Possible introduction of Leishmania tropica to urban areas determined by epidemiological and clinical profiles of patients with cutaneous leishmaniasis in Casablanca (Morocco)
Possible introduction of Leishmania tropica to urban areas determined by epidemiological and clinical profiles of patients with cutaneous leishmaniasis in Casablanca (Morocco)
复制标题
DOI：
10.1016/j.parepi.2019.e00129
复制
发表时间：
2020-05-01
影响因子：
3.2
通讯作者：
Riyad, Myriam
中科院分区：
文献类型：
--
作者：
Baghad, Bouchra;Razanapinaritra, Rojosoa;Riyad, Myriam
利什曼病是由原虫利什曼原虫寄生虫引起的一组传染病，通过受感染的白蛉叮咬传播。这些疾病的异质性受到寄生特性和宿主因素的双重影响。皮肤利什曼病是摩洛哥的一个主要公共卫生问题。其中，CL的地理扩展（特别是由热带利什曼原虫引起的CL），病变的异质外观和诊断CL的困难导致CL的晚期诊断和患者的延迟治疗。因此，本研究的主要目的是描述在卡萨布兰卡（摩洛哥）诊断的CL患者的流行病学和临床概况，这是一个非CL流行地区。在2010年至2016年期间进行了一项横断面研究，在此期间，通过信息表收集了符合纳入标准的患者的流行病学和临床数据。然后，对每位患者采集样本进行寄生虫学和分子诊断，仅将聚合酶链反应阳性和基因分型阳性的患者纳入研究。共分型106例，其中热带乳杆菌61例（57.5%），大乳杆菌38例（35.9%），婴儿乳杆菌7例（6.6%）。所有年龄组的人都受到影响。以热带L为病原体的CL病例在0 ~ 9岁儿童中诊断最多（p = 0.005），而以大L为病原体的CL病例在老年患者中诊断最多（p = 0.004）。多因素logistic回归分析显示，两个临床变量与热带乳杆菌引起的CL有显著相关：病变大小（p = 0.002）和面部病变的发生（p = 0.005）。此外，我们的调查结果强调了前往流行地区旅行时利什曼原虫感染的关联。CL患者感染热带乳杆菌的大量地方性疫点表明，这种形式有传播和产生流行病的趋势，使年轻人更容易感染该疾病。摩洛哥由热带L虫引起的CL流行状况以及人口从农村向城市地区迁移的增加表明，该物种可能被引入城市地区。(C) 2020作者。由爱思唯尔有限公司代表世界寄生虫学家联合会出版。
Leishmaniases are a group of infectious diseases caused by protozoan Leishmania parasites and are transmitted by the bites of infected phlebotomine sandflies. The heterogeneity of these diseases is influenced by both parasitic properties and host factors. Cutaneous leishmaniasis (CL) is a major public health problem in Morocco. where the geographical expansion of a (particularly CL caused by Leishmania tropica), the heterogeneous appearance of lesions and the difficulty in diagnosing CL contribute to late diagnosis of CL and delayed treatment of patients. Therefore, the main objective of this study was to describe the epidemiological and clinical profiles of patients with CL diagnosed in Casablanca (Morocco), which is a non-endemic area for CL. A cross-sectional study was conducted between 2010 and 2016, during which epidemiological and clinical data were collected from patients that met the inclusion criteria through an information sheet. Then, samples were obtained from each patient for parasitological and molecular diagnosis, and only patients with positive polymerase chain reaction and genotyping results were included in the study. Overall, 106 cases of CL were genotyped, of which 61 (57.5%) were caused by L. tropica, 38 (35.9%) by L major and 7 (6.6%) by L. infantum. While all age groups were affected. CL cases wherein L tropica was the causative agent were most frequently diagnosed in children aged 0-9 years (p = 0.005), whereas those caused by L. major were more frequently diagnosed in elderly patients (p = 0.004). Multivariate logistic regression analysis showed that two clinical variables were significantly associated with CL caused by L. tropica: lesion size (p = 0.002) and occurrence of lesion on the face (p = 0.005). Furthermore, the results of our survey highlighted the association of Leishmania infection when travelling to endemic areas. The high number of endemic foci where patients with CL were infected with L. tropica illustrated the tendency of this form to spread and generate epidemics, exposing young people to a greater degree to the disease. The epidemic status of CL caused by L tropica in Morocco and the increased movement of the population from rural to urban areas indicate a possible introduction of this species to urban areas. (C) 2020 The Authors. Published by Elsevier Ltd on behalf of World Federation of Parasitologists.