Andean cutaneous leishmaniasis (Andean-CL, uta) in Peru and Ecuador: the vector Lutzomyia sand flies and reservoir mammals
Graphical abstract
Showing, 1) landscape and human dwellings of the Andean-CL (uta) endemic areas, Huanchoc (2700 m a.s.l.), Ancash Department, Peru; 2) geographical distribution of the Lutzomyia sand fly species, vectors of the Leishmania parasites, causing Andean-CL (uta) in Peru and Ecuador; 3) Monthly biting activities of three species of sand flies, Lu. verrucarum and Lu. peruensis in Peru, and Lu. ayacuchensis in Ecuador, showing higher activities during the rainy seasons; 4) landscape and human dwellings of the Andean-CL endemic areas, Chanchan (1500 m a.s.l.), Chimborazo Province, Ecuador, along with the Chanchan river and railways (Alausi-Huigra).
Introduction
The leishmaniasis is one of the most important emerging and re-emerging infectious vector-borne diseases. It is caused by the infection with about 20 species of the genus Leishmania parasites, and transmitted by the bite of an infected female sand fly belonging to the subfamily Phlebotominae, Phlebotomus spp., transmitting parasites of the subgenus Leishmania (Leishmania) in the Old World, and Lutzomyia spp. transmitting those of two subgenera L. (Leishmania) and L. (Viannia) in the New World. Clinically, the disease is divided into three principal forms, cutaneous (CL), mucocutaneous (MCL), and visceral (VL) known as kala-azar and often fatal if left untreated. It is prevalent in tropical and subtropical geographic zones of the world, affecting at least 12 million people in 98 countries and regions (Desjeux, 2001, WHO, 2010, Alvar et al., 2012).
In the New World, the disease is prevalent in a wide range of distribution from the southern US to the northern Uruguay (Hashiguchi et al., 2017, Satragno et al., 2017). Among the Leishmania-endemic countries of South America, there exist so-called Andean types of CL (Andean-CL, uta) in Peru and Ecuador. In the Peruvian Andes, it has long been known that there exists a unique clinical form of CL known as ‘uta’, caused by L. (V.) peruviana parasites (Lainson et al., 1979, Kreutzer et al., 1983, Lainson, 1983, Lainson, 1996, Lucas et al., 1998, Arevalo et al., 2007). The disease name ‘uta’ has been used synonymously for the vector and the disease in certain endemic areas of the Peruvian Andes, and it was believed to have been present for a long time, probably long before the discovery of the Americas (Hertig, 1942, Weiss, 1943, Herrer and Christensen, 1975). In Ecuador, on the other hand, autochthonous Andean-CL cases, very similar to “classical” Peruvian uta were reported for the first time in 1987 from a small Andean town Paute, Azuay Province, located in the country’s mid-southwestern region (Hashiguchi et al., 1987, Hashiguchi et al., 1991). Since the first report of the cases from Ecuador, it has been considered that the Andean-CL would be mostly similar to the Peruvian uta.
In the previous study, we focused on the causative Leishmania parasites and the patho- and clinico-epidemiology of the Andean-CL (uta) in Peru and Ecuador, and the results suggested that the diseases in the two countries seemed to be changing gradually, especially in the clinico-epidemiological features, the Peruvian form being more severe than the Ecuadorian affecting higher age groups, besides the Ecuadorian form being more rural than before (Hashiguchi et al., 2018). The current study was designed to review the disease, mainly focusing on the vector sand flies and reservoir host mammals of the Leishmania parasites circulating in the Andean-CL endemic areas of the two countries. For this purpose, a survey of the relevant literatures including our unpublished data was conducted thoroughly. Such information is crucial for the future development of intervention and control strategies of the disease, not only for the Andes regions but also for other Leishmania-endemic areas.
Section snippets
Data/information collection
A bibliographic survey was conducted, thoroughly performing a review of the articles reported, using Medline, Global Health and others, with keywords: Peru; Ecuador; phlebotomine sand flies; Lutzomyia; vectors; reservoirs; Leishmania; Andean cutaneous leishmaniasis; uta; and other related-terms/words. Countrywide up-to-date epidemiological data were also collected from the official reports of the Ministries of Public Health of Peru (Centro Nacional de Epidemiologia; Prevención y Control de
Vector Lutzomyia sand flies
In the Andean Leishmania-endemic countries, Colombia, Venezuela, Ecuador, Peru, Bolivia and Argentina, a total of around 20 species of the genus Lutzomyia have been reported as the putative vectors of Leishmania parasites in the regions (Davies et al., 2000, Brazil et al., 2015). Around 162 Lutzomyia species in Peru and 73 species in Ecuador have been recorded; among these only a few species are incriminated as vectors of the Leishmania parasites in both countries (Hashiguchi et al., 1985a,
Comments and conclusions
In this study, the vector Lutzomyia sand flies and reservoir mammals of the Leishmania parasites, circulating in Andean-CL endemic areas of Peru and Ecuador were thoroughly reviewed. The Peruvian L. (V.) peruviana parasite, a principal Leishmania species causing Andean-CL (uta) in Peru, possessed three Lutzomyia species, Lu. peruensis, Lu. verrucarum, and Lu. ayacuchensis as vectors; the first two species were for a long time believed to be vectors of the parasites causing uta, but now the last
Funding
This study was financially supported by the Ministry of Japan (MEXT) (Grant nos. 25257501 and 23256002).
Conflict of interest
The authors have no conflicts of interest to declare.
Acknowledgements
We are indebted to Dr. Masataka Korenaga and Mrs. Kyoko Imamura, Department of Parasitology, Kochi Medical School, Kochi University, Japan, for their invaluable support during the long-term leishmaniasis research project, 1986–2015, in Ecuador, supported by the Ministry of Japan (MEXT). We are also indebted to Ecuadorian, Peruvian and Japanese colleagues for their contributions throughout the project, and to Miss Giovana De La Cruz Vasquez, the Executive Office of Scientific Information and
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2020, Acta TropicaCitation Excerpt :In the Ecuadorian Andes, the natural infection rate of Lu. ayacuchensis with L. (L.) mexicana is constantly high (1–9 or 10%) (Takaoka et al., 1990; Gomez and Hashiguchi, 1991; Kato et al., 2005, 2008a,b; Gomez et al., 2014a; Hashiguchi et al., 2018b), while the ratio of sand flies is mostly less than 1% in lowland tropical and subtropical areas (Gomez et al., 2014b; Hashiguchi et al., 2017). It is known that infection rates of sand flies with Leishmania promastigotes are affected by method of collection.
Anthropophilic phlebotomine sand fly Lutzomyia species and search for the natural Leishmania infections in an area endemic for cutaneous leishmaniasis in Ecuador
2020, Acta TropicaCitation Excerpt :tortura, and Lu. gomezi, were incriminated as probable vectors of the Leishmania parasites (Takaoka et al., 1990; Kato et al., 2005, 2008, 2013; Gomez et al., 2014a,b; Hashiguchi et al., 2017, 2018). Regarding the causative Leishmania parasites, on the other hand, there exist eight species; L. (V.) guyanensis/panamensis, L. (V.) braziliensis, L. (V.) naiffi, L. (V.) lainsoni, L. (L.) mexicana, L. (L.) amazonensis, L. (L.) major-like reported (Mimori et al., 1989; Armijos et al., 1990; Hashiguchi et al., 2017; Kato et al., 2016, 2019).
The 2019 Pan American games: Communicable disease risks and travel medicine advice for visitors to Peru – Recommendations from the Latin American Society for Travel Medicine (SLAMVI)
2019, Travel Medicine and Infectious DiseaseCitation Excerpt :Travelers should be counseled to be careful about vector precautions, as there is no vaccine or prophylaxis to prevent leishmaniasis. Any person with a skin lesion persisting more than a few weeks after return from Peru should be evaluated for CL [47,63–65]. In the case of those highland areas, travelers and advising physicians should be aware of mountain sickness or acute high altitude illness occurrence both reported frequently in altitude exposed travelers, [66].