Diagnosis of cutaneous leishmaniasis in a non- endemic area in Morocco.
Morocco (IFMSA-Morocco), Faculty of Medicine and Pharmacy of Casablanca, Casablanca
Laboratory of parasitology & department of dermatology
Pr. Myriam Riyad
Pr. Myriam Riyad, head of the laboratory of parasitology, and Prof. Soumiya Chiheb, head of the dermatology department.
4 weeks
Cities/Months Jan Feb Mar Apr May Jun Jul Augt Sep Oct Nov Dec
Yes Yes No No No No No No No Yes Yes Yes
Type of Research Project
- Clinical Project with Laboratory work
What is the background of the project?
Cutaneous leishmaniasis (CL) is a vector borne parasitic disease endemic in more than 80 countries worldwide. In Morocco the disease is reported since the beginning of the XX th century with three species reported: Leishmania major, responsible for zoonotic CL, endemoepidemic in the southern pre-saharan regions, L. tropica responsible for hypoendemic old foci in the 1980s in center-south Morocco, but actually characterized by the widest geographical distribution South and North of the country; finally, L. infantum responsible for sporadic CL mainly in the North. CL is a persistent public health problem in Morocco with thousands of cases notified each year. The disease is polymorphic and may be asymptomatic, localized, or disseminated. This polymorphism may be due either to the Leishmania species, the immune status of the host, or the host-parasite relationships. The first sign of an infection is typically a small erythema that develops after a variable prepatent period at the inoculation site by the insect vector. This erythema develops into a papule, then a nodule that progressively ulcerates over a period of 2 weeks to 6 months. Cutaneous lesions vary in severity (e.g. lesion size), clinical appearance (localized CL, disseminated CL …), and time to cure; the healing process being spontaneous. Thus this broad clinical spectrum makes the clinical diagnosis difficult; differential diagnosis is also important because other dermal diseases with similar aspects are common in endemic areas. Although non fatal, CL is treated to accelerate cure to reduce scarring, especially in cosmetic sites, and to prevent parasite dissemination or relapse. However the main problems in treating CL are that clinical diagnosis is difficult especially in the absence of microscopy at the basic health-care level, and the recommended pentavalent antimonials drugs can have serious side-effects, and have variable eficacy according to the infecting Leishmania species and clinical presentations (e.g. mucosal lesions. The management of patients and the contribution to the disease prevention can be improved by enhancing case detection and treatment.
What is the aim of the project?
The aim of this project is to contribute to improve the clinical diagnosis of CL in a non endemic area, i.e. Casablanca.
What techniques and methods are used?
- Clinical diagnosis: it is based on epidemiological information (history of travel to a known endemic focus, …) and on the aspect of the cutaneous lesions (uncovered body parts, painless, …). - Parasitological diagnosis: it is based on the observation of the parasite amastigote form in stained smears of cutaneous samples, culture (isolation of the parasite promastigote form) and genotyping (in situ molecular identification of the responsible species).
What is the role of the student?
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
- contribution to the clinical and biological diagnosis of CL. - contribution to a better knowledge on the clinical aspects associated with the Leishmania species that will be identified through molecular techniques. - contribution to the treatment and follow-up of the patients.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
The training will include lectures and seminars, as well as clinical staff of the dermatology department.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a poster
- The student will prepare a presentation
- The student will have the opportunity to present the results together with the supervisor at a conference
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
-General knowledge about Parasitology. -Basic parasitology skills.
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts:
- Medical students
- Cutaneous leishmaniasis ? M.S. Bailey & D.N.J. Lockwood - Clinics in Dermatology (2007) 25
- Cutaneous leishmaniasis caused by Leishmania major in Morocco: still a topical question – M. Riyad et al.; Eastern Mediterranean Health Journal; 2013; Vol. 19 No. 5.
- Eastern Mediterranean Health Journal
- Detection and molecular typing of Leishmania tropica from Phlebotomus sergenti and lesions of cutaneous leishmaniasis in an emerging focus of Morocco – M. Ajaoud et al. Parasites & Vectors; 2013; 6:217.
- Cutaneous Leishmaniasis in North Africa: a review – K. Aoun & A. Bouratbine - Parasite 2014; 21; 14.
- Detection and molecular typing of Leishmania tropica from Phlebotomus sergenti and lesions of cutaneous leishmaniasis in an emerging focus of Morocco ? M. Ajaoud et al. Parasites & Vectors
- Molecular diagnosis of cutaneous leishmaniasis and identification of the causative Leishmania species in Morocco by using three PCR-based assays – T. Mouttaki et al.; Parasites & Vectors; 2014; 7:420.