- Introduction
- Species Identification of Leishmania (Leishmania) martiniquensis and Leishmania (Leishmania) siamensis
- Phylogenetic Analysis
- Situation of Leishmaniasis in Thailand
- Clinical Spectrum of L. martiniquensis and L. siamensis Infections
- Sandfly Distribution and Potential Vector
- Animal Reservoirs
- Conclusion
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Leishmaniasis in Thailand: A Review of Causative Agents and Situations
Before 1999, leishmaniasis was considered an imported disease in Thailand. Since then, autochthonous leishmaniasis was reported in both immmunocompetent and immmunocompromised patients especially in human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). A new species was identified and named as Leishmania siamensis consisting of two lineages, that is, lineages TR and PG. Analysis of isoenzymes has clarified the more commonly detected L. siamensis lineage PG as Leishmania martiniquensis (MON-229), a species originally reported from the Martinique Island, whereas the L. siamensis lineage TR has been identified as the true novel species, L. siamensis (MON-324). Both cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) have been found among Thai patients. Disseminated CL and VL could be presented in some reported patients who had HIV/AIDS coinfection. So far, only sporadic cases have been reported; thus, the true prevalence of leishmaniasis should be determined in Thailand among the high-risk populations such as people with HIV/AIDS. A recent survey among animals identified L. martiniquensis DNA in black rats (Rattus rattus) suggesting a potential animal reservoir. In addition, L. martiniquensis DNA was identified in Sergentomyia gemmea and Sergentomyia barraudi, the predominant sandfly species in the affected areas. However, further studies are needed to prove that these sandflies could serve as the vector of leishmaniasis in Thailand.
Author Notes
Authors' addresses: Saovanee Leelayoova, Phunlerd Piyaraj, and Mathirut Mungthin, Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand, E-mails: sleelayoova@gmail.com, p_phunlerd@yahoo.com, and mathirut@hotmail.com. Suradej Siripattanapipong, Jipada Manomat, and Peerapan Tan-ariya, Department of Microbiology, Faculty of Science, Mahidol University, Bangkok, Thailand, E-mails: suradejs@rocketmail.com, manomat.j@gmail.com, and peerapan.tan@mahidol.ac.th. Lertwut Bualert, Department of Medicine, Trang Hospital, Trang Province, Thailand, E-mail: dr_lertwut_clinic@yahoo.com.