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International audience; The epidemiological situation of cutaneous leishmaniasis in the region of Annaba (North Eastern Algeria) is explored for the first time. During a clinical survey carried out in the Annaba Hospital between 2004 and 2008, the parasitological study of lesions has revealed 259 positive cases (43.31%). Isoenzymatic identification of 16 strains isolated showed the presence of three Leishmania species and four zymodemes. The hypothesis of the presence of L. infantum is confirmed with two zymodemes, MON-1 and MON-24. The unexpected presence of L. major MON-25 certifies the substantial extension of this zoonotic form to the North. The isolation of L.killicki, whose presence was unsuspected, reiterated the interest of eco-epidemiological analysis of households affected by the disease. Moreover, it is a new zymodeme never isolated so far, the MON-306.

The deletion of a 260-kb segment containing all the coding DNA sequences (CDS) of chromosome 1 of Leishmania major Friedlin strain was performed through homologous recombination during a transfection experiment. This allowed the selection of a mutant clone containing a linear extra chromosome sizing 155 kb (XC155). The structure of XC155 was determined by restriction analysis and DNA cloning and sequencing of the gel-purified chromosome: it is made of a 'mirror' inverted duplication of the 'right' end of chromosome 1a (approximately 25 kb at each end), and in its central part of a complex tandem amplification of the linearized transfection vector containing the hygromycin resistance gene (over approximately 105 kb). No sequence of the coding region of chromosome 1 (including the 1.6-kb 'switch' region) was found. By contrast, XC155 contains two large (approximately 13 kb) clusters of tandemly repeated subtelomeric sequences (272-bp 'satellite' DNA) as well as telomeric hexamer repeats. This extra chromosome was found to be mitotically stable after150 generations without selective pressure in vitro. Two sequence elements are considered which may have an effect on mitotic stability and participate to centromeric function in this extra chromosome: the amplification of the input vector and the 272-bp 'satellite' DNA bound by telomeric repeats.

The genus Leishmania can be taxonomically separated into three main groups: the Old World subgenus L. (Leishmania), the New World subgenus L. (Leishmania) and the New World subgenus L. (Viannia). The haploid genome of Old World Leishmania species has been shown to contain 36 chromosomes defined as physical linkage groups; the latter were found entirely conserved across species. In the present study, we tried to verify whether this conservation of the genome structure extends to the New World species of Leishmania. 300 loci were explored by hybridization on optimized pulsed field gel electrophoresis separations of the chromosomes of polymorphic strains of the six main pathogenic Leishmania species of the New World. When comparing these New World karyotypes with their Old World counterparts, 32 out of 36 linkage groups were found conserved among all species. Four chromosomal rearrangements were found. All species belonging to the L. (Viannia) subgenus were characterized by the presence (i) of a short sequence exchange between chromosomes 26 and 35, and (ii) more importantly, of a fused version of chromosomes 20 and 34 which are separated in all Old World species. 69 additional markers were isolated from a plasmid library specifically constructed from the rearranged chromosomes 20+34 in an attempt to detect mechanisms other than a fusion or breakage: only two markers out of 40 did not belong to the linkage groups 20 and 34. On the other hand, all strains belonging to the New World subgenus L. (Leishmania) were characterized by two different chromosomal rearrangements of the same type (fusion/breakage) as above as compared with Old World species: chromosomes 8+29 and 20+36. Consequently, these two groups of species have 35 and 34 heterologous chromosomes, respectively. Overall, these results show that large-scale chromosomal rearrangements occurred during the evolution of the genus Leishmania, and that the three main groups of pathogenic species are characterized by different chromosome numbers. Nevertheless, translocations seem particularly rare, and the conservation of the major linkage groups should be an essential feature for the compared genetics between species of this parasite.

La leishmaniasis mucocutánea americana es un grave problema de salud en el Perú, particularmente en la región montañosa de Cuzco, donde se produjeron 25% de todos los nuevos casos notificados en 1989. El número de casos ha aumentado notablemente desde principios del decenio de 1980, cuando hubo una emigración estacional en gran escala a las zonas endémicas, especialmente a la región forestal de Madre de Dios, debido al descubrimiento de nuevas minas de oro en esa zona y al deterioro económico en el Perú. Ante la falta de respuesta oficial del Gobierno peruano, centenares de enfermos de leishmaniasis en la zona de Cuzco formaron asociaciones de autoayuda con el objetivo de obtener los medicamentos necesarios para tratar su afección. El logro principal de este movimiento que surgió espontáneamente, apoyado por varias instituciones públicas y privadas, fue animar a los enfermos, particularmente a los pacientes con lesiones de las mucosas, a salir del aislamiento. Como resultado, se han reducido mucho la prevalencia e incidencia de la enfermedad en ese territorio.American mucocutaneous leishmaniasis is an important health problem in Peru, particularly in the mountainous Cuzco Region, where 25% of all new cases reported in 1989 were located. Cases have increased considerably since the beginning of the 1980s, when large-scale seasonal migration to endemic zones occurred, particularly in the forest area of Madre de Dios, following the discovery of new gold deposits there and the deterioration in the economic situation in Peru. Following the lack of official response from the Peruvian government, hundreds of people suffering from leishmaniasis in the Cuzco area formed self-help associations with the objective of obtaining the drugs needed to treat their disease. The major achievement of this spontaneous movement, which was supported by several public and private institutions, was to encourage sick people, particularly patients with mucosal lesions, to emerge from isolation. As a result, the prevalence and incidence of the disease have now considerably decreased in the region.

Resume Les leishmanioses sont des affections parasitaires de plus en plus associees a l'immunodepression et plus particulierement la leishmaniose viscerale au cours de l'infection a VIH dans ie sud de l'Europe. D'apres une etude retrospective de l'Organisation mondiale de la sante, 692 cas ont ete recenses jusqu'en 1995, interessant surtout les adultes de 20 a 40 ans. Les manifestations biocliniques sont souvent atypiques avec des localisations inhabituelles en particulier digestives et pulmonaires. Le diagnostic biologique repose essentiellement sur la mise en evidence du parasite par examen direct et culture, plus recemment par polymerase chain reaction, technique d'auenir. Le diagnostic serologique, inconstamment positif, est toutefois utilise en complement. Les therapeutiques antileishmaniennes classiques sont insuffisantes pour une guerison durable.

Three cases of cutaneous leishmaniasis in guinea-pigs from a rural area near Curitiba (Paraná State, Brazil) are reported. The three parasite isolates were characterized by isoenzyme electrophoresis as Leishmania enriettii, of which two distinct zymodemes were observed.

The wing morphometry of a laboratory-bred population of Phlebotomus perniciosus was studied using a semi-automatic, measurement system. The methods used were found to be precise, reproducible and valid for morphometrical studies. Each of several, different wing indices was found to be similar whether the wing was mounted in Hoyer's medium, Euparal or chloral balm. All samples showed similar differences between the wings of males and females, the wings of the males being smaller than those of the females.

Following the publication of a paper on Conjonctival human myiasis by Oestrus ovis in southern Tunisia by Anane and Ben Hssine (Bull Soc Pathol Exot (2010) 103(5):299-304), the author reminds that the discovery of this disease was made in Algeria, in 1907 by Edmond and Etienne Sergent.

The CIPA programme is a collaborative project including two entomologists from France and seven from South and Central America countries. Its objective is the development of an expert system for computer aided identification of phlebotomine sandflies from the Americas. It also includes the formation of data bases for bibliographic, taxonomic and biogeographic data. Participant consensus on taxonomic prerequisites, standardization in bibliographic data collections and selection of descriptive variables for the final programme has been established through continuous communication among participants and annual meetings. The adopted check-list of American sandflies presented here includes 386 specific taxa, ordered into three genera and 28 sub-genera or species groups.

The authors report a case of gynandromorphism from the species Sergentomyia minuta parroti. This is the 16th case reported in the literature and the third one described from Algeria. The present case shows the predominance of female organs within the morphological characters., Les auteurs rapportent une nouvelle observation de gynandromorphisme chez Sergentomyia minuta parroti. Il s'agit du 16e cas dans la littérature et du 3e cas décrit en Algérie. La particularité de ce cas réside dans la présence de caractères morphologiques à prédominance d'éléments femelles., Harrat Z., Lambert M., Tabet-Derraz O., Dedet J.-P. A propos d'un cas de gynandromorphisme chez Sergentomya minuta parroti(Adler & Theodor) (Diptera, Psychodidae). In: Bulletin de la Société entomologique de France, volume 98 (5), décembre 1993. pp. 459-462.

Three clinico-epidemiological forms of cutaneous leishmaniasis (CL) were described in Tunisia: the zoonotic CL (ZCL) epidemic which occurred in the centre of the country caused by Leishmania major MON-25, the chronic CL (CCL) In the south-east of the country caused by Leishmania killicki MON-8 and the sporadic CL In the North (SCL) caused by Leishmania infantum MON-24. The latter form, described in 1991, prevails in northern Tunisia with approximately thirty cases per year. Its vector, unknown for a long time could be according to the last publications, Phlebotomus perfiliewi or Phlebotomus langeroni; however, its reservoir remains unknown until now. The systematic isoenzymatic characterization permits to identify a great number of strains improving then knowledge on the eco-epidemiology of the disease. Indeed, changes were noted in the geographical distribution of these clinical forms: extension of the ZCL to the North and South, extension of the CCL to North and the SCL to the centre. We report in this note the first mention of L. infantum MON-24 in the two provinces of the centre of Tunisia: Kairouan and Sidi Bouzid, confirming the extension of the SCL to the Centre.

The leishmaniases include several diseases caused by parasites of the genus Leishmania: visceral, cutaneous, and mucocutaneous. An estimated 350 million people in 88 countries on four continents are at risk of infection. The annual incidence of new cases is estimated between 1.5 and 2 million, making the leishmaniases a major public health problem. In several endemic countries, a dramatic increase in the number of leishmaniasis cases has occurred during the last decade, due to environmental risk factors. Immunosuppression is the major individual risk factor. Intervention strategies for prevention or control are hampered by the diversity of the structure of leishmaniasis foci, with many different animals acting as reservoir hosts and a multiplicity of sand fly vectors.

International audience

The first time the term phlebotomine sandfly was used, was by an Italian naturalist, Philippo Bonanni, in 1691. The first description though was made by another Italian naturalist, Scopoli, under the name Bibio papatasi. The name of the genus, Phlebotomus, was not given until 1840 by Rondani and Berté. The first description of an American phlebotomine sandfly was made by Coquillett, in 1907. The discovery of the three first sandflies in Brazil is the work of Lutz and Neiva, in 1912. From this date till 1921, 11 new species were described in this country and since then their number is still increasing and has reached 229 at this time. The history of the identification of phlebotomine sandflies as vectors, in Brazil like elsewhere in South America, is as complex as the one of the leishmaniases themselves, to which it is closely linked. The knowledge of cutaneous leishmaniasis in Brazil goes back to 1909, when Gaspar Vianna proposed to name the parasites that were found Leishmania braziliensis (1911). Following the observation of the Sergent brothers on the role of Phlebotomus papatasi in the transmission of cutaneous leishmaniasis in Algeria (1921), it became obvious that phlebotomine sandflies should be incriminated as vectors of cutaneous leishmaniasis in the Americas and that proof should be sought of their role. This is what various Brazilian scientists have done, like Aragão in 1922, Pessôa and Pestana in 1940. In the 1950s evidence was produced that the different forms of leishmaniasis that infest the American continent were caused by distinct species of the parasite. Subsequently, successful searches for the specific vectors were carried out. A by-product of the epidemiological studies of leishmaniases has been the discovery of the transmission of other parasites of the Trypanosomatid families (Crithidia, Endotrypanum, Trypanosoma). More recently, since the 1960s, a large number of viruses amongst which Rhabdoviridae, Bunyaviridae and Reoviridae, have been isolated from phlebotomine sandflies. Between 1961 and 1995, 69 serotypes of different arboviruses were obtained from different zones of Brazilian Amazonia.

The enzymatic profiles of 22 Jordanian Leishmania isolates obtained from humans, Psammomys obesus and Phlebotomus papatasi were determined using starch-gel electrophoresis and a 15-enzyme system. Thirteen of the isolates were typed as L. major and the other nine, all from Mediterranean or sub-Mediterranean regions, as L. tropica. The two zymodemes of L. major encountered, MON-26 and MON-103, differed in terms of purine nucleoside phosphorylase 2. The MON-26 isolates came from the Jordanian plateau whereas those of MON-103 were only collected from the Jordan valley. The four zymodemes of L. tropica observed (MON-7, MON-137, MON-200 and MON-265) were identical for only two of the 15 enzymes studied (i.e. isocitrate dehydrogenase and glucose phosphate isomerase), confirming the high level of enzymatic polymorphism of L. tropica. So far, MON-200 and MON-265 have only been found in Jordan.

Therapeutic failure in a human immunodeficiency virus-negative patient with visceral leishmaniasis was due to mixed infection by two different Leishmania infantum zymodemes: L. infantum zymodeme MON-98, which is a rare zymodeme and is reported for the first time in Greece, and zymodeme MON-1, which is common in the Mediterranean region. The two strains were isolated from two samples of bone marrow from the patient obtained before the administration of treatment and 20 days later, since there was no improvement in the clinical signs. The zymodemes MON-98 and MON-1 exhibited different behaviors in vitro and showed different sensitivities to meglumine antimoniate in vitro and in vivo, as shown by clinical findings. Mixed infections with different Leishmania strains may explain the differences in the clinical course of leishmaniasis in many patients and may be the reason for treatment failures.

Four human cases of localized cutaneous leishmaniasis caused by Leishmania naiffi are reported. Two of the cases were infected in French Guiana, one in French Guiana or Martinique, and the other in Ecuador or Peru. The geographical distribution of L. naiffi is clearly larger than that initially reported. Three zymodemes were represented by the four isolates, confirming that there is intraspecific polymorphism in L. naiffi.

This report describes the results of epidemiological surveillance of cutaneous leishmaniasis in French military personnel in French Guiana. Data was collected regarding microscopic diagnosis, clinical manifestations, and lesion location as well as compliance with vector control measures. Year-to-year variations in the incidence in the general population have been attributed to changes in climatic conditions. Monitoring incidence and density curves, correlation of findings with local epidemiological data, and analysis of the most recent epidemic in 1998/99 (326 cases, attack rate 3.2% men years) highlight the importance of behavioral factors. The proportion of total cases involving military personnel varied widely from 20 to 85%. Investigation consistently showed that failure to apply elementary protective measures against sandfly bites was the most determinant factor in this proportion. Strict compliance with these measures appears to reduce the risk of infection considerably.

Cutaneous leishmaniasis is present in two different regions of the State of Parana, (South of Brazil): in the Northern area and the Ribeira River Valley. In 1994 there was an outbreak with a total of 1395 leishmaniosis cases. Here, we report on the isolation and characterization of 52 Leishmania stocks isolated between 1995 and 2000 from humans, dogs, and wild reservoir and phlebotomine hosts. The material, obtained by biopsy (punch no. 4) or by aspiration puncture, was inoculated in two media (NNN and Tobbie & Evans) and maintained at a temperature of 24°C. After isolation, parasites were grown in C.C.S. medium (in Erlenmeyer and bottle of Roux) for protein extract preparation, awaiting identification. Isoenzymatic characterisation was made by electrophoresis in starch thick gel, using 13 enzymatic systems. Leishmania stocks were obtained from active lesions of humans coming from 26 counties in the northern region of Parana and 6 from the Adrianopolis borough (Ribeira River Valley). In the northern area of the state stocks were isolated from 8 dogs (Canis familiaris); 1 stock from Nectomys sp., and 3 stocks were isolated from Lutzomyia whitmani. All stocks were identified as Leishmania (Viannia) braziliensis. Fifteen zymodemes were characterized. Zymodemes LMP1 and LPM2 showed a large distribution in both regions studied. These zymodemes are present from the south of Mexico to the North of Argentina.

The value of 2 PCR methods, targeting genomic and kinetoplast minicircle DNA respectively, was investigated for both diagnosis and prevalence studies of canine visceral leishmaniasis (CVL). The first method (R) was 5000-fold less sensitive than the second (method KRV). Both were tested for diagnosis of CVL in 44 sick dogs with confirmed disease using different biological samples. Method R was highly efficient when using invasive samples, but the use of method KRV proved necessary for a 100% sensitive diagnosis using peripheral blood. This method was applied to peripheral blood and skin samples in 263 dogs during a mass survey in the Cévennes focus. PCR was compared to serology and all results were analysed according to clinical status. The 'CVL-infection' prevalence was found to be 79.8% by PCR compared with 29.6% by serology: 89.4% of symptomatic and 65.2% of asymptomatic dogs harboured parasites in peripheral blood. This study confirms the high prevalence of asymptomatic carriers of Leishmania. In total, for the diagnosis of CVL in sick dogs, method R is recommended in view of its 100% positive predictive value (compared with 30% for method KRV). A strategy best adapted for prevalence surveys might combine serology and highly sensitive PCR on peripheral blood.

The Leishmania genome project reference strain, Leishmania major Friedlin, is trisomic for chromosome 1. The complete sequence of this chromosome has revealed that the genes are grouped into two large clusters of the polycistronic type, each borne by one DNA strand and located on each side of a 1.6-kb sequence often termed the switch region. Several hypotheses concerning the role of this switch region have been put forward (region of initiation of transcription for both gene clusters, origin of replication or centromeric sequence). In the present study, we have deleted this region on the three copies of chromosome 1 by sequential targeted replacements. The absence of the switch region did not alter the mitotic stability of the three deleted chromosomes. This region therefore does not appear necessary for chromosomal replication or segregation. However, during the third targeting round, which aimed at knocking out the last switch region, a fourth copy of chromosome 1 that retained this region appeared in all clones analysed. This suggests that the persistence of this switch region is necessary for parasite survival. We then showed that the presence/absence of the switch region did not act upon the expression of a resistance marker gene inserted beforehand into the left gene cluster of the same chromosomal molecule. This result suggests that the presence of this 1.6-kb sequence is not necessary for the expression of all genes on chromosome 1.

A sero-epidemiological survey of school children was carried out in Kousseri, a focus for visceral leishmaniasis. Sero-immunological assays for the detection of anti-Leishmania antibodies were based on the indirect immunofluorescence assay test and counter-immunoelectrophoresis. 9 out of 223 school children tested positive for visceral leishmaniasis (seroprevalence rate of 4%). These 9 cases had no history of the disease. The data obtained confirm the endemicity of visceral leishmaniasis in this focus and call for extensive studies in order to determine the prevalence of the disease in the entire population as well as the main components of the transmission cycle.

Following the publication of a paper on Conjonctival human myiasis by Oestrus ovis in southern Tunisia by Anane and Ben Hssine (Bull Soc Pathol Exot (2010) 103(5):299-304), the author reminds that the discovery of this disease was made in Algeria, in 1907 by Edmond and Etienne Sergent.

In Algeria, visceral leishmaniasis is caused principally by Leishmania infantum MON-1, a common agent of the disease on the edges of the mediterranean basin. Other zymodemes (MON-34 and MON-80) of the same complex have also been isolated from immunologically competent patients. In the present study, the authors report the presence of Leishmania infantum MON-24, the main agent of cutaneous leishmaniasis in northern Algeria, in five children with visceral leishmaniasis.

PARASITE IDENTIFICATION: Leishmaniases are a group of parasitic diseases affecting 88 countries in four continents. Isoenzymatic electrophoresis, presently the gold standard technique for Leishmania identification, has led to the development of the phenetic and phylogenetic classifications commonly in use. Study of the genome of these parasites is particularly important because of the features it presents.Parasite transmission to mammals is facilitated by sandfly saliva. The parasite invades the human dermis by complex mechanisms involving molecular interactions allowing the parasite to survive after intracellular penetration.Clinical outcome of leishmaniases depends on both the Leishmania species tropism and the host's immune response. Immunosuppressive status, whatever its origin, facilitates Leishmania infection and worsens the clinical picture.No new developments have occurred for a long time in the treatment of leishmaniases. Individual prophylactic measures are limited to insecticide impregnated bednets for human use and insecticide collars for prevention of canine leishmaniases.

The authors report the first documented observation of infantile visceral leishmaniasis due to Leishmania infantum MON-24 zymodeme in Tunisia. This zymodeme was isolated from a non-immunodepressed two-year-old child, with visceral leishmaniasis, originating from Zaghouan, in northern Tunisia. This case shows that beside L. infantum MON-1 and MON-80, L. infantum MON-24, the usual parasite of cutaneous leishmaniasis, there exists also a causative agent of visceral leishmaniasis in our country.

Canine leishmaniasis is endemic in Corsica. Sporadic cases of visceral leishmaniasis due to Leishmania infantum have been reported in humans, but no case of cutaneous leishmaniasis has been reported to date. In August 1994, a 42-year-old woman living in Orleans (France) presented with two nodular lesions on the face. These lesions appeared two months after a stay near the Gulf of Ajaccio in Corsica. Histopathological examination revealed intracellular amastigotes. The culture isolate was identified as Leishmania infantum zymodeme MON-29. Epidemiological data and climatic conditions prevailing during the patient's stay suggest that contamination took place in Corsica.

American mucocutaneous leishmaniasis is an important health problem in Peru, particularly in the mountainous Cuzco Region, where 25% of all new cases reported in 1989 were located. Cases have increased considerably since the beginning of the 1980s, when large-scale seasonal migration to endemic zones occurred, particularly the forest area of Madre de Dios, following the discovery of new gold deposits there, and the deterioration in the economic situation in Peru. Following the lack of official response from the Peruvian government, hundreds of people suffering from leishmaniasis in the Cuzco area formed self-help associations with the objective of obtaining the drugs needed to treat their disease. The major achievement of this spontaneous movement, which was supported by several public and private institutions, was to encourage sick people, particularly patients with mucosal lesions, to emerge from isolation. As a result, the prevalence and incidence of the disease have now considerably decreased in the region.The deterioration in Peru's economic situation and the discovery of new gold deposits in the mountainous Cuzco Region have been associated with a considerable increase in cases of American mucocutaneous leishmaniasis. Following a lack of government response to this serious health problem, people with leishmaniasis in the town of Sicuani formed a patients' association in 1983 to try to obtain appropriate drugs for treatment. In 1983-93, eight additional patients' associations were established and, in 1990, these associations (representing 1648 members) united with health authorities and other institutions in the Cuzco Region to form a committee to coordinate their activities. The role of these associations was studied in field work conducted in the region in 1993. In interviews, association activists expressed demands that the government make free drugs available, offer financial compensation to those who acquire the disease through work, improve working conditions in the mines and living conditions for migrant workers, and identify other seasonal employment opportunities in order to prevent migration to the mining areas. The leishmaniasis movement, which originated as a spontaneous initiative, has become more structured and organized over time. A control strategy based on active case finding, early diagnosis, and early treatment of disease has been defined. A major achievement of the patients' associations, especially in Sicuani and Ocongate, has been to encourage sick people to emerge from their isolation. This program provides an example of successful multisectoral coordination and community participation of potential relevance in other countries where mucocutaneous leishmaniasis is endemic.

Opportunist disease in immunocompromised patients and prematured babies, Pneumocystis carinii pneumonia was rare. It represents today inaugural manifestation of SIDA in 35-40% of cases. The research of the parasite becomes a current analysis for a medical laboratory. Biological diagnosis is based on the show of the parasite in the sampling with classical coloration technics. The limits of these colorations have played a great part in the development of fluorescent monoclonal antibody stains. In this evaluation, we compared, on 100 bronchiolo-alveolar-lavage (BAL), the performances of a new direct fluorescent monoclonal antibody stain recently commercialized (Pneumo Cel IF test B.M.D. Laboratories) with those of two classical colorations: May-Grünwald-Giemsa and Gomori-Grocott. Standard colorations revealed 18 positive cases while direct immunofluorescence technic revealed 20 cases of pneumocystosis. This new test has showed reliability, sensitivity and high specificity due to the utilisation of a monoclonal antibody. The preparation and the reading of the slides are rapid and easy. In spite of a very higher price, direct immunofluorescent should become a choice method for the majority of medical analysis laboratories, by reason of its qualities and the many advantages it offers in comparison with classical colorations.

Objective To evaluate the biological parameters obtained by cordocentesis and amniocentesis in the antenatal diagnosis of congenital toxoplasmosis. Design Nine-year retrospective study. Setting Parasitology Laboratory, Department of Obstetrics and Gynaecology and Department of Paediatrics, Centre Hospitalo-Universitaire, Montpellier, France. Participants Two hundred and eighty-six pregnant women infected with toxoplasmosis between 7 and 34 weeks of gestation. Methods Detection of abnormalities by ultrasound examination. Detection in fetal blood of Toxoplasma, of specific IgM and IgA and of nonspecific biological markers. Detection in amniotic fluid of Toxoplasma. Results Out of 286 antenatal diagnoses, 211 were negative (1st group), 40 were positive (2nd group) and led to 8 medical abortions, and 35 were uncertain (3rd group). In the 1st and 3rd groups respectively, 7 (3.3 %) and 5 (14.3 %) cases of congenital toxoplasmosis were observed. Overall, 52 cases of congenital toxoplasmosis were detected : 12 were clinically apparent, 36 subclinical (of which 12 were in groups 1 and 3) and 4 were lost to follow up. Conclusion There is substantial importance in making the diagnosis of toxoplasmosis antenatally in order to limit the number of medical abortions. In our series, the most accurate predictor was the detection of the fetal antibody response (specific IgM and IgA) to Toxoplasma.

Twenty-seven trypanosomatidae stocks isolated from various hosts in French Guiana have been surveyed by Multilocus Enzyme Electrophoresis on cellulose acetate plates. The variability observed at 22 different enzyme systems was considerable, since 21 different enzyme profiles (zymodemes) could be distinguished. Clustering analysis and comparison with four laboratory reference stocks showed clearly that three stocks were distantly related from the rest and most probably cannot be included in the species Trypanosoma cruzi. All the other stocks were more related to the formerly described zymodeme I than to the formerly described zymodemes II and III. Genotype variability in this T. cruzi sylvatic population was notably higher than in domestic populations of the same parasite. This could suggest more frequent genetic exchange occurring in sylvatic cycles. Nevertheless, a population genetic analysis of the data showed a considerable linkage disequilibrium, which rather favors the hypothesis that T. cruzi has a basically clonal population structure in this ecosystem too.

The epidemiological, clinical and biological features of associated visceral leishmaniasis/human immunodeficiency virus infection are examined on the basis of a literature review of 239 published cases. The co-infection is principally located in Southern Europe, mainly in Spain, France and Italy. The study of restricted cohorts of patients showed that co-infection occurs in about 2 to 7% of AIDS patients. A part from the classical symptoms of visceral leishmaniasis, atypical or unusual symptoms (cutaneous, digestive or pulmonary) are described in about 10% of the cases. The parasite is occasionally found in blood and normal skin. Visceral leishmaniasis is frequently associated with other opportunistic diseases. Nine different zymodemes of Leishmania infantum, including two new ones, have been isolated from co-infected patients. There have also been a few cases of tegumentary leishmaniasis associated with AIDS.

A histopathological study of mucocutaneous leishmaniasis due to Leishmania (Viannia) braziliensis was carried out on 28 cutaneous and 114 mucosal biopsies, taken from Bolivian and Peruvian patients. This study showed similar histopathological findings in cutaneous and mucosal lesions. The cutaneous biopsies showed a strong epidermal hyperplasia occasionnally budding in the dermis. In the ulcerative area, the epidermis was totally necrosed and replaced by a fibrino-leucocytic edge. In the dermis, histio-lympho-plasmocytic infiltration was constantly found. The histiocytes often gathered in follicles sometimes with diffuse fibrosis. The parasites were encountered in 28.6 p. 100 of the biopsies. Whatever the mucosa concerned (i.e. nasal, palatal or lingual), the mucosal lesion was not different from the cutaneous lesion. The malpighian epithelium is either absent or the seat of a pseudo-epitheliomatous hyperplasia. Major histio-lympho-plasmocytic infiltration was found and extended through the depth of the lamina propria. Suppurative and fibrinoid necroses coexisted superficially and sometimes penetrated in depth. The parasites were found in about 30 p. 100 of the cases.

The authors present a clinical, biological and epidemiological study of 221 cases of mucocutaneous leishmaniasis observed in Bolivia between January 1990 and April 1991. The patients exhibited cutaneous lesions in 136 cases and mucous involvement in 85 cases. It is stressed on the severity of the disease in Bolivia.

We study the information included in sandfly wings in order to test this organ as a source for the specific discrimination. The cartesian coordinates of the vein intersections are collected using a microscope and a graphic table. From these data a specifically developed software searches for discriminant characters. The present study on 32 New World species shows that, in addition to classical wing indices, discriminative characters are available for inter-specific discrimination.

In order to be comparable, and efficient, the descriptions need to be as complete as possible and realized according to the same parameters. In this respect, we present the standard description of Phlebotomine sandflies elaborated by an American network of entomologists in a collaborative program dedicated to the creation of a Computer Aided Identification Program for Phlebotomine Sandflies of South and Central America (CIPA programme).

The socio-economic cost of leishmaniasis in French Guiana was estimated using a retrospective survey spreading over a period of one year: 1979-80. The financial cost elements taken into account were the following: dermatological consultations, biological tests, treatments and hospitalisation days. Other elements were not evaluated, such as days of military hospital stays, work days suspended and unavailability of service. The cost of leishmaniasis represented 0.13% of the general budget of French Guiana and 0.43% of the global budget of the French Guiana Social Security.

We examined the expression and the antigenicity of the major surface polypeptides of Leishmania braziliensis braziliensis and Leishmania donovani chagasi, parasites which commonly coexist in the same endemic areas of Bolivia. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis protein profiles from surface-iodinated promastigotes showed the presence of a unique iodinatable polypeptide of 72 kDa on the L. b. braziliensis surface and of two major components of 65 and 50 kDa exposed at the surface of L. d. chagasi. Comparison of the peptide digestion profiles of the major iodinated polypeptides of both strains showed no similarity between the maps of the 72- and the 65-kDa polypeptides of L. b. braziliensis and L. d. chagasi, respectively. Immunoprecipitation of surface-labeled L. b. braziliensis Nonidet P-40 extracts with 35 serum specimens obtained from Bolivian patients with cutaneous and mucocutaneous leishmaniasis showed that all serum specimens recognized predominantly the 72-kDa antigen and high-molecular-mass proteins in some cases. The recognition patterns were independent of the geographical origin of the patient, the type of lesion, and the serum antibody titer. Serum specimens from children with visceral leishmaniasis did not precipitate the L. b. braziliensis 72-kDa antigen. Hamster hyperimmune serum against L. b. braziliensis also recognized the 72-kDa surface antigen. However, this recognition was inhibited in the presence of the homologous nonlabeled antigen but not in the presence of heterologous (L. d. chagasi and Trypanosoma cruzi) antigens. The specific recognition of 72-kDa surface antigen in both natural and experimental L. b. braziliensis infections suggests that this antigen could be a good candidate for use in the differential immunodiagnosis and prognosis of the disease.

Les auteurs presentent une collection de 2 277 phlebotomes recoltes dans 26 stations regulierement echelonnees le long du Fleuve Senegal et reparties dans trois pays d’Afrique de l’Ouest : Mali, Mauritanie et Senegal. Ils signalent la presence de Phlebotomus (Phlebotomus) duboscqi, vecteur de la leishmaniose cutanee, a l’orifice des terriers de rongeurs et mentionnent pour la premiere fois en Afrique de l’Ouest 3 exemplaires de Sergentomyia (Parvidens) lesleyae, phlebotome decrit du Soudan et uniquement signale jusqu’a present dans ce pays.

This paper describes the in vitro infection of human established fibroblast lines by Leishmania mexicana amazonensis amastigotes. Intracellular parasites were located within vacuoles. The proportion of infected cells reached a peak of about 50% on Days 2 or 3, and decreased to almost 0 on Days 6 or 8. Transmission electron microscopy was used to document different stages of the degeneration of L. m. amazonensis amastigotes on Days 4 and 5. The proportion of infected fibroblasts decreased in both the control and the irradiated cells, indicating that dilution of the parasites by cell multiplication was not the main factor in the observed decrease of the infection with time. This conclusion was also supported by studies with fibroblasts prelabelled with 3H thymidine. In these studies, total cell associated radioactivity as well as the total and TCA precipitable radioactivity of the culture medium were similar for infected and non-infected fibroblasts during the course of infection. The abortive infection of fibroblasts by L. m. amazonensis provides a potentially useful model for the study of the relationship between host cells and intracellular parasites.

We had previously shown that two polypeptides of Plasmodium falciparum are preferentially recognized by antibodies of resistant squirrel monkeys Saimiri sciureus. Free parasites were isolated from synchronized cultures on human erythrocytes initially inoculated with infected Saimiri erythrocytes. Crude extracts were prepared from mature schizont stages and electrophoresed on preparative NaDodSO4/polyacrylamide gels. Two groups of five monkeys were immunized with protein fractions eluted from the 75- and 100-kilodalton regions of the gels. Strong protection against challenge by the homologous strain of P. falciparum was induced in both groups. Analysis of specific anti-malarial antibodies revealed a homogeneous response of all the animals against a few polypeptides of the mature parasite.

Region Studied The region consisted of a large, enclosed, cultivated area belonging to the Monastery of Keur Moussa, near the city of Thies, in the Cap-verdienne region, where cutaneous leishmaniasis is endemic. This region was chosen because of the numerous cases of cutaneous leishmaniasis in the monastery and the neighbouring villages, and because of the presence of numerous rodent burrows. Twenty human strains were isolated between December 1976 and October 1977. By J.-P. DEDET AND F. DEROUIN Isolation of Leishmania major from Mastomys erythroleucus and Tatera gambiana in Senegal (West Africa)

Les resultats d’une etude portant sur 33 162 exemplaires de Sergentomyia minuta parroti (Adler et Theodor, 1927), Phlebotome herpetophile largement distribue a travers l’Algerie, sont exposes. Les caracteres morphologiques permettent une diagnose specifique aisee. Toutefois, le nombre de dents cibariales augmentant au fur et a mesure de l’aridification bioclimatique, il semble que ce caractere soit dependant du climat.