Leelayoova Saovanee, Siripattanapipong Suradej, Manomat Jipada, Piyaraj Phunlerd, Tan-Ariya Peerapan, Bualert Lertwut, Mungthin Mathirut
Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand.
Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand.
Am J Trop Med Hyg. 2017 Mar;96(3):534-542. doi: 10.4269/ajtmh.16-0604. Epub 2017 Apr 6.
Before 1999, leishmaniasis was considered an imported disease in Thailand. Since then, autochthonous leishmaniasis was reported in both immmunocompetent and immmunocompromised patients especially in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). A new species was identified and named as consisting of two lineages, that is, lineages TR and PG. Analysis of isoenzymes has clarified the more commonly detected lineage PG as (MON-229), a species originally reported from the Martinique Island, whereas the lineage TR has been identified as the true novel species, (MON-324). Both cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) have been found among Thai patients. Disseminated CL and VL could be presented in some reported patients who had HIV/AIDS coinfection. So far, only sporadic cases have been reported; thus, the true prevalence of leishmaniasis should be determined in Thailand among the high-risk populations such as people with HIV/AIDS. A recent survey among animals identified DNA in black rats () suggesting a potential animal reservoir. In addition, DNA was identified in and , the predominant sandfly species in the affected areas. However, further studies are needed to prove that these sandflies could serve as the vector of leishmaniasis in Thailand.
1999年以前,利什曼病在泰国被视为一种输入性疾病。自那时起,在免疫功能正常和免疫功能低下的患者中均有本土利什曼病的报告,尤其是在人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)患者中。一种新物种被鉴定出来并命名为 ,它由两个谱系组成,即TR谱系和PG谱系。同工酶分析已明确更常见检测到的PG谱系为 (MON - 229),这是一种最初在马提尼克岛报告的物种,而TR谱系已被鉴定为真正的新物种, (MON - 324)。泰国患者中已发现皮肤利什曼病(CL)和内脏利什曼病(VL)。在一些报告的合并感染HIV/AIDS的患者中可能出现播散性CL和VL。到目前为止,仅报告了散发病例;因此,泰国应在诸如HIV/AIDS患者等高风险人群中确定利什曼病的真实患病率。最近一项针对动物的调查在黑家鼠( )中发现了 DNA,这表明存在潜在的动物宿主。此外,在受影响地区的主要白蛉物种 和 中也发现了 DNA。然而,需要进一步研究以证明这些白蛉可作为泰国利什曼病的传播媒介。