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Background  Cutaneous leishmaniasis (CL) is an infectious disease caused by various species of  Leishmania  and transmitted by several species of sand flies. CL is among the most neglected tropical diseases, and it has represented a major health threat over the past 20 years in Morocco. The main objectives of this study were to identify relevant sand fly species and detect  Leishmania  infection in the most prevalent species and patient skin samples in Taza, a focus of CL in North-eastern Morocco.    Methodology and finding  A total of 3672 sand flies were collected by CDC miniature light traps. Morphological identification permitted the identification of 13 species, namely 10  Phlebotomus  species and 3  Sergentomyia  species.  P .  longicuspis  was the most abundant species, comprising 64.08% of the total collected sand flies, followed by  P .  sergenti  (20.1%) and  P .  perniciosus  (8.45%). Using nested-kDNA PCR, seven pools of  P .  sergenti  were positive to  Leishmania tropica  DNA, whereas 23 pools of  P .  longicuspis  and 4 pools of  P .  perniciosus  tested positive for  Leishmania infantum  DNA. The rates of  P .  longicuspis  and  P .  perniciosus Leishmania  infection were 2.51% (23/915) and 7.27% (4/55), respectively, whereas the infection prevalence of  P .  sergenti was  3.24%. We also extracted DNA from lesion smears of 12 patients suspected of CL, among them nine patients were positive with enzymatic digestion of ITS1 by  Hae III revealing two profiles. The most abundant profile, present in eight patients, was identical to  L .  infantum , whereas  L .  tropica  was found in one patient. The results of RFLP were confirmed by sequencing of the ITS1 DNA region.    Conclusion  This is the first molecular detection of  L .  tropica  and  L .  infantum  in  P .  sergenti  and  P .  longicuspis , respectively, in this CL focus. Infection of  P .  perniciosus  by  L .  infantum  was identified for the first time in Morocco. This study also underlined the predominance of  L .  infantum  and its vector in this region, in which  L .  tropica  has been considered the causative agent of CL for more than 20 years.

plos neglected tropical diseases

Molecular identification of Leishmania infection in the most relevant sand fly species and in patient skin samples from a cutaneous leishmaniasis focus, in Morocco