title: Prevalence of Cutaneous Leishmaniasis in Districts of High and Low Endemicity in Mali.
abstract: Historically the western sahelian dry regions of Mali are known to be highly endemic for cutaneous leishmaniasis (CL) caused by Leishmania major, while cases are rarely reported from the Southern savanna forest of the country. Here, we report baseline prevalence of CL infection in 3 ecologically distinct districts of Mali (dry sahelian, north savanna and southern savanna forest areas). We screened 195 to 250 subjects from 50 to 60 randomly selected households in each of the 6 villages (four from the western sahelian district of Diema in Kayes region, one from the central district of Kolokani and one from the southern savanna district of Kolodieba, region of Sikasso). The screening consisted of: 1] A Leishmanin Skin Test (LST) for detection of exposure to Leishmania parasites; 2] clinical examination of suspected lesions, followed by validation with PCR and 3] finger prick blood sample to determine antibody levels to sand fly saliva. LST positivity was higher in the western district of Diema (49.9%) than in Kolokani (24.9%) and was much lower in Kolondieba (2.6%). LST positivity increased with age rising from 13.8% to 88% in Diema for age groups 2-5 years and 41-65 years, respectively. All eight PCR-confirmed L. major CL cases were diagnosed in subjects below 18 years of age and all were residents of the district of Diema. Exposure to sand fly bites, measured by anti-saliva antibody titers, was comparable in individuals living in all three districts. However, antibody titers were significantly higher in LST positive individuals (P<0.0001). In conclusion, CL transmission remains active in the western region of Mali where lesions were mainly prevalent among children under 18 years old. LST positivity correlated to higher levels of antibodies to sand fly salivary proteins, suggesting their potential as a risk marker for CL acquisition in Mali.
authors.affiliation: International Center of excellence in research (ICER-MALI), University of Sciences, Techniques and Technology of Bamako (USTTB), Bamako, Mali.
authors.forename: Bourama
authors.initials: B
authors.lastname: Traoré
authors.affiliation: Laboratory of Malaria and Vector Research (LMVR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland, United States of America.
authors.forename: Fabiano
authors.initials: F
authors.lastname: Oliveira
authors.affiliation: Centre National d'Appui à la Lutte contre la Maladie (CNAM), Bamako, Mali.
authors.forename: Ousmane
authors.initials: O
authors.lastname: Faye
authors.affiliation: Centre National d'Appui à la Lutte contre la Maladie (CNAM), Bamako, Mali.
authors.forename: Adama
authors.initials: A
authors.lastname: Dicko
authors.affiliation: International Center of excellence in research (ICER-MALI), University of Sciences, Techniques and Technology of Bamako (USTTB), Bamako, Mali.
authors.forename: Cheick A
authors.initials: CA
authors.lastname: Coulibaly
authors.affiliation: International Center of excellence in research (ICER-MALI), University of Sciences, Techniques and Technology of Bamako (USTTB), Bamako, Mali.
authors.forename: Ibrahim M
authors.initials: IM
authors.lastname: Sissoko
authors.affiliation: International Center of excellence in research (ICER-MALI), University of Sciences, Techniques and Technology of Bamako (USTTB), Bamako, Mali.
authors.forename: Samake
authors.initials: S
authors.lastname: Sibiry
authors.affiliation: International Center of excellence in research (ICER-MALI), University of Sciences, Techniques and Technology of Bamako (USTTB), Bamako, Mali.
authors.forename: Nafomon
authors.initials: N
authors.lastname: Sogoba
authors.affiliation: International Center of excellence in research (ICER-MALI), University of Sciences, Techniques and Technology of Bamako (USTTB), Bamako, Mali.
authors.forename: Moussa Brema
authors.initials: MB
authors.lastname: Sangare
authors.affiliation: International Center of excellence in research (ICER-MALI), University of Sciences, Techniques and Technology of Bamako (USTTB), Bamako, Mali.
authors.forename: Yaya I
authors.initials: YI
authors.lastname: Coulibaly
authors.affiliation: Centre National d'Appui à la Lutte contre la Maladie (CNAM), Bamako, Mali.
authors.forename: Pierre
authors.initials: P
authors.lastname: Traore
authors.affiliation: International Center of excellence in research (ICER-MALI), University of Sciences, Techniques and Technology of Bamako (USTTB), Bamako, Mali.
authors.forename: Sekou F
authors.initials: SF
authors.lastname: Traore
authors.affiliation: Laboratory of Malaria and Vector Research (LMVR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland, United States of America.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Anderson
authors.affiliation: Centre National d'Appui à la Lutte contre la Maladie (CNAM), Bamako, Mali.
authors.forename: Somita
authors.initials: S
authors.lastname: Keita
authors.affiliation: Laboratory of Malaria and Vector Research (LMVR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland, United States of America.
authors.forename: Jesus G
authors.initials: JG
authors.lastname: Valenzuela
authors.affiliation: Laboratory of Malaria and Vector Research (LMVR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Rockville, Maryland, United States of America.
authors.forename: Shaden
authors.initials: S
authors.lastname: Kamhawi
authors.affiliation: International Center of excellence in research (ICER-MALI), University of Sciences, Techniques and Technology of Bamako (USTTB), Bamako, Mali.
authors.forename: Seydou
authors.identifier: 0000-0002-4967-5987
authors.initials: S
authors.lastname: Doumbia
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007299:Insect Bites and Stings / Q000453:epidemiology / Q000469:parasitology; D018320:Leishmania major / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology* / Q000469:parasitology / Q000635:transmission; D008297:Male; D008302:Mali / Q000453:epidemiology; D008875:Middle Aged; D015995:Prevalence; D011576:Psychodidae / Q000469:parasitology / Q000502:physiology; D055815:Young Adult