Microbial Biotechnologies, Agrosciences and Environment Laboratory (BioMAgE), Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh, Morocco.
Laboratory of Parasitology and Vector-Borne-Diseases, Institut Pasteur du Maroc, Casablanca, Morocco.
Zoonoses Public Health. 2024 May;71(3):248-257. doi: 10.1111/zph.13105. Epub 2023 Dec 17.
BACKGROUND AND AIMS: Leishmaniasis is a neglected tropical infection caused by Leishmania parasite that affect human and animal. In Morocco, the cutaneous leishmaniasis has spread substantially to the new areas. The surveillance limited to active foci may underestimate the occurrence of cutaneous leishmaniasis (CL). This study aims to investigate the local transmission of CL in rural districts of Youssoufia province, central Morocco, as a potential focus of CL. METHODS: For this purpose, parasitological, molecular and entomological investigations were carried out in this area. Data collection concerns potential vectors and human cases. Thus, 402 patients were examined for suspected leishmaniasis lesions in three localities of the province of Youssoufia. In these same localities, 983 sand flies were collected by CDC light traps and sticky paper during one-night per month during 6 months. These sand flies were all identified morphologically using the Moroccan identification key. RESULTS: The results showed that among the 25 skin lesions detected in a population of 402 individuals, 18 were confirmed by kDNA nested PCR as CL positive patients, of which only 25% were positive by direct examination. Leishmania tropica and Leishmania major were identified as causative agents of CL in the study area. Direct parasitological examination showed a low sensitivity (27.78%), especially for L. major, although its specificity was evaluated at 100%. Regarding entomological results, both genera of the Moroccan sand fly were collected in the study area: Genus/Phlebotomus (75.28%) and Sergentomyia (24.72%). Phlebotomus (P) papatasi, the proven vector of L. major, was the most abundant species (33.98%), followed by Paralongicollum sergenti (22.58%), the confirmed vector of L. tropica; while Sergentomyia (S) minuta, P. longicuspis, S. fallax and P. kazeruni were collected with, respectively, 17.60%, 16.99%, 7.12% and 1.73%. CONCLUSION: This study constitutes the first report of CL in the study areas, as well as the coexistence of L. tropica and L. major in these rural localities. Local transmission of CL is highly probable, as indicated by the prevalence of the two proven vectors of L. major and L. tropica. To control the spread of this disease, our results suggest the use of highly sensitive molecular methods to detect CL cases in potential leishmaniasis foci, which will improve surveillance.
背景与目的：利什曼病是一种由利什曼原虫引起的被忽视的热带传染病，影响人类和动物。在摩洛哥，皮肤利什曼病已大幅蔓延到新地区。仅限于活动焦点的监测可能低估了皮肤利什曼病（CL）的发生。本研究旨在调查摩洛哥中部 Youssoufia 省农村地区的 CL 局部传播情况，该地区可能是 CL 的焦点。
方法：为此，在该地区进行了寄生虫学、分子学和昆虫学调查。数据收集涉及潜在的媒介和人类病例。因此，在 Youssoufia 省的三个地区检查了 402 名疑似利什曼病病变的患者。在这些相同的地点，在 6 个月期间，每月一晚使用 CDC 灯陷阱和粘性纸收集了 983 只沙蝇。这些沙蝇均使用摩洛哥鉴定钥匙进行形态学鉴定。
结果：结果表明，在 402 个人口中，25 个皮肤病变中，有 18 个通过 kDNA 巢式 PCR 证实为 CL 阳性患者，其中仅 25%通过直接检查呈阳性。在研究区域中，鉴定出利什曼原虫热带亚种和利什曼原虫 major 是 CL 的病原体。直接寄生虫学检查显示敏感性低（27.78%），特别是对于 L. major，尽管其特异性评估为 100%。关于昆虫学结果，在研究区域中收集了两种摩洛哥沙蝇属：Phlebotomus（75.28%）和 Sergentomyia（24.72%）。证明是 L. major 传播媒介的 Phlebotomus（P）papatasi 是最丰富的物种（33.98%），其次是确认的 L. tropica 传播媒介 Paralongicollum sergenti（22.58%）；而 Sergentomyia（S）minuta、P. longicuspis、S. fallax 和 P. kazeruni 的采集量分别为 17.60%、16.99%、7.12%和 1.73%。
结论：本研究首次报道了研究地区的 CL，以及这两种农村地区 L. tropica 和 L. major 的共存。由于两种证实的 L. major 和 L. tropica 传播媒介的存在，CL 的局部传播极有可能发生。为了控制这种疾病的传播，我们的结果表明，在潜在的利什曼病焦点中使用高度敏感的分子方法来检测 CL 病例，这将改善监测。
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