Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-18T07:57:52.440Z Has data issue: false hasContentIssue false
  • English
  • Français

Epidemiological and pathological characteristics of Cutaneous Leishmaniasis from Baluchistan Province of Pakistan

Published online by Cambridge University Press:  23 December 2020

Aisha Khan ,
Rawan Sajid ,
Shaista Gul ,
Ashiq Hussain ,
Mohammad Tahir Zehri ,
Shumaila Naz ,
Sami Simsek Open the ORCID record for Sami Simsek [Opens in a new window] ,
Shahid Waseem ,
Muhammad Sohail Afzal  and
Syed Kamran Ul Hassan Naqvi
...Show all authors
Aisha Khan
Affiliation:
Department of Biosciences, COMSATS University Islamabad, Park Road, Chak Shahzad, Islamabad, Pakistan
Rawan Sajid
Affiliation:
Department of Biosciences, COMSATS University Islamabad, Park Road, Chak Shahzad, Islamabad, Pakistan
Shaista Gul
Affiliation:
Department of histopathology, Bolan Medical Complex Hospital, Quetta, Pakistan
Ashiq Hussain
Affiliation:
Department of Microbiology, Bolan Medical Complex Hospital, Quetta, Pakistan
Mohammad Tahir Zehri
Affiliation:
Department of Microbiology, Bolan Medical Complex Hospital, Quetta, Pakistan
Shumaila Naz
Affiliation:
Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Pakistan
Sami Simsek
Affiliation:
Department of Parasitology, Firat University, Elazig, Turkey
Shahid Waseem
Affiliation:
Alpha Genomics Pvt. Ltd. Plot 4-C, Danyal Plaza, Block A, Main Double Road, PWD, Islamabad, Pakistan
Muhammad Sohail Afzal
Affiliation:
Department of Life Sciences, University of Management & Technology (UMT), Lahore, Pakistan
Syed Kamran Ul Hassan Naqvi
Affiliation:
Department of Biosciences, COMSATS University Islamabad, Park Road, Chak Shahzad, Islamabad, Pakistan
Muhammad Qasim
Affiliation:
Department of Economics, Finance and Statistics, Jönköping International Business School, Jönköping University, Jönköping, Sweden
Haroon Ahmed*
Affiliation:
Department of Biosciences, COMSATS University Islamabad, Park Road, Chak Shahzad, Islamabad, Pakistan
*
Author for correspondence: Haroon Ahmed, E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Cutaneous Leishmaniasis (CL) is considered a neglected tropical disease which in Pakistan can now be considered as a growing public health problem. The exact figures on the magnitude of the disease are lacking both at the national and regional level and only a few health centres are available for diagnosis of CL. The present study was designed to identify the epidemiology of CL infection from August 2018 to December 2019 and to assess clinical aspects of CL in Baluchistan Province of Pakistan. A total of 4072 clinically suspected CL cases were analysed statistically. The highest number of CL cases were reported in May, followed by April, January and then July, February and June and the lowest number of cases were observed in March and November. The highest prevalence rate was found in males where 38% of reported cases were aged 0–9 years. The majority (24.4%) of lesions were found on the hands followed by the face in which cheeks, ears and nose were the effected organs. About 50% of the participants have single lesion while 14% of the participants had two and nearly 3% of the participants have six lesions. The atypical clinical presentations were observed in Baluchistan and common unusual presentations were lupus erythematosus. The study findings suggest that more epidemiological studies and health education campaigns are needed for the population awareness regarding CL in Baluchistan. It is recommended that risk factors should be evaluated to establish control and management strategies to prevent disease at the individual and community level.

Keywords

Clinical featuresCutaneous LeishmaniasisLeishmania tropicaPakistan
Type
Research Article
Information
Parasitology , Volume 148 , Issue 5 , April 2021 , pp. 591 - 597
Check for updates
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Aara, N, Khandelwal, K, Bumb, RA, Mehta, RD, Ghiya, BC, Jakhar, R, Dodd, C, Salotra, P and Satoskar, AR (2013) Clinco-epidemiologic study of cutaneous leishmaniasis in Bikaner, Rajasthan, India. American Journal of Tropical Medicine and Hygiene 89, 111–115.CrossRefGoogle ScholarPubMed
Abeijon, C, Kashino, SS, Silva, FO, Costa, DL, Fujiwara, RT, Costa, CH and Campos-Neto, A (2012) Identification and diagnostic utility of Leishmania infantum proteins found in urine samples from patients with visceral leishmaniasis. Clinical and Vaccine Immunology 19, 935–943.CrossRefGoogle ScholarPubMed
Afghan, AK, Kassi, M, Kasi, PM, Ayub, A, Kakar, N and Marri, SM (2011) Clinical manifestations and distribution of cutaneous leishmaniasis in Pakistan. Journal of Tropical Medicine 359145, 8 pages.Google Scholar
Alavinia, SM, Arzamani, K, Reihani, MH and Jafari, J (2009) Some epidemiological aspects of cutaneous leishmaniasis in Northern Khorasan Province, Iran. Journal of Arthropod-Borne Diseases 3, 50.Google ScholarPubMed
Alvar, J, Yactayo, S and Bern, C (2006) Leishmaniasis and poverty. Trends in Parasitology 22, 552–557.CrossRefGoogle ScholarPubMed
Alvar, J, Vélez, ID, Bern, C, Herrero, M, Desjeux, P, Cano, J, Jannin, J and den Boer, M and WHO Leishmaniasis Control Team (2012) Leishmaniasis worldwide and global estimates of its incidence. PLoS ONE 7, e35671.CrossRefGoogle ScholarPubMed
Antinori, S, Schifanella, L and Corbellino, M (2012) Leishmaniasis: new insights from an old and neglected disease. European Journal of Clinical Microbiology & Infectious Diseases 31, 109–118.CrossRefGoogle ScholarPubMed
Ayub, S, Gramiccia, M, Khalid, M, Mujtaba, G and Bhutta, RA (2003) Cutaneous leishmaniasis in Multan: species identification. Journal of Pakistan Medical Association 53, 445–447.Google ScholarPubMed
Bacellar, O, Lessa, H, Schriefer, A, Machado, P, de Jesus, AR, Dutra, WO, Gollob, KJ and Carvalho, EM (2002) Up-regulation of Th1-type responses in mucosal leishmaniasis patients. Infection and Immunity 70, 6734–6740.CrossRefGoogle ScholarPubMed
Bari, AU (2008) Clinical spectrum of nasal leishmaniasis in Muzaffarabad. Journal of College of Physicians and Surgeons Pakistan 19, 146–149.Google Scholar
Bari, AU and Raza, N (2010) Lupoid cutaneous leishmaniasis: a report of 16 cases. Indian Journal of Dermatology, Venereology and Leprology 76, 85.CrossRefGoogle Scholar
Bhutto, AM, Soomro, RA, Nonaka, S and Hashiguchi, Y (2003) Detection of new endemic areas of cutaneous leishmaniasis in Pakistan: a 6-year study. International Journal of Dermatology 42, 543–548.CrossRefGoogle ScholarPubMed
Bhutto, AM, Soomro, FR, Baloch, JH, Matsumoto, J, Uezato, H, Hashiguchi, Y and Katakura, K (2009) Cutaneous leishmaniasis caused by Leishmania (L.) major Infection in Sindh province, Pakistan. Acta Tropica 111, 295–298.CrossRefGoogle ScholarPubMed
Blum, J, Desjeux, P, Schwartz, E, Beck, B and Hatz, C (2004) Treatment of cutaneous leishmaniasis among travellers. Journal of Antimicrobial Chemotherapy 53, 158–166.CrossRefGoogle ScholarPubMed
Carvalho, GM, Filho, JDA, Falcao, AL, Rocha Lima, AC and Gontijo, CM (2008) Naturally infected Lutzomyia sand flies in a Leishmania-endemic area of Brazil. Vector-Borne and Zoonotic Diseases 8, 407–414.CrossRefGoogle Scholar
Chaudhary, RG, Bilimoria, FE and Katare, SK (2008) Diffuse cutaneous leishmaniasis: co-infection with human immunodeficiency virus (HIV). Indian Journal of Dermatology, Venereology and Leprology 74, 641.CrossRefGoogle Scholar
Croft, SL, Sundar, S and Fairlamb, AH (2006) Drug resistance in leishmaniasis. Clinical Microbiology Reviews 19, 111–126.CrossRefGoogle ScholarPubMed
de Paiva-Cavalcanti, M, de Morais, RCS, Pessoa-e-Silva, R, Trajano-Silva, LAM, da Cunha Gonçalves-de-Albuquerque, S, Tavares, DDHC, Brelaz-de-Castro, MCA, e Silva, RDF and Pereira, VRA (2015) Leishmaniases diagnosis: an update on the use of immunological and molecular tools. Cell & Bioscience 5, 31.CrossRefGoogle ScholarPubMed
Desjeux, P (2004) Leishmaniasis: current situation and new perspectives. Comparative Immunology, Microbiology & Infectious Diseases 27, 305–318.CrossRefGoogle ScholarPubMed
de Souza, VL, Veras, PS, Welby-Borges, M, Silva, T, Leite, BR, Ferraro, RB, Meyer-Fernandes, JR, Barral, A, Costa, JML and de Freitas, LA (2011) Immune and inflammatory responses to Leishmania amazonensis isolated from different clinical forms of human leishmaniasis in CBA mice. Memórias do Instituto Oswaldo Cruz 106, 23–31.CrossRefGoogle Scholar
de Souza, A, Marins, DSS, Mathias, SL, Monteiro, LM, Yukuyama, MN, Scarim, CB, Löbenberg, R and Bou-Chacra, NA (2018) Promising nanotherapy in treating leishmaniasis. International Journal of Pharmaceutics 547, 421–431.CrossRefGoogle ScholarPubMed
Ejaz, A, Raza, N, Din, QU and Bux, H (2008) Outbreak of cutaneous leishmaniasis in Somniani, Balochistan–implementation of preventive measures for deployed personnel of armed forces. Journal of Pakistan Association of Dermatologist 18, 220–225.Google Scholar
Elmahallawy, EK, Martínez, AS, Rodriguez-Granger, J, Hoyos-Mallecot, Y, Agil, A, Mari, JMN and Fernández, JG (2014) Diagnosis of leishmaniasis. Journal of Infection in Developing Countries 8, 961–972.CrossRefGoogle ScholarPubMed
Firdous, R, Yasinzai, M and Ranja, K (2009) Efficacy of glucantime in the treatment of Old World cutaneous leishmaniasis. International Journal of Dermatology 48, 758–762.CrossRefGoogle ScholarPubMed
Gadisa, E, Tsegaw, T, Abera, A, Elnaiem, DE, den Boer, M, Aseffa, A and Jorge, A (2015) Eco-epidemiology of visceral leishmaniasis in Ethiopia. Parasites and Vectors 8, 381.CrossRefGoogle ScholarPubMed
Galgamuwa, LS, Sumanasena, B, Yatawara, L, Wickramasinghe, S and Iddawela, D (2017) Clinico-Epidemiological patterns of Cutaneous Leishmaniasis patients attending the Anuradhapura teaching hospital, Sri Lanka. Korean Journal of Parasitology 55, 1.CrossRefGoogle ScholarPubMed
Georgiadou, SP, Makaritsis, KP and Dalekos, GN (2015) Leishmaniasis revisited: current aspects on epidemiology, diagnosis and treatment. Journal of Translational Medicine 3, 43–50.Google Scholar
Ghatee, MA, Taylor, WR and Karamian, M (2020) The geographical distribution of Cutaneous Leishmaniasis causative agents in Iran and its neighboring countries, a review. Frontiers in Public Health 8, 11.CrossRefGoogle ScholarPubMed
Hussain, M, Munir, S, Khan, TA, Khan, A, Ayaz, S, Jamal, MA, Ahmed, I, Aziz, S, Watany, N and Kasbari, M (2018) Epidemiology of cutaneous leishmaniasis outbreak, Waziristan, Pakistan. Emerging Infectious Diseases 24, 159.CrossRefGoogle ScholarPubMed
Iddawela, D, Vithana, SMP, Atapattu, D and Wijekoon, L (2018) Clinical and epidemiological characteristics of cutaneous leishmaniasis in Sri Lanka. BMC Infectious Diseases 18, 108.CrossRefGoogle ScholarPubMed
Iftikhar, N, Bari, I and Ejaz, A (2003) Rare variants of cutaneous leishmaniasis: whitlow, paronychia and sporotrichoid. International Journal of Dermatology 42, 807–809.CrossRefGoogle ScholarPubMed
Irum, S, Aftab, M, Khan, A, Naz, S, Simsek, S, Habib, A, Afzal, MS, Nadeem, MA, Qasim, M and Ahmed, H (2021) Cutaneous Leishmaniasis (CL): a cross-sectional community based survey on knowledge, attitude and practices in a highly endemic area of Waziristan (KPK Province), Pakistan. Acta Tropica 213, 105746.CrossRefGoogle Scholar
Kakarsulemankhel, JK (2004) Present situation of cutaneous leishmaniasis in Balochistan, Pakistan. Pakistan Journal of Biological Sciences 7, 698–702.Google Scholar
Kassi, M and Kasi, PM (2005) Diagnosis of cutaneous leishmaniasis by fine needle aspiration cytology: a report of 66 cases. Tropical Doctor 35, 50–51.CrossRefGoogle ScholarPubMed
Kassi, M, Tareen, I, Qazi, A and Kasi, PM (2004) Fine-needle aspiration cytology in the diagnosis of cutaneous leishmaniasis. Annals of Saudi Medicine 24, 93–97.CrossRefGoogle Scholar
Kassi, M, Kassi, M, Afghan, AK, Rehman, R and Kasi, PM (2008) Marring leishmaniasis: the stigmatization and the impact of cutaneous leishmaniasis in Pakistan and Afghanistan. PLOS Neglected Tropical Diseases 2, e259.CrossRefGoogle ScholarPubMed
Katakura, K (2009) Molecular epidemiology of leishmaniasis in Asia (focus on cutaneous infections). Current Opinion in Infectious Diseases 22, 126–130.CrossRefGoogle Scholar
Khan, NH, ul Bari, A, Hashim, R, Khan, I, Muneer, A, Shah, A, Wahid, S, Yardley, V, O'Neil, B and Sutherland, CJ (2016) Cutaneous leishmaniasis in Khyber Pakhtunkhwa province of Pakistan: clinical diversity and species-level diagnosis. American Journal of Tropical Medicine and Hygiene 95, 1106–1114.CrossRefGoogle ScholarPubMed
Khan, A, Afzal, MS and Ahmed, H (2019) Leishmaniasis in Pakistan: a call for action. Travel Medicine and Infectious Disease 32, 101516.CrossRefGoogle Scholar
Llanos-Cuentas, A, Tulliano, G, Araujo-Castillo, R, Miranda-Verastegui, C, Santamaria-Castrellon, G, Ramirez, L, Lazo, M, De Doncker, S, Boelaert, M, Robays, J and Dujardin, JC (2008) Clinical and parasite species risk factors for pentavalent antimonial treatment failure in cutaneous leishmaniasis in Peru. Clinical Infectious Diseases 46, 223–231.CrossRefGoogle ScholarPubMed
Mughal, TM (2014) Cutaneous Leishmaniasis and assessment of environmental risk factors in Mirpur AJK. Journal of Rawalpindi Medical College 18, 110–113.Google Scholar
Nawaz, R, Khan, AM, Khan, SU and Rauf, A (2010) Frequency of cutaneous leishmaniasis in an Afghan refugee camp at Peshawar. Gomal Journal of Medical Sciences 8, 16–19.Google Scholar
Özbilgin, A, Töz, S, Harman, M, Topal, SG, Uzun, S, Okudan, F, Güngör, D, Erat, A, Ertabaklar, H, Ertuğ, S and Gündüz, C (2019) The current clinical and geographical situation of cutaneous leishmaniasis based on species identification in Turkey. Acta Tropica 190, 59–67.CrossRefGoogle ScholarPubMed
Qureshi, NA, Ali, A, Rashid, U and Ali, N (2016) Prevalence of Leishmania tropica in schoolboys of Khyber agency, FATA near Pak-Afghan border. Acta Tropica 164, 90–94.CrossRefGoogle ScholarPubMed
Rahman, HU and Rehman, AU (2017) Cutaneous leishmaniasis in Dir Lower District, North-West Pakistan: epidemiology and treatment response. Journal of Pakistan Association of Dermatologists 27, 353–362.Google Scholar
Salman, SM, Rubeiz, NG and Kibbi, AG (1999) Cutaneous leishmaniasis: clinical features and diagnosis. Clinics in Dermatology 17, 291–296.CrossRefGoogle ScholarPubMed
Shaheen, N, Qureshi, NA, Qureshi, MZ, Fatima, H, Afzal, M and Alhewairini, SS (2020) Molecular epidemiological survey of cutaneous leishmaniasis from Azad Jammu and Kashmir, Pakistan. Acta Tropica, 206, 105434.CrossRefGoogle ScholarPubMed
Shakila, A, Bilqees, FM, Salim, A and Moinuddin, M (2006) Geographical distribution of cutaneous leishmaniasis and sand flies in Pakistan. Turkish Journal of Parasitology 30, 1–6.Google Scholar
Shamsuddin, S, Mengal, JA, Gazozai, S, Mandokhail, ZK, Kasi, M, Muhammad, N and Ahmad, SB (2017) Atypical presentation of cutaneous leishmaniasis in the native population of Balochistan. Journal of Pakistan Association of Dermatologists 16, 196–200.Google Scholar
Simon Brooker, NM, Adil, K, Agha, S, Reithinger, R, Rowland, M, Ali, I and Kolaczinski, J (2004) Leishmaniasis in refugee and local Pakistani populations. Emerging Infectious Diseases 10, 1681.CrossRefGoogle Scholar
Sinha, PK, Pandey, K and Bhattacharya, SK (2005) Diagnosis & management of leishmania/HIV co-infection. Indian Journal of Medical Research 121, 407–414.Google ScholarPubMed
Talari, SA, Talaei, R, Shajari, G, Vakili, Z and Taghaviardakani, A (2006) Childhood cutaneous leishmaniasis: report of 117 cases from Iran. Korean Journal of Parasitology 44, 355.CrossRefGoogle ScholarPubMed
Torres-Guerrero, E, Quintanilla-Cedillo, MR, Ruiz-Esmenjaud, J and Arenas, R (2017) Leishmaniasis: a review. F1000Research 6, 750.CrossRefGoogle ScholarPubMed
Tsukayama, P, Núñez, JH, De Los Santos, M, Soberón, V, Lucas, CM, Matlashewski, G, Llanos-Cuentas, A, Ore, M, Baldeviano, GC, Edgel, KA and Lescano, AG (2013) A FRET-based real-time PCR assay to identify the main causal agents of New World tegumentary leishmaniasis. PLOS Neglected Tropical Diseases 7, e1956.CrossRefGoogle ScholarPubMed
Uzun, S, Gürel, MS, Durdu, M, Akyol, M, Fettahlıoğlu Karaman, B, Aksoy, M, Aytekin, S, Borlu, M, İnan Doğan, E, Doğramacı, ÇA and Kapıcıoğlu, Y (2018) Clinical practice guidelines for the diagnosis and treatment of cutaneous leishmaniasis in Turkey. International Journal of Dermatology 57, 973–982.CrossRefGoogle ScholarPubMed
Weirather, JL, Jeronimo, SM, Gautam, S, Sundar, S, Kang, M, Kurtz, MA, Haque, R, Schriefer, A, Talhari, S, Carvalho, EM and Donelson, JE (2011) Serial quantitative PCR assay for detection, species discrimination, and quantification of Leishmania spp. in human samples. Journal of Clinical Microbiology 49, 3892–3904.CrossRefGoogle ScholarPubMed
World Health Organization (2010) Control of the Leishmaniases: Report of a Meeting of the WHO Expert Committee on the Control of Leishmaniases, 22–26 March 2010. Geneva: World Health Organization.Google Scholar
World Health Organization (2020) Leishmaniasis. https://www.who.int/leishmaniasis/burden/en/ (Accessed 19 March 2020).Google Scholar
Yohannes, M, Abebe, Z and Boelee, E (2019) Prevalence and environmental determinants of cutaneous leishmaniasis in rural communities in Tigray, northern Ethiopia. PLOS Neglected Tropical Diseases 13, e0007722.CrossRefGoogle ScholarPubMed
Zijlstra, EE (2016) The immunology of post-kala-azar dermal leishmaniasis (PKDL). Parasites Vectors 9, 464.CrossRefGoogle Scholar