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A review of Leishmaniasis in Eastern Africa

Journal of Nanjing Medical University 2009年第2期23卷 79-86页

作者： Peter K.Ngure albert kimutai Zipporah W.Ng'ang'a Geoffrey Rukunga Willy K.Tonui Science Department Daystar University Kenyatta University Jomo Kenyatta University of Agriculture and Technology Kenya Medical Research Institute

The review presents the epidemiology of leishmaniasis in the Eastern Africa region. We searched PUB MED and MEDLINE with several key words-namely,＂leishmaniasis＇;＂cutaneous＇,＂diffuse cutaneous ＂,＂ mucosal＂, and ＂visceral leishmaniasis＂; ＂kala azar＂ and ＂post kala azar dermal leishmaniasis＂ -for recent clinical and basic science articles related to leishmaniasis in countries in the Eastern Africa region. Poverty, wars, conflicts and migration have significantly aggravated leishmaniases in Eastern Africa. Of particular concern is the increasing incidence of Leishmania-HIV co-infection in Ethiopia where 20-40% of the persons affected by visceral leishmaniasis are HIV-co-infected. Sudan has the highest prevalence rate of post kala-azar dermal leishmaniasis（PKDL） in the world, a skin complication of visceral leishmaniasis（VL） that mainly afflicts children below age ten. In view of its spread to previously non-endemic areas and an increase in imported cases, leishmaniasis in Eastern Africa should be considered a health emergency.

关键词： Leishmaniasis cutaneous visceral Eastern Africa

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Evaluation of the adjuvanticity of artemisinin with soluble Leishmania major antigens in BALB/c mice

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Journal of Nanjing Medical University 2009年第6期23卷 359-372页

作者： albert kimutai Willy K. Tonui Michael M. Gicheru Peter Kamau Ngure Johnstone Ingonga Stella Kepha Laban Ireri Njeru Dorcas Wachira Robert Karanja Muhia Milkah Mwangi Lydia B. Nyamwamu Department of Zoological Sciences Kenyatta University Centre for Biotechnology Research and Development Kenya Medical Research Institute Science Department Daystar University School of Biological Sciences University of Nairobi

Objective： To determine the adjuvant potential of artemisinin with a soluble leishmanial antigen in vaccinating BALB/c mice. Methods： Seventy two female BALB/c mice were randomly assigned into six groups. The mice were vaccinated with soluble Leishmania antigens （SLA） alone, artemisinin co-administered with SLA, SLA and Bacille Calmette Gu fin （BCG） vaccine, and artemisinin and BCG alone. Unvaccinated mice formed the control group. The induction of cell-mediated immunity following vaccination was determined by measuring in vitro lymphocyte proliferation and the production of interleukin （IL）-4, IL-5 and gamma interferon （IFN-γ） determined by flow cytometry. Protection against L. major was determined by quantifying parasite burdens in L. major infected footpads using a limiting dilution assay and by measuring lesion sizes of the infected footpad compared to the contralateral uninfected footpad. Results： Mice receiving SLA plus artemisinin produced significantly high levels of IL-4 and IL-5 （P 〈 0.05） and low levels of IFN-γ, resulting in exacerbated disease. In addition, subcutaneous administration of SLA ＋ artemisinin, artemisinin alone or SLA alone resulted in the development of large footpad swellings and high parasite loads that were comparable to those of the control unvaccinated mice （P 〉 0.05）, resulting in exacerbated disease. Conclusion： These data suggest that artemisinin is not a suitable adjuvant for Leishmania vaccines. However, since artemisinin has been shown to be effective against Leishmania parasites in vitro and in vivo, further studies ought to be conducted to determine its immunochemotherapeutic potential when co-administered with Leishmania antigens.

关键词： Artemisinin Leishmania Soluble Leishmania antigens BALB/c mice immunity cytokine adjuvant interleukin-4 （IL-4） IL-5 IFN-γ lesion size footpad lesion vaccine parasite burden proliferation stimulation index

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