title: Transmission of visceral leishmaniasis in a previously non-endemic region of Tunisia: detection of Leishmania DNA in Phlebotomus perniciosus.
abstract: Visceral leishmaniasis (VL) has been endemic in northern Tunisia and has occurred sporadically in the center of Tunisia. Recently, there have been several cases from areas known to be free of VL. We report in this work all human and canine cases of VL recorded between 2003 and 2011 and an entomological study of phlebotomine fauna in a previously non-endemic region. Sixty-three cases of VL were diagnosed and identified as L. infantum using several different methods. Eight species of 179 sand flies were caught and identified by both morphological and molecular methods. Two genera were present, Phlebotomus and Sergentomya, with an abundance of the subgenus Phlebotomus (Larrousius) spp., a classic vector of VL in Tunisia. Moreover, Leishmania DNA was detected in seven unfed Phlebotomus pernicousus and L. infantum was identified in three of them. This result confirms the establishment of a transmission cycle of VL in the studied region by the coexistence of infected vectors with infected hosts.
authors.affiliation: Laboratory of Parasitology and Mycology, Faculty of Pharmacy of Monastir, Clinical Biology Department, 99-UR/08-05 Monastir, Tunisia. najla.chargui@laposte.net
authors.forename: Najla
authors.initials: N
authors.lastname: Chargui
authors.forename: Najoua
authors.initials: N
authors.lastname: Haouas
authors.forename: Darine
authors.initials: D
authors.lastname: Slama
authors.forename: Mohamed
authors.initials: M
authors.lastname: Gorcii
authors.forename: Kaouther
authors.initials: K
authors.lastname: Jaouadi
authors.forename: Nawel
authors.initials: N
authors.lastname: Essabbah-Aguir
authors.forename: Habib
authors.initials: H
authors.lastname: Mezhoud
authors.forename: Hamouda
authors.initials: H
authors.lastname: Babba
mesh_terms: D000818:Animals; D016054:DNA, Protozoan / Q000235:genetics; D004285:Dogs; D005260:Female; D006801:Humans; D007891:Leishmania / Q000235:genetics / Q000472:pathogenicity; D007898:Leishmaniasis, Visceral / Q000453:epidemiology / Q000635:transmission*; D008297:Male; D010691:Phlebotomus / Q000235:genetics / Q000472:pathogenicity; D011576:Psychodidae / Q000469:parasitology; D014416:Tunisia / Q000453:epidemiology
chemical_list: D016054:DNA, Protozoan