1. Leishmania
and
Leishmaniasis

2. Leishmania currently affects 12 million people in 88 countries.
Cause:
Leishmania spp.
Over 23 different species of Leishmania exist.
Vector:
Sand flies of genus Phlebotomus in the old world
Sand flies of genus Lutzomyia in the new world.

3. Leishmaniasis Sand Flies Visceral Cutaneous L. donovani L. infantum
Leishmania major
L. tropica
Sand Flies
Phlebotomus papatasi  L. major
P. sergenti  L. tropica
P. alexandri  L. donovani/infantum

4. Taxonomy of
Leishmania
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5. Phylum: Sarcomastigophora Class: Zoomastrgophora Order: Kinetplastida
Kingdom: Protisata
Phylum: Sarcomastigophora
Class: Zoomastrgophora
Order: Kinetplastida
Family: Trypanosomatidae
Genus: Leishmania
Species: Donovani, Tropica, major

6. Leishmania
Life cycle
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7. Life Cycle Reservoir Vector
Pathology: Parasites in macrophages; Infiltration to skin/RE cells
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8. Promastigotes differentiate to complement resistant metacyclic promastigotes in the sand fly midgut
procyclic
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10. The intermediate host and vector of Leismania are species of sandflies (Phlebotomus and Lutzomyia spp.).  Female sandflies become infected when taking a blood meal containing amastigotes in white blood cells (macrophages). 
In the gut of the sandfly, amastigotes transform into promastigotes, attach to the gut wall and multiply by longitudinal binary fission.  After approximately 1 week, they transform into the infective metacyclic promastigotes which are so numerous in the anterior gut and pharynx that they may block it.  
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11. Humans are infected when an infected sandfly regurgitates the metacyclic promastigotes while taking a blood meal.  Promastigotes that enter the bloodstream are phagocytized by macrophages, in which they transform into amastigotes and multiply.  
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12. Leishmania spp. Amastigote
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13. Leishmania spp. Promastigote
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14. Leishmania
Promastigote
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15. Leishmania spp (Promastigote)
Single flagellum found in sand flies
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16. Leishmaniasis Macrophage rupturing Amastogotes
Amastogotes with nucleus and kinetoplast
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17. Leishmania
Amastigotes
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18. Leishmaniasis rosette
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19. Leishmaniasis 1- Cutaneous leishmaniasis (CL).
2- Mucocutaneous leishmaniasis (ML).
3- Visceral leishmaniasis (VL).
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20. Cutaneous leishmaniasis
Have different names such as oriental sore, Al mohtafirah, Al domal.
Caused by L.tropica and L.major in the old world.
widely distributed in the Mediterranean, Middle East, India, and Africa .
characterized by skin lesions (oriental sore). 
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21. Infected macrophages containing amastigotes are found primarily at the site of infection around the sores.  The sores are characterized by an elevated rim encircling the lesion.  The sores generally heal by themselves within a year, but secondary bacterial infections are possible in open sores.
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22. Patient infected with CL
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23. Mucocutaneous leishmaniasis
found in South America—particularly Peru, Bolivia, Paraguay, Ecuador, Colombia, and Venezuela .
Caused by L. braziliensis, L. major and L.tropica
characterized by lesions near mucosal membranes. 
The initial site if infection is a small red papule that ulcerates in a few weeks.  The lesions are flat (no raised rim) and often oozing.  Infections of the ear, nose and mouth area lead to degeneration of the cartilage and soft tissues, resulting in disfigurement.
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24. Patient infected with MCL
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25. Visceral leishmaniasis
commonly known as kala-azar ,
Found in Africa to India and China .
Caused by L. donovani and L. infantum
In most areas, individuals do not develop sores but in some cases, small lumps may appear over the entire body or in patches on the nose.
Common symptoms include: weight loss, fever, low blood cell count, and enlarged spleen and liver.
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26. Patient infected with VL.
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27. Symptomatic dogs
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28. Sand fly

29. Sand fly taxonomy Kingdom: Animalia. Phylum: Arthropoda.
Class: Insecta.
Order: Diptera.
Family: Psychodidae.
Genus: Phlebotomous, Sergentomyia, Lutzomyia.
Species: P. papatasi, P. sergenti, S. antennata,
S. clydi.
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30. It has a brownish body colour. The body covered with dense hairs.
General
characteristics
It has a brownish body colour.
The body covered with dense hairs.
V wing shape at rest.
It has a weak flight for short distance and for short levels.
Nocturnal habit.
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31. Sand fly life cycle
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32. The eggs are elongated oval-shaped
The first larval instar has a dark head capsule and can be distinguished by the presence of two caudal bristles, all subsequent instars bearing four bristles.
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33. Male & Female sand flies
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34. Diagnosis Prevention Cutaneous leishmaniasis Gives Life Long Immunity
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35. DIAGNOSTIC TESTS for human visceral and cutaneous Leishmaniasis
Serological methods:
IFA (>1/800)
ES (4-24 arc)
Molecular methods: PCR
Culture
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36. Indirect Immunofluorescence. Search for antibodies.
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37. An electrosyneresis strip
Note the arc (a) appeared by the connection of the
antigen (b) with the positive control (c) and the positive to Leishmania
sample (d).
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38. Treatment & Prevention
pentamidine
There is a strong need for
new drugs with less Toxicity
coetaneous leishmaniasis gives life long immunity
Control of Leishmania transmission is challenging because of difficulties in limiting contact with shadflie
Insecticide spray to kill sand flies
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39. allah protect you
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