E. Chouihi

The epidemiological situation of leishmaniasis in Tunisia is characterised by the co-existence in a very limited territory (165,000 km2, Sahara included), of 4 clinical forms: the infantile visceral leishmaniasis (VL) and 3 cutaneous leishmaniasis (CL) forms (sporadic, zoonotic and chronic). In addition to the useful epidemiological data, identification of the causative parasitic species is essential to determine the geographic distribution of each form and to select appropriate therapeutic procedure and suitable control measures. 226 Leishmania isolates, 135 human's coming from 59 VL cases and 76 CL cases and 91 canine's were identified by the isoenzyme electrophoresis reference technique. Results confirm the endemicity of the 4 forms mentioned above. The sporadic CL, confined to the North of the country is principally caused by L. infantum MON-24 (72.2%). VL which has reached the southern ridge in the central area of Tunisia, in the governorate of Kairouan (36 typed isolat...

Dogs are the main reservoir host of Leishmania infantum, etiologic agent of human visceral leishmaniasis (HVL) and canine visceral leishmaniasis (CVL). Transmission of L. infantum to humans and dogs is mainly through the bite of infected sand flies. In the Western Mediterranean basin, Phlebotomus perniciosus is the main vector of L. infantum. However, occasional vertical transmission of L. infantum has been reported. This study investigated L. infantum vertical transmission in offspring of experimentally infected dogs. Among 14 surviving puppies from three female beagle dogs that developed CVL following an experimental infection with L. infantum, one was tested positive by indirect immunofluorescence antibody test, by PCR and by xenodiagnosis with a high parasite burden in the spleen at 14 months old. None of the remaining puppies were tested positive for L. infantum. These findings strongly suggest that infected puppies following vertical transmission can sustain infection and contribute in infecting sand flies with L. infantum. Any strategy for controlling CVL should take into consideration the vertical transmission of L. infantum.

... 9. AYADI A, BEN ISMAIL R & BEN RACHID MS – Extension de l'aire de transmission du kala azar à Leishmania infantum vers le centre et le sud de la Tunisie. Arch Inst Pasteur Tunis, 1991, 68, 269-73. 10. BELHAJ S, PRATLONG F, TOUMI NH, KALLEL K, MAHJOUB H et al. ...

The anti-sandflies and, insecticides impregnated collars are actually mentioned as the main mean for prevention and control of Canine leishmaniasis. An evaluation of the Scalibor collar was undertaken in leishmaniasis active sites in Tunis area, (northern Tunisia). Eighty leishmaniasis free dogs (42 collared and 38 as control dogs) were submitted to a serological detection using ELISA technique for anti-Leishmania antibodies before and after transmission season in 2005 and 2006. Seroconversions were detected by ELISA and controlled by indirect immunofluorescence antibodies test. Confirmation of infection in seroconverted dogs was based on the detection of the parasite by culture in NNN medium or detection of parasite's DNA by real time PCR. Among 38 control dogs, 6 (15.8%) were infected by Leishmania infantum during the study period against zero in the collar group; the difference is statistically significant (p=0.02). This result is an additional confirmation of the prophylactic properties of Scalibor protector band against canine leishmaniosis.

The anti-sandflies and, insecticides impregnated collars are actually mentioned as the main mean for prevention and control of Canine leishmaniasis. An evaluation of the Scalibor collar was undertaken in leishmaniasis active sites in Tunis area, (northern Tunisia). Eighty leishmaniasis free dogs (42 collared and 38 as control dogs) were submitted to a serological detection using ELISA technique for anti-Leishmania antibodies before and after transmission season in 2005 and 2006. Seroconversions were detected by ELISA and controlled by indirect immunofluorescence antibodies test. Confirmation of infection in seroconverted dogs was based on the detection of the parasite by culture in NNN medium or detection of parasite's DNA by real time PCR. Among 38 control dogs, 6 (15.8%) were infected by Leishmania infantum during the study period against zero in the collar group; the difference is statistically significant (p=0.02). This result is an additional confirmation of the prophylacti...

Forty-two patients with visceral leishmaniasis in Tunisia were treated with meglumine antimoniate and followed-up for clinical improvement and blood parasite load determined by quantitative real-time polymerase chain reaction (PCR). Parasite loads before treatment ranged from 27 to 5.3 x 10(7) parasites/mL. At the end of treatment, parasite load decreased significantly in 39 cured patients (P < 0.001). The decrease in parasite load after treatment was greater than 99% for 34 patients and PCR results became negative in 23 of them. Two patients without clinical improvement showed no or slight decreases in parasite load (209 versus 202 parasites/mL and 1,765 versus 146 parasites/mL). One patient showed had a relapse seven months after showing a good response to treatment. His parasitemia remained high despite a sharp decrease (5.2 x 10(5) versus 5.9 x 10(3) parasites/mL).