title: Coexistence of Leishmania tropica and Leishmania infantum in Sefrou province, Morocco.
abstract: Cutaneous leishmaniasis (CL) has been recently emerged in new foci, posing a public health problem. Increasing cases of CL have been reported during recent years in Sefrou province, a previously non-endemic area. The present study was designed for epidemiological and parasitological characterization of the disease for the first time in this area. The results of a retrospective analysis of CL cases reports, between 2000 and 2011 showed that the incidence was estimated to 463/100,000 inhabitants/year, with a total of 1242 cases were notified from 1997 to 2011. Most patients were infected in the sector El Menzel (22.81%) and Sefrou (20.51%). Other cases have been reported in the 15 other sectors, reflecting the geographical spread of the disease. The highest rate lesions were found in the age group of 9 years or less with significant differences (p-value<2.2e-16) comparing to the older age groups. The most affected lesion was localized in the face (64%). The average number of lesions per patient was 2.35 with a maximum of 5 lesions. The clinical aspects of lesions were mostly crusted. The causative agents of CL in this province were identified as the coexistence of L. tropica and L. infantum by species-specific ITS1-PCR-RFLP assay. CL remains an emergent disease in Sefrou with an incidence and a continuously geographical spread. Recent environmental changes, auspicious to vectors had probably contributed to that situation.
authors.affiliation: Laboratory of Microbial Biotechnology, FST, Sidi Mohammed Ben Abdellah University, Fes, Morocco.
authors.forename: Hmamouch
authors.initials: H
authors.lastname: Asmae
authors.affiliation: National Reference Laboratory of Leishmaniasis, National Institute of Health, Rabat, Morocco.
authors.forename: Amarir
authors.initials: A
authors.lastname: Fatima
authors.affiliation: National Reference Laboratory of Leishmaniasis, National Institute of Health, Rabat, Morocco.
authors.forename: Fellah
authors.initials: F
authors.lastname: Hajiba
authors.affiliation: Provincial Laboratory of Parasitic Diseases, Sefrou, Morocco.
authors.forename: Karzaz
authors.initials: K
authors.lastname: Mbarek
authors.affiliation: Laboratory of Microbial Biotechnology, FST, Sidi Mohammed Ben Abdellah University, Fes, Morocco.
authors.forename: Bekhti
authors.initials: B
authors.lastname: Khadija
authors.affiliation: National Reference Laboratory of Leishmaniasis, National Institute of Health, Rabat, Morocco.
authors.forename: Rhajaoui
authors.initials: R
authors.lastname: Mohamed
authors.affiliation: National Reference Laboratory of Leishmaniasis, National Institute of Health, Rabat, Morocco. Electronic address: sebti.faiza@yahoo.fr.
authors.forename: Sebti
authors.initials: S
authors.lastname: Faiza
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D016054:DNA, Protozoan / Q000235:genetics; D005260:Female; D005784:Gene Amplification; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D018314:Leishmania infantum / Q000235:genetics / Q000302:isolation & purification*; D007895:Leishmania tropica / Q000235:genetics / Q000302:isolation & purification*; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology* / Q000469:parasitology*; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D012150:Polymorphism, Restriction Fragment Length; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D016054:DNA, Protozoan
keywords: Cutaneous leishmaniasis; ITS1-PCR; L. infantum; L. tropica; Morocco; Sefrou