What is the insect vector for leishmania?
Inside the human host, which cells do the parasites replicatewithin?
What are the two forms of leishmania and how are they different?
Promastigotes – found in the sandfly – they have a flagellum (which they move towards) and they are motile Amastigotes – found within humans/other vertebrate hosts – they have resorbed their flagellum and are no longer motile – found in macrophages
Where, across the world, are sandflies found?
Warm parts of the world – Southern Europe, Asia, Africa, Central and South America, Australia
How is transmission of leishmania in Europe changing?
It is spreading northwards
Describe the appearance and behaviour of sandflies.
They are small and hairy They hop around before settling down to bite Unlike mosquitoes, they are silent in attack
Which gender of sandflies takes blood meals?
Females – need blood to provide nutrition for eggs
What are the four major forms of leishmaniasis?
Visceral Leishmaniasis Cutaneous Leishmaniasis Diffuse Cutaneous Leishmaniasis Mucocutaneous Leishmaniasis
What is another name for visceral leishmaniasis?
Kala Azar (black fever)
What are the features of visceral leishmaniasis?
Irregular fever Weight loss Enlarged liver and spleen Anaemia
What are some risk factors for visceral leishmaniasis?
Malnutrition Immunosuppression (e.g. because of drugs) HIV
Which type of leishmania causes the majority of cases of visceral leishmaniasis in Ethiopia?
How is visceral leishmaniasis diagnosed?
Visualisation of the amastigote parasite my microscopic examination of aspirates Antibody detection
What are the treatment options for visceral leishmaniasis?
Sodium stibogluconate or meglumin antimoniate Liposomal amphotericin B
What other clinical manifestation of leishmania can occur during or after treatment for visceral leishmaniasis?
Post Kala-azar Dermal Leishmaniasis (PKDL)
Describe the features of local cutaneous leishmaniasis.
Heals spontaneously Immunity from reinfection NOTE: it can still leave disfiguring scars
Describe the features of diffused cutaneous leishmaniasis.
Disseminated lesions Resembles leprosy No spontaneous healing Difficult to treat Frequent relapses
Which part of the body does mucocutaneous leishmaniasis typically affect?
Mouth and nose
Describe the features of mucocutaneous leishmaniasis.
Disfiguring and destroys mucous membranes No spontaneous healing Frequent relapses
What type of leishmania are the majority of cutaneous leishmaniasis lesions caused by?