Twenty-four new human cases of cutaneous leishmaniasis due to Leishmania killicki in Metlaoui, southwestern Tunisia. Probable role of Phlebotomus sergenti in the transmission

Abstract

Metlaoui district in the South-west of Tunisia is a classical focus of cutaneous leishmaniasis (CL) due to . Leishmania major. Since 2005, a single case of CL due to . L. killicki has been reported. We report twenty four human cases due to this parasite, affecting men and women from 2 to 70 years old. . Leishmania killicki have been typed using molecular techniques: polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP) and gene sequencing. Four strains from patients have been successfully cultured on NNN medium and isoenzymatically typed as . L. killicki MON-8. Our results strongly suggests that Metlaoui is a new . L. killicki focus with a stable transmission cycle. Sand flies fauna in the same focus was also studied. 1400 Phlebotomine sand flies (785 males/615 females) have been caught during an entomological survey. . Leishmania major DNA has been found in one . P. papatasi female, the most abundant species, whereas . L. killicki DNA has been found in one . Phlebotomus sergenti female emphasizing the probable role of this species as vector of this zoonotic parasite. © 2012 Elsevier B.V..