Laboratory of Parasitology and Vector-Borne-Diseases, Institut Pasteur du Maroc, 1, place Louis Pasteur, 20360 Casablanca, Morocco; Laboratory of Microbial Biotechnology and Bioactive Molecules, Faculty of Sciences and Technologies, Sidi Mohammed Ben Abdellah University, B.P. 2202, Fes, Morocco.
Laboratory of Parasitology and Vector-Borne-Diseases, Institut Pasteur du Maroc, 1, place Louis Pasteur, 20360 Casablanca, Morocco.
Acta Trop. 2022 Mar;227:106288. doi: 10.1016/j.actatropica.2021.106288. Epub 2021 Dec 20.
In Morocco, cutaneous leishmaniasis (CL) is an endemic disease; it is considered a major public health problem caused by three species Leishmaniamajor, Leishmaniatropica, and the dermotropic variant MON-24 of Leishmaniainfantum. This species has three incriminated vectors named; Phlebotomus ariasi, Phlebotomus longicuspis and Phlebotomus perniciosus, with the dog as reservoir.The main aim of this review is to elucidate the current epidemiological pattern of CL due to L.infantum and to investigate the factors facilitating its propagation throughout the country. Therefore, the number of CL cases due to L.infantum, their repartition; the distribution of L.infantum vectors, as well as the factors affecting their abundance and spread were investigated. We showed a wide extension of this form of CL, from the north of Morocco to the Saharan areas, as well as an increase of reported cases. This extension of the disease has been accompanied by a juxtaposed spread and a high abundance of confirmed vectors of L. infantum, which are present in almost all bioclimatic zones. In this review, we have highlighted the impact of climate: temperature, humidity, precipitation; vegetation and human activities on the geographical expansion of L. infantum vectors. These abiotic and biotic factors constitute favorable conditions for the increase of vector populations, and their introduction into areas where they did not exist before, and subsequently raise the risk of introduction of this form of cutaneous leishmaniasis into previously free areas. To conclude, CL by L.infantum, traditionally evolving as a sporadic form, is changing to an endemic mode, which seeks more epidemiological studies, and more attention from the health authorities when implementing control programs.
在摩洛哥，皮肤利什曼病（CL）是一种地方病；它被认为是由三种物种引起的主要公共卫生问题：Leishmania major、Leishmania tropica 和 Leishmania infantum 的皮肤嗜性变体 MON-24。该物种有三种被指控的媒介，分别是：Phlebotomus ariasi、Phlebotomus longicuspis 和 Phlebotomus perniciosus，而狗则是其宿主。本次综述的主要目的是阐明由 L.infantum 引起的 CL 的当前流行病学模式，并研究促进其在全国传播的因素。因此，研究了 L.infantum 引起的 CL 病例数及其分布；L.infantum 媒介的分布，以及影响其丰度和传播的因素。我们发现这种形式的 CL 从摩洛哥北部到撒哈拉地区广泛传播，并报告病例有所增加。这种疾病的扩展伴随着 L. infantum 确认媒介的同时传播和高丰度，这些媒介几乎存在于所有生物气候区。在本次综述中，我们强调了气候的影响：温度、湿度、降水；植被和人类活动对 L. infantum 媒介地理扩张的影响。这些非生物和生物因素为媒介种群的增加创造了有利条件，并将它们引入以前不存在的地区，随后增加了这种形式的皮肤利什曼病传入以前无病地区的风险。总之，L.infantum 引起的 CL 传统上呈散发性形式，正在向地方性模式转变，这需要更多的流行病学研究，并在卫生当局实施控制计划时给予更多关注。
