Leishmaniasis

‫داء ا لليشمانيات‬
MHD –IOM UN Iraq
 Learning Objectives
• Describe signs, symptoms, and transmission of
Leshmanisis
• List essential preventive and control measures
 ‫‪Leshamniasis‬‬

‫يسبب داء الليشمانيات طفيلي من الطفيليات الليشمانية األوالية التي يزيد عدد أنواعها على ‪ 20‬نوعا ً‪ .‬ويفوق‬
‫عدد أنواع ذباب الرمل المعروفة بنقل الطفيليات الليشمانية ‪ 90‬نوعا ً‬
 Leshmanisis

Leishmaniasis is caused by a protozoa parasite from over 20 Leishmania species.

Over 90 sandfly species are known to transmit Leishmania parasites.
 Key Facts
• There are 3 main forms of leishmaniases – visceral (also known as
kala-azar, which is and the most serious form of the disease),
cutaneous (the most common), and mucocutaneous.

• Leishmaniasis is caused by protozoan parasites which are

transmitted by the bite of infected female phlebotomine sandflies.

• The disease affects some of the poorest people and is associated

with malnutrition, population displacement, poor housing, a weak
immune system and lack of financial resources.
 Key Facts
• Leishmaniasis is also linked to environmental
changes such as deforestation, building of
dams, irrigation schemes and urbanization.
• An estimated 700 000 to 1 million new cases
occur annually.
 Transmission
• Parasite transmission to humans occurs by the
bite of an infected sandfly.
• The sandfly becomes infected after biting an
parasitized host .
• Person-to-person transmission by sexual
contact, blood transfusions and the use of
contaminated syringes has also been
described, but they are exceptionally rare.
 Incubation period based on type
• The incubation period is from 2 weeks to 4
months from the bite.(Cutaneous
leishmaniosis )
• The incubation period ranges from 10 days to
2 years (often from 2 to 4 months). (Visceral
leishmaniosis or kala azar)
 Most Common types
• The most common forms are cutaneous
leishmaniasis, which causes skin sores.

• visceral leishmaniasis, which affects several

internal organs (usually spleen, liver, and bone
marrow).
 visceral leishmaniasis: symptoms

• silent infection, without any symptoms or signs.

• People who develop clinical evidence of infection usually have

fever, weight loss, enlargement (swelling) of the spleen and
liver, and abnormal blood tests.

• People may have low blood counts, including a low red blood
cell count (anemia), a low white blood cell count (leukopenia),
and a low platelet count (thrombocytopenia).
 cutaneous leishmaniasis: Symptoms
• Some people have a silent infection, without any symptoms or
signs.
• People who develop clinical evidence of infection have one or
more sores on their skin.
• The sores can change in size and appearance over time.
• The sores may start out as papules (bumps) or nodules
(lumps) and may end up as ulcers (like a volcano, with a raised
edge and central crater); skin ulcers may be covered by scab
or crust.
• The sores usually are painless but can be painful. Some
people have swollen glands near the sores (for example,
under the arm, if the sores are on the arm or hand).
 Sand fly-‫ب لرمل‬
‫ذبا ا‬

Sand Flies or Sand Fly are also known as Sand Gnat, Sandflea. Their most
important ability is to bite and suck blood.
You might want to compare it to a mosquito!
• Sand flies love sandy areas ,extremely active
from June to August.
• Physical Appearance: The length ranges from
1.5mm to 5mm. They are brownish in color.
They have dense growth of hair all over their
head, thorax, abdomen, and legs.They have
large black compound eyes.
Homeland :
• Sand Flies are mostly active in warm climate only when there is a little wind and no
rain during the months of June to August.
• In warm cities they may be prevalent all through the year. Hence they are usually
found in wet soils.
• They become inactive in case of strong wind, and drop in temperature or rain.
Behaviors :
• Sand Flies are very much attracted to shiny surfaces,
moving objects, warmth, and carbon dioxide.
• Sand Flies always travel in swarms (a group of sand
flies). So, if you have just noticed a single sand fly, then
just do not ignore it as the other members of the
swarm are somewhere near.
• Sand Flies are not fast. Hence they are easily going to
give it up on you, if you are running or kayaking as they
would not be able to keep it up on your pace.
Feeding Habits:
• Both male and female sand fly feed on the plant nectar.
• It is the female sand fly that also feeds on blood as they need protein from
blood for egg laying and reproductive cycles.
Life Cycle:
• The life cycle of a sand fly begins at a dry area having a humid
environment.
• The humid environment prevents the eggs from dehydration.
• Also the environment needs not be too cold else it might lead the eggs to
stop developing.
• The overall life cycle of a sand fly takes 20 to 40 days
 Sand -Fly Bite
• As soon as a female sand fly bites a human being, she injects
her saliva containing anti-coagulant.
• As you might be aware that human blood has a coagulating
property because of which it’s not easy for the sand midget to
suck blood.
• Hence the saliva containing anti-coagulant makes it easier to
extract blood.

Immediate Symptoms :red, bumpy and itchy lesions!

 Getting Rid of sand flies
Indoors prevention :
• Vacuuming (acuum every nook and corner of the
house, especially the carpets.
• If you come across any cracks in walls, floors, ceiling,
window panels, etc then vacuum these as well.
• It has been proven the vacuuming kills adult and eggs
of sand flies.
• Closing cracks and gaps, After cleaning the house
properly, spray the DEET Insect Repellent
Citronella Candles or Oil Lamp
• ‫يت ورق الكينا االساسي‬2‫ز‬Eucalyptus Oil Spray or
Candles
Lavender Oil Spray or Candles
Insect Repellent
 Home made Prevention
• Orange Peel Extracts –You can keep orange peel extracts
at windows, balcony, terrace, doors, or any other entry or
exit to keep the biting midges away.

• Lemon, Lime or any other citrus juice – you can use the
lemon, lime or any other citrus juice for spraying purpose.

• We would also suggest you to sprinkle salt on carpets for

24 hours before vacuuming. As there are certain theories
suggesting that salt dehydrates sand flies.
 Outdoor Prevention

• Insecticides – If your garden or lawn is infested then you could spray

insecticides having ‘d-limonene’ and ‘linalool’ as contents. However make
sure that you follow the instructions written on the insecticide carefully,
in some cases you might need to keep children and pets outside the
sprayed area for couple of hours.

• Citronella \ Eucalyptus \ Lavender Oil Spray – You can spray citronella oil
or eucalyptus oil or lavender oil spray on the infested plants or area.

• Lemon, Lime or any other citrus juice – This is another homemade

remedy wherein you can use the lemon, lime or any other citrus juice for
spraying purpose on infested plants.
Boric Acid – If the sand flies have infested your garbage can then just put some boric acid
on the floor near garbage can.
Diatomaceous Earth – If the infested area is sand, soil or any moist area then you can sprinkle
diatomaceous earth. However you would need to sprinkle it again in case of a shower or rain.
 If you are going out on a stroll or walk in area prone to sand fly
bites, then we would suggest you to use below listed steps to
keep them away:
• Keep yourself covered – Its really mandatory to keep yourself completely
covered, wear socks, full sleeve shirts or tops, full length trousers or pants,
hats or caps.

• Wear light-colored clothes as sand flies are attracted towards dark shades.
Apply below listed repellents before going out in
outdoors.

• Eucalyptus Oil‫ – زيتورقا لكينا‬You can sprinkle it on your clothes, hat or cap. Do not
use it on sensitive areas like eyes.
• Coconut Oil – You can apply it on your hands, feet, legs, face.
• Avocado Oil mixed with Dettol or Savlon – Sprinkle it on your clothes, hat or cap.
• The inside of Banana Peel – Rub the banana peel on your hands, legs, etc.
• Vinegar‫ – خل‬You can sprinkle it on your clothes, hat or cap. Do not use it on
sensitive areas like eyes.
• Lavender Oil – You can sprinkle it on your clothes, hat or cap. Do not use it on
sensitive areas like eyes.
• Tee Tree Oil – You can sprinkle it on your clothes, hat or cap. Do not use it on
sensitive areas like eyes.
• Garlic – You can either eat the garlic orally (if you feel like) else you can also rub it
on your hands and legs.
 Pregnancy
• leishmaniasis can be transmitted congenitally
from an asymptomatic mother to her child.
 Vaccine
• No vaccines or drugs to prevent
infection are available.