Cutaneous Leishmaniasis in Saudi Arabia

1

??? ???? ?????? ?????? Cutaneous Leishmaniasis in
Saudi Arabia
Supercourse
Presented by
Dr Khalid Al-Aboud Medical Director and
Consultant Dermatologist
King Faisal Hospital, Makkah,Saudi Arabia. E-mail
amoa65_at_hotmail.com
2
Background
L
eishmaniasis is a protozoal disease caused
by Leishmania parasite, which is transmitted by
the sand fly . Leishmaniasis is of three types
cutaneous leishmaniasis, muco-cutaneous and the
visceral (Kala-azar )
3
Leishmaniasis Life-Cycle
Sand fly Stages
Human Stages
Sand fly takes a blood meal
Promastigotes are Phagocytized by macrophages
Divide in midgut and migrate to proboscis
(Injects promastigote stage into the tissue)
Promastigotes transfer into amastigotes
inside macrophages
Amastigotes transform Into promastigote stage
in midgut
Ingestion of Parasitized cell
Amastigotes multiply in cells (Including
macrophages) of Various tissues
Sand fly takes a blood meal
Infective stage
(ingest macrophages Infected with amastigotes )
Diagnostic stage
4
Leishmaniasis
Ways of Infection
5
Leishmaniasis
Sand Flies are vector of the disease. More than
500 species and subspecies in the world.Of which
,only 35 types are known to transmit the
disease,Phlebotomus in OCL,and Lutzomia in
NCL. There are more than 21 Leishmanial species .

6
Diagnosis of Leishmaniasis
7
Leishmaniasis reservoir hosts
8
Leishmaniasis
W
O
Our focus of presentation
R
L
gt 12 Million people infected in 88 countries
gt 350 Million people are risk
D
Annually,0.5M (VL)80,000 Deaths,1.5M(CL)
Visceral Leishmaniasis
Cutaneous Leishmaniasis
Mucocutaneous Leishmaniasis
9
Types of Leishmaniasis
Visceral
Fever
Hepatosplenomegaly
Weight loss

• Death, 90 in
• Bangladesh, Brazil, India, Nepal,and in Sudan

Cutaneous

• Skin ulceration,
• 90Afghanistan
• ,Syria,Iran,Iraq,Brazil,Peru,
• and Saudi Arabia

Mucocutaneous
Skin and mucus membranes affection

• Might be fatal. 90
• in Bolivia,
• Brazil and Peru

10
Saudi Arabia
Leishmaniasis
It is known in the Kingdom back to 1950. Ministry
of Health has established the leishmaniasis unit
in the 1980 Under The precautionary medicine to
follow-up the disease in the Saudi cities
11
Saudi Arabia
Leishmaniasis
There are VL and CL. VL caused by L.Donovani LON
42,and the Rattus rattus is the reservoir. 2
types of CL(ZCL and ACL) In the Riyadh and
Eastern province ,ZCL transmitted by P.Papatasi
and caused by L.Major LON4
12
Saudi Arabia
Leishmaniasis
CL in Southern region is ACL transmitted by
P.Sergenti and caused by L.Tropica LON 72
13
Saudi Arabia
Leishmaniasis
There are 20 types of Sand Flies in the KSA.7 are
Phlebotomous and 13 are of Sergentomyia type.
14
Visceral Leishmaniasis
N
Northern
Al-jouf
Tabouk
Medina
Riyadh
Makkah
Eastern
Baha
Najran
Aseer
Jazan
Affected area
15
Reported Cases of Visceral Leishmaniasis
1984-2004
16
Cutaneous Leishmaniasis
C
utaneous leishmaniasis has many local names
17
Seasonal Variation of
Cutaneous Leishmaniasis
The peak of cutaneous leishmaniasis is in August,
October, December, January and February. The
least number of cases are reported in May and
June.
18
Geographical Distribution of
Northern
Cutaneous Leishmaniasis
8.4
Al-jouf
2001
Tabouk
18.2
7.6
Hail
Qaseem
Alhsa only 41.2
Medina
Riyadh
9.6
Makkah
Eastern
Baha
Najran
Aseer
N
Jazan
19
Geographical Distribution of
Northern
Cutaneous Leishmaniasis
9.1
Al-jouf
2004
Tabouk
26.6
18.5
Hail
4.1
Qaseem
Alhsa 20.9
Medina
Riyadh
4.1
Makkah
Eastern
Baha
Najran
Aseer
N
Jazan
20
Reported Cases of Cutaneous Leishmaniasis
1983-2004
21
Reported Cases of Cutaneous Leishmaniasis
1983-2004
22
Reported Cases of Cutaneous Leishmaniasis
1983-2004
23
Reported Cases of Cutaneous Leishmaniasis
1983-2004(infant)
1403-1424 H (Infants)
Leishmaniasis usually affects children more than
other age groups .
24
The Clinical types of Cutaneous Leishmaniasis
25
The clinical types of Cutaneous Leishmaniasis
26
Thank you