Wüstenschiff

LEISHMANIASIS - EUROPE: IMPORTED
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Date: Thu 12 Jan 2012
Source: TropNet [edited]
http://www.tropnet.net/index.php?id=103


Imported cases of leishmaniasis have become more frequent in Europe over the past years due to increased travel to risk areas. Standardized species identification and treatment protocols are warranted to provide patients with the best possible treatment.

The broad availability of PCR allows a rapid determination of species. Each species has a different sensibility to the different anti-leishmanial drugs. Therefore, a species-specific treatment approach has been evaluated for many species and has been widely applied in many centres recently.

As the leishmania species influences the outcome of systemic treatment, parasite species identification is of high clinical relevance. In particular, in the setting of travel clinics, where the origin of an infection often cannot be assigned to a specific location, more sophisticated species identification than just a geographical one is required.

Currently, treatment recommendations are usually based on data from endemic regions, but travelers could have different treatment responses to anti-leishmanial drugs than the endemic population with repeated contact to leishmania parasites. Moreover, more treatment options are available to western travelers as compared to endemic settings, where high cost and inadequate logistics can be a major problem. Therefore, data on the efficacy of specific treatment approaches in travellers are needed.

Little is known on the frequency and treatment of cutaneous and mucosal leishmaniasis in Switzerland and Europe. Lack of efficacy to one or the other drug may arise. Therefore, an international surveillance is necessary to monitor the efficacy of a species-specific treatment. Since the number of patients in Switzerland of each species of cutaneous leishmaniasis is too small, an international surveillance system is necessary.

Project Goal:
Improving treatment of leishmaniasis based on clinical presentation and molecular species differentiation

Objectives:
1. Exchange between specialist and harmonisation of treatment recommendations in Europe
2. Surveillance of treatment of cutaneous and mucosal leishmaniasis in Europe

The consortium so far consists of 17 participants from 12 institutions from 7 European countries (UK: 3 partner institutions; France: 3 partner institutions; Belgium: one partner institution; Germany: 2 partner institutions; Netherlands: one partner institution; Switzerland: one partner institution; Spain: one partner institution).

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[Leishmania is endemic in southern Europe. A recent study from Spain found that 2028 patients were diagnosed in the 12-year period from 1997 to 2008, of which 1/3rd were co-infected with human immunodeficiency virus. (Gil-Prieto R et al. Epidemiology of leishmaniasis in Spain based on hospitalization records (1997-2008). Am J Trop Med Hyg. 2011;85:820-5).

In the southern Mediterranean region, the disease is most frequent in children, whereas in Europe, and particularly in France, it is mostly an opportunistic infection associated with immunosuppression (Marty P et al. Mediterranean visceral leishmaniasis. Bull Acad Natl Med. (Paris) 2011;195:181-8).

In most countries, neither visceral nor cutaneous leishmaniasis is a notifiable disease, and, therefore, data on the number of imported cases are lacking. The TropNet project will provide new data and help to determine whether leishmaniasis should be made a notifiable disease in Europe. - Mod.EP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1wZE.]

Hallo Andreas,

als mir gerade der zuvor gepostete Artikel in die Hände fiel, musste ich gleich an euren Hautausschlag denken. Wie ist die Sache eigentlich ausgegangen? Ist bei euch wieder alles ok?

Gruß
Birgitt