne zoonosis which is not treated as a major public health concern in Argentina. After more than 20 years without reports of infection in an area regarded as Trichinella-free, research studies reported that infection occurred in humans, pigs and game animals, including the recent outbreak of human trichinellosis revealed here. The outbreak, affecting 64 individuals, occurred in July 2010 in the province of Entre Ríos. Epidemiological studies, clinical observations, laboratory analyses and immunoserological specific assays (indirect immunofluorescence, IIF, and ELISA) were performed. Food samples were analyzed by artificial digestion, and Trichinella larvae isolates were identified to the species level by multiplex PCR. The main source of infection, commercially available food, had a parasite load of 1.1 muscle larvae per gram. Larvae were identified as Trichinella spiralis. Patients presented predominantly with oedema, fever and myalgia; and laboratory findings and/or immunoserological tests were positive for trichinellosis. Individuals received outpatient treatment. No deaths or secondary sequelae were recorded. Results suggest that the presence of T. spiralis infection should be suspected in all endemic areas, especially where animal husbandry and official food safety controls are not properly conducted. The lack of the cases reported ought not to be taken as a proof of parasite absence. We highlight the importance of the urgent need to implement interdisciplinary and inter-institutional programs aimed to control infection transmission, to guarantee food safety and to conduct epidemiological surveillance studies.