Determination of sand fly fauna and molecular detection of Leishmania in sand flies in Antalya Province, Southern Turkey.

Visceral leishmaniasis (VL) and cutaneous leishmaniasis (CL) are diseases transmitted by infected female sand flies. Since the eradication of malaria in Turkey, CL is the main vector-borne disease in the country, with more than 2000 cases per year, making it a significant public health problem. The aims of this study were to carry out an entomological survey in Antalya Province, an endemic area for CL in the Mediterranean Region of Turkey, to identify sand fly fauna and to screen female specimens for the presence of Leishmania parasites (Leishmania infantum, L. tropica, L. major, and L. donovani) using molecular analysis. Sand flies were collected in 42 localities of seven districts in Antalya Province using CDC miniature light traps in two different periods, June 2012 and September 2013. The specimens were kept in 96% ethanol until the dissection was done. The head and genitalia of the specimens were cut for preparing individual slides for species identification. The rest of the body of female specimens was kept separately. The specimens were identified at the species level, and 27 pools were generated according to the locations and species for screening the presence of Leishmania. A commercial kit was used for DNA extractions. Real-time and conventional polymerase chain reaction (PCR) targeting the internal transcribed spacer region (ITS1) were then performed. In total, 1306 specimens comprising nine species belonging to the Phlebotomus genus were collected in the study region, with Phlebotomus neglectus/syriacus (38.82%) the most abundant, followed by P. alexandri (21.67%) and P. tobbi (20.44%). In the 27 pools, Leishmania infantum DNA was detected in four pools containing P. neglectus/syriacus and one pool containing P. tobbi. In conclusion, the sand fly fauna in the Antalya Province is diverse. The probable vector sand fly species are P. neglectus/syriacus and P. tobbi with high dominance (59.26%), which indicates a high risk of CL transmission. The data presented here may help to shed more light on the transmission cycles of the Leishmania parasite in this CL endemic area.

Evaluation of Malaria Cases Detected in Antalya Province between 2012 and 2017

Objective: Malaria is an important infectious disease that is transmitted by female mosquitoes of the genus Anopheles infected with parasites of the genus Plasmodium. In this research, it was aimed to contribute to the ongoing studies on malaria control in Antalya. Methods: In this study, malaria data between 2012-2017 obtained from Antalya Provincial Directorate of Health were used. The patients with malaria were evaluated in terms of the years and months they were detected in, age group, gender, parasite species which were detected and their sources. Results: During the 6-year period, a total of 1905 blood samples were surveyed and 36 (1.89%) patients were reported. The most patients occurred in June and August (5 patients in each month, 13.89%). Of the patients, 94.44% (34 patients) were 15 years old and over. By gender, 83.33% (n=30) of patients were male, 16.67% (n=6) were female. The disease agent responsible for most of the patients with malaria was P. falciparum (80.55%, 29 patients), followed by P. vivax (11.11%, 4 patients), P. ovale (5.56%, 2 patients) and P. malariae (2.78%, 1 patient). All patients with malaria were from abroad. Conclusion: For malaria control, studies on the early diagnosis and treatment of the disease and the integrated mosquito control programs should be uninterruptedly maintained.

Investigation of Susceptibility Levels of Culex pipiens L. (Diptera: Culicidae) Populations to Synthetic Pyrethroids in Antalya Province of Turkey.

BACKGROUND: Culex pipiens L. (Diptera: Culicidae) is an important vector of several pathogens. This mosquito is widely distributed throughout the world. We aimed to determine the susceptibility levels of Cx. pipiens populations to some synthetic pyrethroid insecticides in Antalya, Turkey. METHODS: The immature stages of mosquitoes were collected from eight locations in Alanya, Dösemealti, Kemer, Kumluca, and Manavgat districts of Antalya between Apr and Oct of 2017. Adult susceptibility tests were carried out according to a modified version of the Centers for Disease Control and Prevention bottle bioassay. In the tests, the World Health Organization recommended diagnostic doses; permethrin (0.75%), etofenprox (0.5%), deltamethrin (0.05%) and lambda-cyhalothrin (0.05%) were used. RESULTS: As a result of the susceptibility tests, deltamethrin was the least effective insecticide and it caused 58.78-97.56% mortalities on Cx. pipiens populations while permethrin was the most effective substance that caused 100% mortality on all populations. While all of the tested populations were found susceptible to permethrin, and possible resistant or resistant to deltamethrin. Etofenprox and lambda-cyhalothrin led to 91.54-100% and 93.1-100% mortalities, respectively. CONCLUSION: The possible resistance or resistance to deltamethrin in all the areas is caused by the widespread use of this chemical against pests in agriculture and public health applications for long-term. Moreover, a concordance was found between resistance levels and the intensity of pesticide application in agriculture and public health, and organic and chemical pollution levels in the sampled habitats.

[Cutaneous leishmaniasis and its status in Antalya, Turkey]. / Kutanöz Leishmaniasis ve Antalya Ilindeki Durumu.

OBJECTIVE: Leishmaniasis is a group of diseases, in different clinical forms, caused by the intracellular protozoan parasites, Leishmania species. The disease is transmitted by a female sand fly infected with the parasite sucking blood from people. Cutaneous leishmaniasis (CL) is the most common form of the disease. The aim of this study is to examine the status of CL in the Antalya province and contribute to the prevention of the disease in this region. METHODS: The data of CL cases officially notified in the province between 2005 and 2012 were provided by the Basic Health Statistics Module of Ministry of Health. The cases were evaluated according to months, seasons, years, age groups, gender, and locations. RESULTS: Between 2005 and 2012, 220 CL cases were reported officially. Out of 220 cases, 129 (58.64%) and 91 (41.36%) were male and female, respectively. One hundred and eighteen (53.64%) of the cases were in individuals under 20 years old. The highest rate of cases was determined in May (33 cases, 15%) and also during spring (75 cases, 34.09%), while the lowest rate was obtained in July (11 cases, 5%) and also during summer (46 cases, 20.91%). It was determined that CL cases were generally reported from suburbs and villages of districts of the Antalya province. CONCLUSION: The number of cases has decreased in Antalya in recent years. However, the climate, nature, vegetation cover, socio-economic structure, population mobility and continuous notification of the cases from the certain areas of the province are considered significant risk factors. Therefore, health screenings, public health education and vector control applications should be regularly performed by sectorial cooperation throughout the year.

[Evaluation of malaria cases in Antalya between 2001 and 2011]. / Antalya Ilinde 2001 ile 2011 Yillari Arasindaki Sitma Vakalarinin Degerlendirilmesi.

OBJECTIVE: Malaria is a mosquito-borne infectious disease that is transmitted by female Anopheles mosquitoes to humans when an infected mosquito bites a person. In this research, we examined the epidemiology of malaria using the data provided by the Malaria Control Unit of the Infectious Disease Divison of Antalya Health Directory, from the years 2001 to 2011. METHODS: The cases were evaluated according to age groups, gender, months and parasite species. RESULTS: During this period, a total of 131.989 blood samples were evaluated and 66 malaria cases (0.0005%) were reported, and the highest rate of cases occurred during September. Seventy-four percent (49) of malaria cases were male, 26% (17 cases) were female. The species of malaria parasites were recorded in 86% of cases, of which Plasmodium vivax was the most common (57 cases), with P. falciparum accounting for 14% of cases (9 cases). All P. falciparum cases were found to be imported cases coming to Antalya from other countries. Most of the malaria cases (78.8%) were 15 years old and over. CONCLUSION: We belived that our resarch contributes to the epidemiology of malaria and its prevention in Antalya region.