MOLECULAR EPIDEMIOLOGY (LEI. Dr Isabel Mauricio, [The LeishEpiNetSA consortium] Schoenian Q Canavate C, Dujardin JC,. Campino LM, Do Monte S, ...
WorldLeish4,
Lucknow, India
#615 C O N T R O L S T R A T E G I E S F O R V I S C E R A L L E I S H M A N I A S I S (VL) A N D M U C O C U T A N E O U S L E I S H M A N I A S I S (MCL) IN S O U T H A M E R I C A : A P P L I C A T I O N S O F M O L E C U L A R E P I D E M I O L O G Y (LEI Dr Isabel Mauricio, [The LeishEpiNetSA consortium] Schoenian Q Canavate C, Dujardin JC, Campino LM, Do Monte S, Oddone R, Arevalo J, Mello N, Feliciangeli D, Cupolillo E London School of Hygiene and Tropical Medicine
isabel,mauricio(5)lshtm.ac,uk
A full a n d detailed u n d e r s t a n d i n g o f t h e t r a n s m i s s i o n cycles a n d e p i d e m i o l o g y o f visceral (VL) a n d m u c o c u t a n e o u s leishmaniasis (MCL) is n e c e s s a r y t o develop disease control a n d surveillance. Molecular epidemiology a n d population genetics can resolve the diversity a n d structure of Leishmania p o p u l a t i o n s . A c c o r d i n g l y a n E U - f u n d e d initiative w a s l a u n c h e d i n 2 0 0 6 t o create a multidisciplinary collaborative project linking 6 E u r o p e a n a n d 6 S o u t h A m e r i c a n partners. T h e a i m s w e r e a) t o apply m o l e c u l a r m e t h o d s t o i m p r o v e u n d e r s t a n d i n g o f t h e e p i d e m i o l o g y o f t h e s u b g e n u s V i a n n i a a n d L. i n f a n t u m ( s y n . L. c h a g a s i ) i n S o u t h A m e r i c a , a n d b ) t o e v a l u a t e k n o w l e d g e , a t t i t u d e s a n d p r a c t i s e s ( K A P ) i n c o m m u n i t i e s a n d a m o n g h e a l t h w o r k e r s . W e h a v e d e v e l o p e d a full r a n g e o f m i c r o s a t e l l i t e ( M L M T ) a n d m u l t i l o c u s s e q u e n c e t y p i n g ( M L S T ) m a r k e r s f o r t h e L . (V.) b r a z i l i e n s i s c o m p l e x a n d f o r L . (V.) g u y a n e n s i s . M L M T a n d M L S T a n a l y s e s h a v e a l s o b e e n e s t a b l i s h e d i n S o u t h A m e r i c a f o r L . ( L . ) infantum, with methods proven b y a previous European network. These methods are n o w being applied f o r 1) elucidating parasite-vector-host relationships and their epidemiological impact 2) assessing the epidemiological importance of recombinant Leishmania genotypes, 3) assessing the spread of treatment resistance and 4 ) comparing the genotypes o f Leishmania isolated f r o m diverse clinical c a s e s of l e i s h m a n i a s i s a n d d r u g susceptible a n d drug-resistant strains. A s u r v e y of k n o w l e d g e , attitude a n d practises a m o n g health professionals and patients has been undertaken in Paraguay, Peru, V e n e z u e l a a n d Brazil. A series o f publications a n d reports will be written to d i s s e m i n a t e findings f r o m the project, linked to s u g g e s t i o n s for i m p r o v e d control strategies. T e c h n o l o g y transfer a n d training, including a w o r k s h o p in V e n e z u e l a t o train y o u n g researchers o n the n e w typing m e t h o d s for Leishmania, have taken place. S o m e outputs o f LeishEpiNetSA are s u m m a r i s e d inother abstracts a t W o r l d L e i s h 4 . T h e co-ordinator (M. A. Miles) or partners a b o v e can be contacted for further information, or through the website http://clioc.ioc.fiocruz.br/comunidade_europeia/Principal.html.
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C U T A N E O U S L E I S H M A N I A S I S IN S O U T H E R N S R I L A N K A Dr Upali Rathnayake.
R.M.U.K.Rathnayake,
RH.Chandrawansa,
T.L.Rathnayake
District director o f H e a l t h services, M a t a r a , Sri L a n k a u r a t h k e @ s l t n e t . l k
A b s t r a c t I n t r o d u c t i o n C u t a n e o u s L e i s h m a n i a s i s ( C L ) h a s b e e n s p o r a d i c i n S r i L a n k a s i n c e its first reported c a s e in 1992. H o w e v e r t h e r e is n o w e v i d e n c e o f a n e m e r g i n g e p i d e m i c o f C L in s o u t h e r n part o f t h e island. R e a s o n s for this situation are not very clear a n d are largely speculative. Objective T o s t u d y t h e d i s e a s e b u r d e n a n d t h e e p i d e m i o l o g i c a l f e a t u r e s of C L in s o u t h e r n p r o v i n c e of Sri L a n k a with a v i e w to r e c o m m e n d preventive m e a s u r e s M e t h o d Analysis of data collected at t h e d e r m a t o l o g y unit o f G e n e r a l hospital M a t a r a f r o m 2 0 0 6 J a n u a r y t o 2 0 0 8 July a n d m a p p i n g t h e m a c c o r d i n g t o health administrative divisions, Medical officer o f health a r e a s a n d public health m i d w i f e areas. Galle district is n o t c o n s i d e r e d in t h e s t u d y a s t h e r e w e r e n o r e p o r t e d c a s e s o f L e i s h m a n i a s i s t o K a r a p i t i y a t e a c h i n g hospital d e r m a t o l o g y clinic f r o m G a l l e district. R e s u l t s Total n u m b e r o f c a s e s = 5 3 4 . Distribution according t o years : 2 0 0 6 - 118, 2 0 0 7 - 2 5 1 , 2 0 0 8 u p t o July - 165, Male/female ratio: 1:1, A g e distribution: < 1 y e a r 1(0.2), 1-10 y 43(8.1), 11-20 y 1 2 6 (23.6), 2 1 - 3 0 y 6 9 (13), 3 1 - 4 0 y 8 9 (16.7), 4 1 - 5 0 y 8 7 (16.2), 5 1 - 6 0 y 6 2 (11.6), 6 1 - 7 0 y 44(8.2), 7 1 - 8 0 y 11(2), 8 1 - 9 0 y 2 (0.4) L o c a t i o n o f the lesion: face 120(22.5), forearm 93(17.4), arm 83(15.5), l e g77(14.4), chest 43(8.1), hand 3 9 (7.3), h e a d a n d n e c k 2 0 (3.7), foot 6(1.1), thigh 3(0.6), a b d o m e n 2(0.4), not recorded 48(9) S m e a r results: positive 3 0 9 ( 5 8 ) , negative 150(28), not r e c o r d e d 65(12.1), awaiting results 7 (1.3), clinically diagnosed 3(0.6). S e a s o n a l variation: 2006,2007,2008 (up t o July) respectively, J a n u a r y 14,26,20; February 5,29,25 M a r c h 20,13,25 April 0,13,19 M a y 5,22,26 J u n e 9,15,21 July 6,8,29 A u g u s t 11,26 September 10,15, October 17,30 November 0,29 December 21,25. Conclusions a n d r e c o m m e n d a t i o n s C u t a n e o u s L e i s h m a n i a s i s is a n e m e r g i n g public health p r o b l e m with a n increasing trend in the recent times. In the absence o f a vaccine, conventional public health w i s d o m should prevail. T h i s w o u l d include health education, vector control, a n d notification o f the disease. 108
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W o r l d Congress o n Leishmaniasis 2 0 0 9
WorldLeish4 T to 7 February 2009 L u c k n o w , India t h
Abstract Book
