Leishmania and Leishmaniasis

1. Leishmania and Leishmaniasis

2. Leishmania currently affects 12 million people in 88 countries. • Cause: • Leishmania spp. • Over 23 different species of Leishmania exist. • Vector: • Sand flies of genus Phlebotomus in the old world • Sand flies of genus Lutzomyia in the new world.

3. Leishmaniasis • Visceral • L. donovani • L. infantum • Cutaneous • Leishmania major • L. tropica Sand Flies Phlebotomus papatasi  L. major P. sergenti  L. tropica P. alexandri  L. donovani/infantum

4. Taxonomy of Leishmania lab 6 by wafa menawi

5. Kingdom: Protisata Phylum: Sarcomastigophora Class: Zoomastrgophora Order: Kinetplastida Family: Trypanosomatidae Genus:Leishmania Species:Donovani, Tropica, major

6. Leishmania Life cycle lab 6 by wafa menawi

7. Life Cycle Reservoir Vector Pathology:Parasites in macrophages; Infiltration to skin/RE cells lab 6 by wafa menawi

8. Promastigotes differentiate to complement resistantmetacyclic promastigotes in the sand fly midgut metacyclic procyclic lab 6 by wafa menawi

9. lab 6 by wafa menawi

10. The intermediate host and vector of Leismania are species of sandflies (Phlebotomus and Lutzomyia spp.).  Female sandflies become infected when taking a blood meal containing amastigotes in white blood cells (macrophages).  In the gut of the sandfly, amastigotes transform into promastigotes, attach to the gut wall and multiply by longitudinal binary fission.  After approximately 1 week, they transform into the infective metacyclic promastigotes which are so numerous in the anterior gut and pharynx that they may block it.   lab 6 by wafa menawi

11. Humans are infected when an infected sandfly regurgitates the metacyclic promastigotes while taking a blood meal.  Promastigotes that enter the bloodstream are phagocytized by macrophages, in which they transform into amastigotes and multiply.   lab 6 by wafa menawi

12. Leishmania spp. Amastigote lab 6 by wafa menawi

13. Leishmania spp. Promastigote lab 6 by wafa menawi

14. Leishmania • Promastigote lab 6 by wafa menawi

15. Leishmania spp (Promastigote) Single flagellum found in sand flies lab 6 by wafa menawi

16. Leishmaniasis Macrophage rupturing Amastogotes Amastogotes with nucleus and kinetoplast lab 6 by wafa menawi

17. Leishmania • Amastigotes lab 6 by wafa menawi

18. Leishmaniasis rosette lab 6 by wafa menawi

19. Leishmaniasis 1- Cutaneous leishmaniasis (CL). 2- Mucocutaneous leishmaniasis (ML). 3- Visceral leishmaniasis (VL). lab 6 by wafa menawi

20. Cutaneous leishmaniasis • Have different names such as oriental sore, Al mohtafirah, Al domal. • Caused by L.tropica and L.major in the old world. • widely distributed in the Mediterranean, Middle East, India, and Africa . • characterized by skin lesions (oriental sore).  lab 6 by wafa menawi

21. Infected macrophages containing amastigotes are found primarily at the site of infection around the sores.  The sores are characterized by an elevated rim encircling the lesion.  The sores generally heal by themselves within a year, but secondary bacterial infections are possible in open sores. lab 6 by wafa menawi

22. Patient infected with CL lab 6 by wafa menawi

23. Mucocutaneous leishmaniasis • found in South America—particularly Peru, Bolivia, Paraguay, Ecuador, Colombia, and Venezuela . • Caused by L. braziliensis, L. major and L.tropica • characterized by lesions near mucosal membranes.  • The initial site if infection is a small red papule that ulcerates in a few weeks.  The lesions are flat (no raised rim) and often oozing.  Infections of the ear, nose and mouth area lead to degeneration of the cartilage and soft tissues, resulting in disfigurement. lab 6 by wafa menawi

24. Patient infected with MCL lab 6 by wafa menawi

25. Visceral leishmaniasis • commonly known as kala-azar, • Found in Africa to India and China . • Caused by L. donovani and L. infantum • In most areas, individuals do not develop sores but in some cases, small lumps may appear over the entire body or in patches on the nose. • Common symptoms include: weight loss, fever, low blood cell count, and enlarged spleen and liver. lab 6 by wafa menawi

26. Patient infected with VL. lab 6 by wafa menawi

27. Symptomatic dogs lab 6 by wafa menawi

28. Sand fly

29. Sand fly taxonomy Kingdom: Animalia. Phylum: Arthropoda. Class: Insecta. Order: Diptera. Family: Psychodidae. Genus: Phlebotomous, Sergentomyia, Lutzomyia. Species: P. papatasi, P. sergenti, S. antennata, S. clydi. lab 6 by wafa menawi

30. General characteristics • It has a brownish body colour. • The body covered with dense hairs. • V wing shape at rest. • It has a weak flight for short distance and for short levels. • Nocturnal habit. lab 6 by wafa menawi

31. Sand fly life cycle lab 6 by wafa menawi

32. The eggs are elongated oval-shaped • The first larval instar has a dark head capsule and can be distinguished by the presence of two caudal bristles, all subsequent instars bearing four bristles. lab 6 by wafa menawi

33. Male & Female sand flies Male Female lab 6 by wafa menawi

34. Diagnosis • Prevention Cutaneous leishmaniasis Gives Life Long Immunity lab 6 by wafa menawi

35. DIAGNOSTIC TESTS for human • visceral and cutaneous Leishmaniasis • Serological methods: • IFA (>1/800) • ES (4-24 arc) • Molecular methods: PCR • Culture lab 6 by wafa menawi

36. Indirect Immunofluorescence. Search for antibodies. lab 6 by wafa menawi

37. An electrosyneresis strip Note the arc (a) appeared by the connection of the antigen (b) with the positive control (c) and the positive to Leishmania sample (d). lab 6 by wafa menawi

38. Treatment & Prevention • pentamidine • There is a strong need for new drugs with less Toxicity • coetaneous leishmaniasis gives life long immunity • Control of Leishmania transmission is challenging because of difficulties in limiting contact with shadflie • Insecticide spray to kill sand flies lab 6 by wafa menawi

39. allah protect you lab 6 by wafa menawi