Risk factors and prediction analysis of cutaneous leishmaniasis due to Leishmania tropica in Southwestern Morocco

• Published in: Infection, genetics and evolution Vol. 61; pp. 84 - 91
• Main Authors: El Alem, Mohamed Mahmoud Mohamed, Hakkour, Maryam, Hmamouch, Asmae, Halhali, Meryem, Delouane, Bouchra, Habbari, Khalid, Fellah, Hajiba, Sadak, Abderrahim, Sebti, Faiza
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.07.2018
• Subjects: Cutaneous leishmaniasis; Holt-Winters; ITS1 PCR-RFLP; Leishmania tropica; Socioeconomic-demographic-environmental factors; Cutaneous leishmaniasis; Holt-Winters; Socioeconomic-demographic-environmental factors; Leishmania tropica; ITS1 PCR-RFLP
• ISSN: 1567-1348; 1567-7257
• DOI: 10.1016/j.meegid.2018.03.017

Cutaneous leishmaniasis is currently a serious public health problem in northern Africa, especially in Morocco. The causative parasite is transmitted to a human host through the bite of infected female sandflies of the genus Phlebotomus. The objective of the present study is to characterize the causative organisms and to predict the risk of cutaneous leishmaniasis (CL) cases in six provinces in southwestern Morocco, based on the spatial distribution of cases in relation to environmental factors and other risk factors such as socio-economic status and demographics. A molecular study was carried out using ITS1 PCR-RFLP method of the ribosomal DNA of Leishmania. An epidemiological study on CL cases was reported between 2000 and 2016 in this current investigation in six provinces in southwestern Morocco. Statistical analysis was performed using a linear regression model to identify the impact as well as the interaction between all predictor variables on the distribution of CL in the studied provinces. The forecast Holt-Winters (HW) method was used to describe the trend and seasonality of CL cases. The ITS1-PCR- RFLP analysis revealed the presence of Leishmania tropica in all studied provinces. The spatial distribution of CL cases documented in all studied provinces during the sixteen years showed a heterogeneous pattern and fluctuation trend with an average prevalence of 9.92 per 100,000 inhabitants. In addition, the forecast HW model predicts continued variability of trend and seasonality of CL cases in the upcoming years. This study confirmed the importance of socioeconomic factors, in particular poverty and the vulnerability rate, on distribution and emergence of CL. This study revealed a relationship between increasing risk of CL occurrence due to Leishmania tropica, as well as the distribution and emergence thereof, and socioeconomic factors in the investigated area. •First molecular study of cutaneous leishmaniasis in southwest area of Morocco•DNA sequence analysis revealed the presence of Leishmania tropica as the main causative agent of CL in the study area.•Poverty and vulnerability rate were the main risk factors for emergence of CL (p < 0.05).•Holt-Winters model has been used to describe the trend and seasonality in the high-risk provinces of CL.