جستجوی مقالات مرتبط با کلیدواژه « cutaneous leishmaniasis » در نشریات گروه « پزشکی »

We aimed to analyze a four-year trend of Cutaneous leishmaniasis (CL) to determine risk levels and hotspots in North-central Ethiopia.

This retrospective study was conducted at Boru Meda Hospital (BMH) from March to April 2023, focusing on CL patients treated at the leishmaniasis treatment center (LTC). Data collected included age, gender, CL type, and other clinical factors. Each patient's origin was traced and geographically mapped by elevation to assess CL risk levels.

There were a total of 573 CL patients reported from 46 districts, with a higher number of male patients (n=356) compared to female patients (n=217) (P <0.001). The median age of the patients was 21 years [15-30], with the highest number of CL cases observed among individuals aged 16 to 30 years. The majority of cases (69%) presented with localized CL (LCL). About 39% of patients had a previous treatment history for CL. A significant clustering of CL cases was observed at elevation of 2301-3300 meters above sea level (χ2:17.5; P <0.001), with the highest incidence (case notification) of 14.2/100,000 population.

Foci of CL, were burdened at higher elevations and no clinical variation were observed between elevation differences. The majority of cases were concentrated in an area covering approximately 21.4% of the total land mass. CL continues to be a significant issue in North-central Ethiopia and has the potential to spread to new areas.

Cutaneous leishmaniasis is a major health problem caused by an intracellular pathogen of the genus Leishmania. CL results in morphologically distinct skin injuries, ranging from nodules to plaques and ulcers, which persist as a recuperating incessant injury depending on the type of contaminating parasite. There is still no effective treatment to reduce the skin lesions in patients infected with CL. The aim of this study was to develop strategies to treat skin lesions in CL patients.

We retrieved the transcriptomic data of skin lesions from patients with CL and normal skin from the GEO database. The PPIN was constructed using the STRING database and Cytoscape v3.10.1 software. Critical genes were identified by topological network analysis and cluster detection. Finally, gene ontology and repurposing drugs for critical genes were determined.

CD8A, IFNG, IL-6, PTPRC, CCR7, TLR2, GSTA5, CYBB, IL-12RB2, ITGB2, FCGR3A, CTLA4, and IFNG were identified as the critical genes in PPIN and subnetworks. Enrichment analysis revealed that T-cell receptor signaling, TLR signaling, cytokine-cytokine receptor interaction, graft-versus-host disease, leishmaniasis, chemokine signaling, primary immunodeficiency, and Th17 cell differentiation were the major pathways associated with critical genes. The drug repurposing results identified cyclosporine, rituximab, infliximab, blinatumomab, and methylprednisolone as candidates for treatment of CL.

After validating our model with available experimental data, we found that critical molecules and drug candidates play a crucial role in
the treatment of skin lesions caused by Leishmania in prospective studies.

Cutaneous leishmaniasis is one of the most common diseases in Iran. This research was conducted to determine the effect of the educational intervention based on the theory of conservation motivation on the prevention of cutaneous leishmaniasis in boys in the seventh, eighth, and ninth grades in the population covered by Mashhad Health Center No. 1, Mashhad City, Iran, in 2020.

In this quasi-experimental study, 80 (out of the 23152) seventh, eighth, or ninth grade students covered by Mashhad Health Center No. 1 were selected by random cluster sampling. After determining the needs in the framework of the protection motivation theory, an educational intervention was designed and implemented for the experimental group. Two groups completed study questionnaires before, immediately after, and three months after the educational intervention. Finally, the obtained data were analyzed using Mann-Whitney, chi-square, and Fisher exact tests in SPSS software, version 24.

Before the intervention, the two groups showed no significant differences regarding the theoretical structure of conservation motivation. After the intervention in the experimental group immediately after and three months after the intervention, significant differences were observed regarding the mean scores of the perceived sensitivity (P>0.001), perceived intensity (P>0.001), fear (P>0.001), perceived response effectiveness (P>0.001), protection motivation (P>0.001) and behavior (P>0.001) of the cutaneous leishmaniasis. In the control group, the changes were not significant.

The educative intervention based on motivational protection theory in male adolescents has a significant increase in the preventative behaviors of cutaneous leishmaniasis, and the protection motivation theory can be used as a framework in designing educational programs to promote the preventive behaviors of cutaneous leishmaniasis in male adolescents.

Knowing the level of awareness, attitude, and performance of people is an important step in leishmaniasis prevention. This study aimed to investigate the knowledge, attitude, and practice of people in Damghan district about cutaneous leishmaniasis in 2018-2020.

In this cross-sectional descriptive study, for 500 people living in urban and rural areas, a semi-structured researcher-made questionnaire approved for content validity and reliability was randomly completed by a trained questionnaire and information was recorded and analyzed using SPSS21 software.

The mean age of the subjects was 37.7, and 52.6% of them were in the age group of 20-40 years. 55% of people had poor knowledge, and 61% and 65% had moderate attitudes and performance, respectively. 97.2%, 72%, and 32.4% of the subjects did not know the agent, reservoir, and symptoms of the disease, respectively. To prevent the disease; 44.6% of people did not take any action, 54.2% installed nets on doors and windows, and also 28.5%, 40.2%, and 25.3%, respectively, always used mosquito nets, insecticide sprays, and insect repellent ointments.

Despite being the disease endemic in the region, the level of knowledge, attitude, and practice of the people was weak to moderate. Therefore, raising the KAP levels of the county's people about leishmaniasis is highly recommended.

Cutaneous leishmaniasis (CL) is a parasitic disease that presents a broad spectrum of clinical features. Treatment of CL is problematic. We aimed to compare the field therapeutic efficacy of topical nanoliposomes containing 0.4% amphotericin B (Nano Lip-AmB) alone and in combination with cryotherapy and/or Glucantime® on human CL in the endemic areas of Iran.

This retrospective study was performed based on the results of using Nano Lip-AmB alone or with Glucantime® and/or cryotherapy in the treatment of zoonotic cutaneous leishmaniasis (ZCL) in patients referred to health centers of Isfahan, Golestan and Ilam Provinces of Iran as endemic foci of ZCL caused by Leishmania major besides Mashhad and Bam cities as endemic foci of anthroponotic cutaneous leishmaniasis (ACL) caused by with L. tropica.

Two hundred and seventy-eight patients with CL were included in the current study. All of the patients (100%) who received Nano Lip-AmB alone or in combination with Glucantime® and/or cryotherapy based on guideline of Iranian national committee for the treatment of CL. Two patients with 7 skin lesions, who was resident in ACL endemic area and received Nano Lip-AmB plus Glucantime® and another patient was a resident of ZCL endemic area and received Nano Lip-AmB plus cryotherapy showed clinical relapses after treatment.

Sina Ampholeish® in combination with other standard protocols of treatment of CL is well tolerated and with acceptable clinical efficacy rate.

Systemic or topical form of pentavalent antimony compounds such as Meglumine Antimoniate (MA) are used as Standard treatment for cutaneous leishmaniasis (CL). However an increasing number of studies demonstrate evidence of treatment failure with said drugs. The objective of this study was to determine the factors associated with systemic MA treatment failure in patients with acute cutaneous leishmaniasis. In this case-control study, patients with urban CL who were referred to leishmaniasis clinics in Mashhad from 2017 to 2018 were followed up 12 months after the start of treatment and were evaluated for improvement or failure according to the national leishmaniasis protocol. 112 cases of CL, 59 men and 53 women with a mean age of 23.3 ± 21.11 years were studied. The number of patients with clinical improvement was significantly higher in women (P = 0.005). Also age, BMI, occupation and education, the possible infection and living location, past medical, drug and leishmaniasis recurrence history, lesion’s characteristics, ulceration were also significantly different between the two groups of improved and unhealed patients. The results of this study showed that the male sex, age less than 18 years, receiving pentostam, previous treatment history, lymphadenopathy, urban leishmaniasis, duration of illness more than 4 months, having a single lesion especially on the face, BMI less than 18 and a lesion size of more than 3 cm is more common in patients with treatment failure.

 Cutaneous Leishmaniasis (CL) is a public health problem in many countries in Asia. Fars province in the south of Iran is an area with endemic CL.

 This study aimed to estimate CL’s lifetime and point prevalence in the Fars province’s general population.

 This cross-sectional study was conducted on 11779 participants living in Marvdasht, the second largest county of Fars province, Iran, in 2019 to estimate CL’s lifetime and point prevalence. In total, 59 urban and 55 rural clusters (with 30 households per cluster) were randomly selected. Door-to-door interviews were conducted by trained nurses to collect the required data.

 The point prevalence was estimated at 3.56 (95% confidence interval: 2.6-4.8) per 1000 population. The lifetime prevalence of CL was 8.48 (95% confidence interval:7.99-9.00) per 100 population. There was no difference between urban and rural areas and gender regarding fresh or old scars, and CL scares (P ≤ 0.05 for all).

 Based on the results, Marvdasht in Fars province was the hyperendemic area for CL. Since the lifetime prevalence of CL in Marvdasht is almost 8%, 89% of the people of this city are at risk of contracting Leishmania. As a result, more public health interventions are needed to control the CL epidemic in Marvdasht.

Cutaneous leishmaniasis (CL) is an endemic infection in the Middle East, including Iran that is also spreading to new foci. We aimed to determine the leishmaniasis species causing CL in Alborz province.

Overall, out of 55-suspected CL patients referred to health centers in Alborz Province, north central Iran in 2019, 40 patients had positive smear for CL based on optical microscopy. The internal transcribed spacer 1 (ITS1) of nuclear ribosomal DNA (rDNA) was amplified by PCR. Leishmania species were identified by PCR–restriction fragment length polymorphism (PCR-RFLP) using BshF I (Hae III) enzyme.

Out of the 40 positive patients with CL, 34 cases (85%) had been caused by Leishmania (L) major and six (15%) by L. tropica. Fifteen patients had no history of traveling to the disease endemic areas, of which nine were Iranians. Skin lesions and scars caused by CL were mostly observed on the hands and face. Moreover, more than two skin lesions were observed in 22 cases (55%), all of which were infected with L. major. A single skin ulcer was seen in 18 (45%) of the CL patients.

Climate change, reduced rainfall, and demographic changes such as migration into Alborz Province and the increasing marginalization of the population and their entry to settle in new areas might have caused natural transmission of both L. tropica and L. major in this province.

The present study aimed at investigating the topical effect of the combination of Plantago ovata and vinegar on the improvement of rural cutaneous leishmaniasis lesions.

The present randomized double‑blind controlled clinical trial was performed on 42 patients with rural skin leishmaniasis. In the case group, in addition to injecting glucantime into the lesion according to the latest national instructions, a combination of P. ovata and vinegar was applied topically twice a day for 8 weeks. In the control group, only glucantime injection into the lesion was performed for 8 weeks according to the latest national guidelines. At the end of the 1st, 2nd, 3rd, 4th, 8th, and 12th weeks after the intervention, the lesion area and improvement were evaluated and recorded.

The results of the present study indicated the lesion area in the case group with the mean of 0.35 ± 0.39 cm and 0.18 ± 0.27 cm in the 8th and 12th weeks, respectively was significantly less than that of the control group with the mean of 0.64 ± 0.78 cm and 0.56 ± 0.44, respectively (P < 0.05). Twelve weeks after the intervention, 84.1% of the lesions in the case group and 65.9% of the lesions in the control group were completely improved (P < 0.05).

According to the results of the present study, the improvement of leishmaniasis lesion with the topical application of the combination of P. ovata and vinegar was significantly more than that of the control group in the 8th and 12th weeks after the intervention.

 Cutaneous leishmaniasis (CL) has been considered one of the most common serious parasitic diseases. Some cities in Iran are known as the center of this important parasitic disease. The World Health Organization (WHO) defines CL as an infectious parasitic disease in the tropics, which can be challenging. The aim of this study was to investigate the epidemiological situation of CL (the identification of parasite, vector, and reservoir) in Ardestan.

 This descriptive-analytical cross-sectional study was performed in 2015-2016. Overall, 121 patients with CL who referred to Ardestan Dermatology and Leishmaniasis Center were sampled, and the Leishmania species were determined in the samples using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, following the amplification of the internal transcribed spacer 1 (ITS1) region in the parasite genome. Finally, the vector and reservoir species were detected by zoology experts according to identification keys.

 The incidence of the disease had the highest (57.8%) and lowest (4.1%) levels in summer and spring, respectively. The disease was prevalent in both women and men but was more common in men (51.2%). The majority of patients (27.3%) were in the age group of 21-30 years, and most of the wounds (71.1%) were nodules. More than one wound on the body was observed in 54.5% of patients, and the disease was prevalent in 13.2% of patients and their family members. Occupationally, students showed the highest disease frequency (32%). The response to treatment with meglumine antimoniate (glucantime) was more effective than the other treatments. The species of the Leishmania vector in the Ardestan region was identified as Phlebotomus papatasi, and the species of the reservoirs in this region were Rhombomys opimus and Meriones libycus.

 Further research is needed to determine the carriers and reservoirs of the disease in other regions in order to reach a constructive decision for appropriate strategies to control the disease.

 Cutaneous leishmaniasis is a significant public health issue worldwide. Cutaneous leishmaniasis is the most prevalent in the world among the different types of leishmaniasis. Currently, available medications have had no discernible influence on the disease's progression. Up to now, there has been no approved cutaneous leishmaniasis vaccine. New developments in vaccination might be a potential way to come up with a vaccination that is successful for the treatment of cutaneous leishmaniasis.

 This research was conducted to learn more about an effective vaccine for Leishmania major, the ailment's primary cause of CL, which was designed using computational methods. Thus, a multiepitope protein was designed by utilizing potential immune system epitopes, including predicted MHC class I, MHC class II, Cytotoxic T lymphocytes, B-cell, and Interferon-gamma epitopes of Cysteine protease b (CPB), Leishmania homologue of activated C kinase (LACK), and Kinetoplastid membrane protein-11 (KMP-11) antigenic proteins. In order to enhance vaccine immunogenicity, two resuscitation-promoting factors of Mycobacterium tuberculosis were used as adjuvants. Final epitopes were matched with suitable linkers to construct the recombinant structure. The physicochemical and immune-based characteristics of the designed vaccine have been forecasted by using different tools. Moreover, homogeneity modeling was performed to obtain a high-quality 3D structure, followed by refinement and validation. Finally, the codon optimization based on E. coli resulted in a higher CAI value and optimal GC content, followed by combining it in the pET-14b cloning vector.

Evaluation of the various characteristics of the designed vaccine showed that it is an immunogenic and non-allergenic antigen that can induce immune responses against Leishmania major infection, which could be promising for cutaneous leishmaniasis.

 Research shows that a recombinant vaccine can be an effective candidate against cutaneous leishmaniasis.

Different forms of leishmaniasis are important infectious diseases in Iran. While Rudbar County of Guilan Province has been introduced as a cutaneous leishmaniasis focus, there are few published data about the phlebotomine sand flies (Diptera: Psychodidae, Phlebotominae) of the province and their medical importance.

The present study is going to provide a review of sand fly-borne infections in Guilan Province and a checklist of sand flies of the province. Also, a note is presented on the name Sergentomyia murgabiensis sintoni.

Using the main databases such as Web of Science, PubMed, Scopus, Google Scholar, Scientific Information Database (SID), IranMedex and Magiran which were searched up to September 2022 and reviewing the literature, the available data about the sand fly-borne diseases of Iran and Guilan Province were extracted and analyzed.

In total, 11 species representing two genera of sand flies, Phlebotomus and Sergentomyia, are found in Guilan Province. The checklist and distribution of sand flies of the province have been provided. All species of the genus Phlebotomus in the province are proven or suspected vectors of leishmaniasis. Sand fly-borne leishmaniasis (cutaneous and visceral), sand fly fever and lizard leishmaniasis, which are among the endemic infections of the province, are discussed. Also, a taxonomic note is presented on the name Sergentomyia murgabiensis sintoni.

The prevalence of suspected or proven vectors of sand fly-borne diseases in Guilan Province is noteworthy. The study of the ecology of sand flies and detecting the exact vectors and reservoirs of leishmaniasis and phlebotomine fever by serological or molecular- specific tests in the province are recommended. Moreover, additional samplings of sand flies from localities, where have not been studied, are necessary.

Phlebotomus and Sergentomya are distributed in the old-world regions and transmit leishmaniases through mammalian and reptile hosts. Cutaneous leishmaniasis (CL) is one of the most important diseases in Iran. Iranian sand flies belong to three Oriental, Palearctic, and Afrotropical Regions. Fars Province is located in Palearctic, but southern parts are affected Oriental region situations on phglebotomine population variety. Therefore, a comprehensive study was required on the vectors of the disease in this Province.

Regarding the approved role of the environmental factors in creating the fauna and distribution of living crea-tures, the “de martonne climate method” was used, and the climate was noticed as an important environmental factor for the determination of vector distribution. Accordingly, 14 sampling sites were selected from 10 foci in different climates of Fars Province. 19648 sand flies were collected from the studied areas in this Province during 2016.

Phlebotomus papatasi and Se. antennata were the most frequent species, which were caught from in/outdoor areas. Phlebotomus sergenti and Ph. alexandri were caught from both Palearctic and Oriental zones but were more prevalent in the cold semi-arid climate of the Palearctic zone. Moreover, they were not caught from the hot desert and summer Mediterranean climates of the Oriental zone.

It seems that Ph. papatasi as the main vector of CL could be well distributed in different climates in Fars. Moreover, some species like Ph. sergenti preferred especial climates in the Palearctic zone. Therefore, these data could be helpful to control leishmaniases more efficiently.

Climate change can facilitate the expansion of leishmaniasis and create the suitable habitat for vector and reservoir species. The objective of this study was to estimate the prevalence of cutaneous leishmaniasis (CL) at the climatic regions of Iran.

The literature search was conducted to identify all published studies reporting the prevalence or incidence of CL in humans in Iran. Atotal of 350 articles that reported leishmaniasis in Iran were retrieved, due to eligibility criteria, only 42 studies were selected to the final systematic review and meta‑analysis procedure. Random effects meta‑analysis was done with the estimate of heterogeneity being taken from an inverse‑variance model. Subgroup analysis was conducted and it stratified the studies according to climatic regions. Between‑study heterogeneity was assessed by using I2 and Cochran’s Q method I2 value of heterogeneity. Meta regression was used to investigate factors potentially contributed the between‑study heterogeneity.

Individual studies showed that prevalence per 100,000 population estimated the range from 1.5 to 318.7 with the overall random pooled prevalence of 83.3 (95% confidence interval 74.5–92.1). Subgroup analysis by climatic regions showed that many studies were conducted in the desert areas and also, it has more prevalent than the other climatic regions.

Leishmaniasis was more prevalent in regions with dry and desert climates than the other climatic regions. One of the advantages of this work is that the majority of selected studies have been conducted on population‑base. However, some of the studies have been designed poorly or have had a lack of internal validity