Prevalence of Cutaneous Leishmaniasis in Districts of High and Low Endemicity in Mali.
Prevalence of Cutaneous Leishmaniasis in Districts of High and Low Endemicity in Mali.
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DOI：
10.1371/journal.pntd.0005141
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发表时间：
2016-11
影响因子：
3.8
通讯作者：
Doumbia S
中科院分区：
文献类型：
--
作者：
Traoré B;Oliveira F;Faye O;Dicko A;Coulibaly CA;Sissoko IM;Sibiry S;Sogoba N;Sangare MB;Coulibaly YI;Traore P;Traore SF;Anderson JM;Keita S;Valenzuela JG;Kamhawi S;Doumbia S
历史上，马里西萨赫勒干旱地区是由大型利什曼原虫引起的皮肤利什曼病（CL）高度流行的地区，而该国南部稀树草原森林却很少报告病例。在这里，我们报告了马里 3 个生态不同地区（干燥萨赫勒地区、北部稀树草原和南部稀树草原森林地区）CL 感染的基线流行率。我们从 6 个村庄中的每一个随机选择的 50 至 60 个家庭中筛选了 195 至 250 名受试者（其中 4 个来自凯耶斯地区西萨赫勒迪马区，1 个来自科洛卡尼中部地区，1 个来自锡卡索地区科洛迪巴南部稀树草原区）。筛查包括： 1] 利什曼原虫皮肤测试 (LST)，用于检测是否接触利什曼原虫寄生虫； 2] 对可疑病变进行临床检查，然后通过 PCR 进行验证，3] 手指刺血样本以确定白蛉唾液的抗体水平。迪马西部地区的 LST 阳性率 (49.9%) 高于科洛卡尼 (24.9%)，而科隆迪巴 (2.6%) 则低得多。在迪马，2-5 岁和 41-65 岁年龄组的 LST 阳性率分别从 13.8% 上升到 88%。所有 8 例 PCR 确诊的大型利斯特氏菌 CL 病例均在 18 岁以下的受试者中诊断，且均为 Diema 区的居民。通过抗唾液抗体滴度测量，生活在这三个地区的个体遭受白蛉叮咬的情况相当。然而，LST 阳性个体的抗体滴度显着较高（P<0.0001）。总之，CL 传播在马里西部地区仍然活跃，该地区的病变主要流行于 18 岁以下儿童。 LST 阳性与白蛉唾液蛋白抗体水平较高相关，表明它们有可能成为马里 CL 获得的风险标记。人们普遍认为利什曼病等被忽视的热带病（NTDS）集中在贫困人口中。它影响着多达 1200 万人，全球每年新增 1.5 至 200 万病例。根据利什曼原虫的种类，宿主可能会患上皮肤利什曼病 (CL) 或内脏利什曼病。在马里，由大型利什曼原虫引起的 CL 通过受感染的白蛉叮咬传播。本研究的目的是确定 LST 阳性的基线患病率、之前接触利什曼原虫寄生虫的测试、CL 病变的患病率以及抗 P 水平。杜博斯克奇唾液抗体，表明生活在马里西部、中部和南部这三个生态不同的研究地点的人群中是否接触过病媒叮咬。迪马西部地区的 LST 阳性率 (85.1%) 高于科洛卡尼 (24.6%)，而科隆迪巴 (2.7%) 则低得多。所有 8 例 PCR 确诊的大型利斯特氏菌 CL 病例均在 18 岁以下的受试者中诊断，且均为 Diema 区的居民。通过抗唾液抗体滴度测量，确定了生活在这三个地区的个体暴露于白蛉叮咬的情况，并且LST阳性个体的抗体滴度较高（P<0.0001）。这项研究的结果提供了这些地区 CL 患病率的最新信息。
Historically the western sahelian dry regions of Mali are known to be highly endemic for cutaneous leishmaniasis (CL) caused by Leishmania major, while cases are rarely reported from the Southern savanna forest of the country. Here, we report baseline prevalence of CL infection in 3 ecologically distinct districts of Mali (dry sahelian, north savanna and southern savanna forest areas). We screened 195 to 250 subjects from 50 to 60 randomly selected households in each of the 6 villages (four from the western sahelian district of Diema in Kayes region, one from the central district of Kolokani and one from the southern savanna district of Kolodieba, region of Sikasso). The screening consisted of: 1] A Leishmanin Skin Test (LST) for detection of exposure to Leishmania parasites; 2] clinical examination of suspected lesions, followed by validation with PCR and 3] finger prick blood sample to determine antibody levels to sand fly saliva. LST positivity was higher in the western district of Diema (49.9%) than in Kolokani (24.9%) and was much lower in Kolondieba (2.6%). LST positivity increased with age rising from 13.8% to 88% in Diema for age groups 2–5 years and 41–65 years, respectively. All eight PCR-confirmed L. major CL cases were diagnosed in subjects below 18 years of age and all were residents of the district of Diema. Exposure to sand fly bites, measured by anti-saliva antibody titers, was comparable in individuals living in all three districts. However, antibody titers were significantly higher in LST positive individuals (P<0.0001). In conclusion, CL transmission remains active in the western region of Mali where lesions were mainly prevalent among children under 18 years old. LST positivity correlated to higher levels of antibodies to sand fly salivary proteins, suggesting their potential as a risk marker for CL acquisition in Mali. It is generally assumed that neglected tropical diseases (NTDS) such as leishmaniasis are concentrated in poor populations. It affects as many as 12 million people, with 1.5 to 2 million new cases every year around the world. Depending on the species of Leishmania, the host can develop cutaneous leishmaniasis (CL) or visceral leishmaniasis. In Mali, CL caused by Leishmania major is transmitted through the bite of infected sand flies belonging to the species Phlebotomus duboscqi. The objectives of this study were to determine the baseline prevalence of LST positivity, a test of previous exposure to Leishmania parasites, the prevalence of CL lesions, and the level of anti-P. duboscqi salivary antibodies, indicative of exposure to vector bites, in populations living in western, central and southern Mali, three ecologically distinct study sites. LST positivity was higher in the western district of Diema (85.1%) than in Kolokani (24.6%) and was much lower in Kolondieba (2.7%). All eight PCR-confirmed L. major CL cases were diagnosed in subjects below 18 years of age and all were residents of the district of Diema. Exposure to sand fly bites, measured by anti-saliva antibody titers, was established in individuals living in these three districts and antibody titers were higher in LST positive individuals (P<0.0001). The finding of this study provides an update on the prevalence of CL in these regions.
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影响因子：
3.3
作者：
Paz, Carlos;Samake, Sibiry;Doumbia, Seydou
通讯作者：
Doumbia, Seydou
影响因子：
2.4
作者：
Rohousova, I;Ozensoy, S;Volf, P
通讯作者：
Volf, P
DOI：
10.4269/ajtmh.2006.75.744
发表时间：
2006-10-01
影响因子：
3.3
作者：
Bern, Caryn;Amann, Josef;Maguire, James H.
通讯作者：
Maguire, James H.
影响因子：
168.9
作者：
Herwaldt, BL
通讯作者：
Herwaldt, BL
影响因子：
3.8
作者：
Anderson JM;Samake S;Jaramillo-Gutierrez G;Sissoko I;Coulibaly CA;Traoré B;Soucko C;Guindo B;Diarra D;Fay MP;Lawyer PG;Doumbia S;Valenzuela JG;Kamhawi S
通讯作者：
Kamhawi S