Geographical Distribution and New Situation of Leishmania Species after the Control of Cutaneous Leishmaniasis Foci in Errachidia Province, Morocco, in 2014.

In Errachidia province, the incidence of cutaneous leishmaniasis (CL) has increased over the past decade and it was higher in 2010 (860.34 per 100,000 inhabitants), with 3445 cases. The number of cases declined sharply and decreased from 3445 cases in 2010 to 8 cases in 2014 following the control action plan interventions. The total of patients was diagnosed only on clinical basis and the lesions were considered caused by L. major. The epidemiological study was conducted between 2001 and 2014 and the molecular detection of CL was studied to identify the circulating parasite species in this province by using the ITS1-PCR-RFLP methods. In 2010, the molecular identification of 11 samples revealed the presence of L. major in the most affected circles: Goulmima, Er-Rissani, and Errachidia. In 2014 the molecular characterization of 7 among 8 cases reported in this year showed the presence of L. tropica in Errachidia circle. This is the first molecular identification of L. tropica in Errachidia province. The detection of this species after the intensified control measures strategies suggests that it was probably dissipated through the dominance of L. major.

Epidemiological characteristics of a new focus of cutaneous leishmaniasis caused by Leishmania tropica in Settat, Morocco.

A new emerging focus of human cutaneous leishmaniasis (HCL) caused by Leishmania tropica was identified within the province of Settat. This study was performed in order to analyze the reasons of the extension of CL in this area, and to describe the clinico-epidemiological characteristic of this emerging focus during 2007-2012. A total of 553 suspected cases of CL were diagnosed in laboratory of Settat, controlled and confirmed in reference national laboratory of leishmaniasis in Rabat. Leishmania parasite is found in 356 cases. Most of them (33.89%) were recorded in localities of Ouled Ghalem (110 cases) and Laamarcha (102 cases) of El Borouj sector. The lesions were typically small, dry and mostly located on the face and extremities. Majority of infection (25%) was recorded among children under 11 years old, and female (72%). Strains of L. tropica were identified by PCR ITS1 from positive slides and zymodeme MON-102 was typed using isoenzyme technique on starch gel electrophoresis.

Molecular epidemiological study of cutaneous leishmaniasis in Beni Mellal and Fquih Ben Saleh provinces in Morocco.

Leishmaniases are parasitic diseases frequent in the Mediterranean Basin. Cutaneous leishmaniasis (CL) has been recently emerged in several new foci, causing a public health problem in Morocco. This study was performed to evaluate the epidemiological status of cutaneous leishmaniasis (CL) in Beni Mellal and Fquih Ben Saleh Provinces and to identify the causative agent. A total of 584 (56% female, 44% male) confirmed cases of CL were enrolled during the study period 2000-2012. Majority of cases (56%) were recorded in three sectors: Zaouiat Cheikh, Beni Mellal and Oulad Ayad. Fisher statistical test showed that there is a significant effect of the total cases of CL affected in the 185 localities. The age distribution of CL cases was relatively stable, with the majority of patients (62.34%) aged less than 9 years old with significant differences (p-value<2.2e-16). CL lesions were mostly located on the face (89%). The average number of lesions per patient was 1.38. Leishmania tropica was identified as the causative agent based on species-specific ITS1-PCR-RFLP assay.

Coexistence of Leishmania tropica and Leishmania infantum in Sefrou province, Morocco.

Cutaneous leishmaniasis (CL) has been recently emerged in new foci, posing a public health problem. Increasing cases of CL have been reported during recent years in Sefrou province, a previously non-endemic area. The present study was designed for epidemiological and parasitological characterization of the disease for the first time in this area. The results of a retrospective analysis of CL cases reports, between 2000 and 2011 showed that the incidence was estimated to 463/100,000 inhabitants/year, with a total of 1242 cases were notified from 1997 to 2011. Most patients were infected in the sector El Menzel (22.81%) and Sefrou (20.51%). Other cases have been reported in the 15 other sectors, reflecting the geographical spread of the disease. The highest rate lesions were found in the age group of 9 years or less with significant differences (p-value<2.2e-16) comparing to the older age groups. The most affected lesion was localized in the face (64%). The average number of lesions per patient was 2.35 with a maximum of 5 lesions. The clinical aspects of lesions were mostly crusted. The causative agents of CL in this province were identified as the coexistence of L. tropica and L. infantum by species-specific ITS1-PCR-RFLP assay. CL remains an emergent disease in Sefrou with an incidence and a continuously geographical spread. Recent environmental changes, auspicious to vectors had probably contributed to that situation.