Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya

dc.contributor.author Amro, Ahmad
dc.contributor.author Al-Dwibe, Hamida
dc.contributor.author Gashout, Aisha
dc.contributor.author Moskalenko, Olga
dc.contributor.author Galafin, Marlena
dc.contributor.author Hamarsheh, Omar
dc.contributor.author Frohme, Marcus
dc.contributor.author Jaeschke, Anja
dc.contributor.author Kuhls, Katrin
dc.contributor.author Schoenian, Gabriele
dc.date.accessioned 2020-01-29T19:49:18Z
dc.date.available 2020-01-29T19:49:18Z
dc.date.issued 2017-09-07
dc.description.abstract Background Cutaneous leishmaniasis (CL) is a major public health problem in Libya. In this paper, we describe the eco-epidemiological parameters of CL during the armed conflict period from January 2011 till December 2012. Current spatiotemporal distributions of CL cases were explored and projected to the future using a correlative modelling approach. In addition the present results were compared with our previous data obtained for the time period 1995± 2008. Methodology/Principal findings We investigated 312 CL patients who presented to the Dermatology Department at the Tripoli Central Hospital and came from 81 endemic areas distributed in 10 districts. The patients presented with typical localized lesions which appeared commonly on the face, arms and legs. Molecular identification of parasites by a PCR-RFLP approach targeting the ITS1 region of the rDNA was successful for 81 patients with two causative species identified: L. major and L. tropica comprised 59 (72.8%) and 22 (27.2%) cases, respectively. Around 77.3% of L. tropica CL and 57.7% of L. major CL caused single lesions. Five CL patients among our data set were seropositive for HIV. L. tropica was found mainly in three districts, Murqub (27.3%), Jabal al Gharbi (27.3%) and Misrata (13.7%) while L. major was found in two districts, in Jabal al Gharbi (61%) and Jafara (20.3%). Seasonal occurrence of CL cases showed that most cases (74.2%) admitted to the hospital between November and March, L. major cases from November till January (69.4%), and L. tropica cases mainly in January and February (41%). Two risk factors were identified for the two species; the presence of previously infected household members, and the presence of rodents and sandflies in patient's neighborhoods. Spatiotemporal projections using correlative distribution models based on current case data and climatic conditions showed that coastal regions have a higher level of risk due to more favourable conditions for the transmitting vectors. Conclusion Future projection of CL until 2060 showed a trend of increasing incidence of CL in the northwestern part of Libya, a spread along the coastal region and a possible emergence of new endemics in the north-eastern districts of Libya. These results should be considered for control programs to prevent the emergence of new endemic areas taking also into consideration changes in socio-economical factors such as migration, conflicts, urbanization, land use and access to health care. en_US
dc.description.sponsorship We would like to thank Stephanie Thomas and Nils Tjaden (Dept. Biogeography, University of Bayreuth, Bayreuth, Germany) for introduction to and support in the modelling part. Many thanks also to Mohammad Akhoundi and Jan VotyÂpka for very helpful discussion concerning the selection of the most relevant bioclimatic variables for modelling. en_US
dc.identifier.citation Amro A, Al-Dwibe H, Gashout A, Moskalenko O, Galafin M, Hamarsheh O, et al. (2017) Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya. PLoS Negl Trop Dis 11(9): e0005873. en_US
dc.identifier.issn 1935-2735
dc.identifier.uri https://dspace.alquds.edu/handle/20.500.12213/5058
dc.language.iso en en_US
dc.title Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya en_US
dc.type Article en_US
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