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      New Clinicoepidemiologic Profile of Cutaneous Leishmaniasis, Morocco

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          Abstract

          During the past 20 years, cutaneous leishmaniasis has emerged as a major public health threat in Morocco. We describe distribution of Leishmania major and L. tropica in Morocco and a new focus of cutaneous leishmaniasis due to L. infantum. We recommend using molecular techniques to diagnose suspected leishmaniasis cases.

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          The leishmaniases as emerging and reemerging zoonoses.

          R.W. Ashford (2000)
          The 20 or so species of Leishmania which have been recorded as human infections are all either zoonotic, or have recent zoonotic origins. Their distribution is determined by that of their vector, their reservoir host, or both, so is dependent on precise environmental features. This concatenation of limiting factors leads to specific environmental requirements and focal distribution of zoonotic or anthroponotic sources. Human infection is dependent on the ecological relationship between human activity and reservoir systems. Examples are available of the emergence of leishmaniasis from the distant past to the present, and can be postulated for the future. These emergences have been provoked by the adoption of new, secondary reservoir hosts, the adoption of new vector species, transport of infection in humans or domestic animals, invasion by humans of zoonotic foci, and irruption of reservoir hosts beyond their normal range. The leishmaniases therefore present an excellent model for emerging disease in general, and for the generation of the principles governing emergence. The model is, however, limited by gaps in our knowledge, usually quantitative, sometimes qualitative, of the structure of reservoir systems.
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            Treatment of cutaneous leishmaniasis among travellers.

            P Desjeux, Charles E Schwartz, C Hatz … (2004)
            Leishmaniasis is endemic in 88 countries on five continents. There are 1-1.5 million cases of cutaneous leishmaniasis reported yearly worldwide. There has been a sharp increase in recorded cases over the last 10 years. Based on geographical distribution, cutaneous leishmaniasis is divided into Old World and New World leishmaniasis. In the past, species could be inferred from geographical setting or determined by performing culture and isoenzyme analysis. The recently developed and now widely available PCR technology allows a rapid diagnosis with determination of most species, and thus enables a species-orientated treatment. While the Old World species mostly cause benign and often self-limiting cutaneous disease, the American species cause a broad spectrum of conditions from benign to severe manifestations, including mucosal involvement. The response to treatment varies according to the species. Therefore, a species-specific approach is proposed. Drugs for systemic and topical treatment are presented and discussed with regard to their application, use and adverse effects. Indications for local or systemic treatment are proposed. Drugs under investigation are also mentioned. An overview of published treatment options and a treatment recommendation is given for each of the most important species. The level of evidence of the studies leading to these recommendations is given.
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              Estimation of population at risk of infection and number of cases of Leishmaniasis.

              P Desjeux, P Deraadt, Alfred Ashford (1992)
              In this paper, Dick Ashford, Philippe Desjeux and Peter deRaadt attempt to estimate the total number of people at risk of acquiring disease caused by infection with Leishmania spp. In many areas a very small risk is distributed among large numbers of people so, although the number of people at risk may be large, the number of infections may be very small. An estimate of the global annual incidence of new cases has also been made. This refers to reported clinical disease and probably grossly underestimates the number of infections. The methods by which the estimates have been made are specified so that they, as well as the estimates themselves, may be criticized and modified with some degree of objectivity.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): September 2007
                Volume: 13
                Issue: 9
                Pages: 1358-1360
                Affiliations
                [* ]Institut National d’Hygiène, Rabat, Morocco
                [† ]Al-Quds University, East Jerusalem, Palestine
                [‡ ]Manchester College, North Manchester, Indiana, USA
                [1 ]These authors contributed equally to this article.
                Author notes
                Address for correspondence: Abedelmajeed Nasereddin, Al-Quds University, Faculty of Medicine, Al-Quds Nutrition and Health Research Center, Abu-Deis, PO Box 20760, East Jerusalem, Palestine; email: abdm@ 123456pob.huji.ac.il
                Article
                Publisher ID: 06-0946
                DOI: 10.3201/eid1309.070946
                PMC ID: 2857267
                PubMed ID: 18252108
                SO-VID: d174c1a0-59bc-4ffc-890e-66daaff64acc
                History
                Categories
                Subject: Dispatch

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: leishmania tropica,cutaneous leishmaniasis,dispatch,polymerase chain reaction,morocco
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: leishmania tropica, cutaneous leishmaniasis, dispatch, polymerase chain reaction, morocco

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