Abstract
Increasing risk factors are making leishmaniases a growing public health concern for many countries around the world. The aim of this study was to assess the seroprevalence of Leishmania infantum infection in the general population and in HIV infected subjects of Northern Greece, bordering the Mediterranean basin where leishmaniasis is endemic. The clinical cases of the disease during the last 6 years (2001–2006) are also presented. A low frequency of L. infantum antibodies was found by IFA and ELISA in 1,525 healthy individuals (2.8%), aged 18–80 years, living in the 16 prefectures of Northern Greece (Macedonia and Thrace regions), and in 167 HIV positive subjects (0.6%). Fifty-seven clinical cases were diagnosed in the same area and an approximate annual incidence of 0.34/100,000 was estimated. No endemic foci were identified and the cases of the disease were sporadic. Most presented with the visceral form (VL), few with the cutaneous, and one with VL-HIV co-infection. A significant shift in the age of people at risk was observed, with children less affected than adults (children/adults ratio: 0.36). No relevant data from previous studies are available to demonstrate a possible change of the infection in Northern Greece. The results of this study could be used as a reference for leishmaniasis surveillance in the area.
Similar content being viewed by others
References
Yannakopoulos K (1879) On some endemic diseases on the island of Spetses. Galenus 65–68
Tetsis JA (1881) Tsanaki or putrefied illness of children in Hydra. Galenus 3(21):369–371
Tselentis Y, Gikas A, Chaniotis B (1994) Kala-azar in Athens basin. Lancet 343(8913):1635
Maltezou MC, Siafas C, Mavrikou M, Spyridis P, Stavrinadis C, Karpathios T, Kafetsis DA (2000) Visceral leishmaniasis during childhood in southern Greece. Clin Infect Dis 31(5):1139–1143
Papadopoulou C, Kostoula A, Dimitriou D, Panagiou A, Bobojianni C, Antoniades G (2005) Human and canine leishmaniasis in asymptomatic and symptomatic population in Northwestern Greece. J Infect 50:53–60
Antoniou M, Doulgerakis C, Pratlong F, Dedet JP, Tselentis Y (2004) Short report: treatment failure due to mixed infection by different strains of the parasite Leishmania infantum. Am J Trop Med Hyg:71–72
Papadopoulos B, Tselentis Y (1994) Sandflies in the greater Athens region, Greece. Parasite 1(2):131–140
Chaniotis B, Spyridaki I, Scoulika E, Antoniou M (2000) Colonization of phlebotomus neglectus (Diptera: psychodidae), the major vector of visceral leishmaniasis in Greece. J Med Entomol 37(3):346–348
Ashford RW (2000) The leishmaniases as emerging and reemerging zoonoses. Int J Parasitol 30:1269–1281
Desjeux P (2004) Leishmaniasis: current situation and new perspectives. Com Immunol Microbiol Infect Dis 27(5):305–318
World Health Organization (2000) Leishmania/HIV co-infection south-western Europe, 1990–1998: retrospective analysis of 965 cases. WHO, Geneva, LEISH/2000:42
Leontides LS, Saridomechelakis MN, Billinis C, Kontos V, Koutinas AF, Galatos AD, Mylonakis ME (2002) A cross-sectional study of Leishmania spp. infection in clinically healthy dogs with polymerase chain reaction and serology in Greece. Vet Parasitol 16(1090):19–27
Haralabidis S, Daffas G, Epivatianos P (1992) Detection of specific IgG, IgM and IgE immunoglobulins against parasites from inhabitants of Macedonia, Greece. Acta Microbiol Hellenica 37(3):365–367
Frydas S, Theodoridis Y, Rollis TS, Hatzistilianou I, Adama-Moraitou KK, Paludi D, Di luzio S, Castellani L, Gritli A, Di Gioacchino M (2001) Leishmania antibodies in children serum samples in correlation with disease in dogs. Int J Immunopathol Pharmacol 14(3):173–178
Anonymous (2002) Statistical yearbook of Greece. National Statistical Service of Greece, Athens, p 71
Spanakos G, Patsoula E, Kremastinou T, Saroglou G, Vakalis N (2002) Development of a PCR-based method for diagnosis of Leishmania in blood samples. Mol Cellul Probes 16:415–420
Lachaud L, Marchergui-Hammami S, Chabbert E, Dereure J, Dedet JP, Bastien P (2002) Comparison of six PCR methods using peripheral blood for detection of canine visceral leishmaniasis. J Clin Microbiol 40:210–215
Pizzuto M, Piazza M, Senese D, Scalamonga C, Calattini S, Corsico L, Persico T, Adriani B, Magni C, Guaraldi G, Gaiera G, Ludovici A, Gramiccia M, Galli M, Moroni M, Corbellino M, Antinori S (2001) Role of PCR in diagnosis and prognosis of visceral Leishmaniasis in patients coinfected with human immunodeficiency virus type 1. J Clin Microbiol (39)357–361
Gari-Toussaint M, Lelievre A, Marty P, Le Fichoux Y (1994) Contribution of serological tests to the diagnosis of visceral leishmaniasis in patients infected with human immunodeficiency virus. Trans R Soc Trop Med Hyg 88:301–302
Costa C, Stewart J, Gomes R, Garcez L, Ramos P, Bozza M, Satoskar A, Dissanayake S, Santos R, Silva M, Shaw J, David J, Maguire J (2002) Asymptomatic human carriers of Leishmania chagasi. Am J Trop Med Hyg 66(4):334–337
Choudhry A, Puri A, Guru PY, Saxena RP, Saxena KC (1992) An indirect fluorescent antibody (IFA) test for the serodiagnosis of Kala-Azar. J Commun Dis 24(1):32–36
Le Fichoux Y, Quaranta JF, Aufeuvre JP, Lelievre A, Marty P, Suffia I, Rousseau D, Kubar J (1999) Occurrence of Leishmania infantum parasitemia in asymptomatic blood donors living in an area of endemicity in southern France. J Clin Microbiol 37(6):1953–1957
Riera C, Fisa R, Udina M, Gallego M, Portus M (2004) Detection of Leishmania infantum cryptic infection in asymptomatic blood donors living in an endemic area (Eivissa, Balearic Islands, Spain) by different diagnostic methods. Trans R Soc Trop Med Hyg 98(2):102–110
Ali A, Ashford RW (1994) Visceral leishmaniasis in Ethiopia. IV. Prevalence, incidence and relationship between infection and disease in an endemic area. Ann Trop Med Parasitol 88:289–293
Badaro R, Jones TC, Carvalho JM, Sampaio D, Reed SG, Barral A, Teixeira R, Johnson WD (1986) New perspectives on a subclinical form of visceral leishmaniasis. J Infect Dis 154:1003–1011
Antoniou M, Economou I, Wang X, Psaroulaki A, Spyridaki I, Papadopoulos B, Christidou A, Tsafantakis E, Tselentis Y (2002) Fourteen-year seroepidemiological study of zoonoses in a Greek village. Am J Trop Med Hyg 66(1):80–85
Kyriakou DS, Alexandrakis MG, Passam FH, Kourelis TV, Foundouli P, Matalliotakis E, Maniatis AN (2003) Quick detection of Leishmania in peripheral blood by flow cytometry. Is prestorage leucodepletion necessary for leishmaniasis prevention in endemic areas? Transfus Med 13(2):59–62
Federico G, Damiano F, Caldarola G, Fantini C, Flocchi V, Ortona LA (1991) Seroepidemiological survey on Leishmania infantum infection. Eur J Epidemiol 7(4):380–383
Marty P, Lelievre A, Quaranta JF, Rahal A, Gari-Toussaint M, Le Fichoux Y (1994) Use of leishmanin skin test and western blot analysis for epidemiological studies in visceral leishmaniasis areas: experience in a highly endemic focus in Alpes-Martimes (France). Trans R Soc Trop Med Hyg 88(6):658–659
Garrote J, Gutierrez MP, Izquierdo RL, Duenas MA, Zarzosa P, Canavate C, Bali ME, Almaraz A, Bratos M, Berbel C, Rodriguez-Torres A, Domingo AO (2004) Seroepidemiologic study of Leishmania infantum infection in Castilla-Leon, Spain. Am J Trop Med Hyg 7(4):403–406
Pineda J, Gallardo J, Macias J, Delgado J, Regordan C, Morillas F, Relimpio F, Martin-Sanchez J, Sanchez-Quijano A, Leal M, Lissen E (1998) Prevalence of and factors associated with visceral leishmaniasis in human immunodeficiency virus type 1-infected patients in southern Spain. J Clin Microbiol 36(9):2419–2422
Garcia-Garcia JA, Martin-Sanchez J, Gallego M, Rivero-Roman A, Camacho A, Morillas-Marquez F, Vergara S, Macias J, Pineda JA (2006) Use of noninvasive markers to detect Leishmania infection in asymptomatic human immunodeficiency virus-infected patients. J Clin Microbiol 44(12):4455–4458
Lindgren E, Naucke T, Menne B (2004) Climate variability and visceral leishmaniasis in Europe. In: Report of the scientific working group on leishmaniasis. WHO, Geneva. Document TDR/SWG/04:88–92
Moral L, Rubio EM, Moya M (2002) A leishmanin skin test survey in the human population of l’Alacanti region (Spain): implications for the epidemiology of leishmania infantum infection in southern Europe. Trans R Soc Trop Med Hyg 96(20):129–132
Del Giudice P, Mary-Krauze M, Pradier C, Grabar S, Dellamonica P, Marty P, Gastaut JA, Costagliola D, Rosenthal E, French Hospital Database on HIV Clinical Epidemiologic Group (2002) Impact of highly active antiretroviral therapy on the incidence of visceral leishmaniasis in a French cohort of patients infected with human immunodeficiency virus. J Infect Dis 186(9):1366–1370
Lazanas MC, Tsekes GA, Papandreou S, Harhalakis N, Scandalaki A, Nikiforakis E, Saroglou G (1993) Liposomal amphotericin B for leishmaniasis treatment of AIDS patients unresponsive to antimonium compounds. AIDS 7:1018–1019
Campino L, Abranches P (2002) Cutaneous leishmaniasis. Unusual disease in Portugal? Acta Med Port 15(5):387–390
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Diza, E., Kansouzidou, A., Gerou, S. et al. Leishmaniases in Northern Greece: seroprevalence of the infection and incidence of the disease during the period 2001–2006. Eur J Clin Microbiol Infect Dis 27, 997–1003 (2008). https://doi.org/10.1007/s10096-008-0538-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10096-008-0538-y