Acta Tropica 127 (2013) 1–5 Contents lists available at SciVerse ScienceDirect Acta Tropica journal h om epa ge: www.elsevier.com/locate/actatropica Epidemiologic study and molecular detection of Leishmania and sand fly species responsible of cutaneous leishmaniasis in Foum Jamâa (Azilal, Atlas of Morocco) Hassan Arroub a , Salsabil Hamdi b , Malika Ajaoud b , Khalid Habbari a , Meryem Lemrani b,∗ a Laboratory of Management and Valorization of Naturals Resources, FST, Sultan Moulay, Slimane University, M’GHILA Route de Fes, B.P. 523, Beni Mellal 23000, Morocco b Laboratoire de Parasitologie et Maladies Vectorielles, Institut Pasteur du Maroc, Casablanca, Morocco a r t i c l e i n f o Article history: Received 13 December 2012 Received in revised form 25 February 2013 Accepted 10 March 2013 Available online 21 March 2013 Keywords: Cutaneous leishmaniasis ITS1-PCR Leishmania tropica Phlebotomus sergenti Morocco a b s t r a c t The region of Foum Jamâa (province of Azilal) has become endemic for cutaneous leishmaniasis (CL) since 2006. The objective of this study was to investigate molecular identification of the etiological agent of CL in this region; we also carried out an entomological survey of Phlebotomine sand flies (Diptera: Psychodidae) in this focus to study the sand fly fauna, species composition, and the monthly prevalence of sand flies during 1 year. In the period between 2009 and 2010, skin scrapings spotted on glass slides were collected from 119 patients, aged from 9 months to 70 years old, who came from 43 localities distributed in 3 sectors in Foum Jamâa (FJ). The ITS1 PCR-RFLP was used to identify the Leishmania parasite responsible for the recent cases of CL in FJ. Our results revealed that the disease is caused by L. tropica. No significant association was observed between gender and the rate of CL in presenting patients, while the highest rate of positive lesions was found in the age group of 9 years old or under (86.67%). In this study, we found also that L. tropica infection mostly caused single lesions (67.90%) that were located in the face (96.30%). Morphological identification was performed on a total of 1152 sand flies (23% females and 77% males) collected by sticky paper traps. 57% of the total collected flies were identified as Phlebotomus (Paraphlebotomus) sergenti (Parrot). © 2013 Elsevier B.V. All rights reserved. 1. Introduction In Morocco, three species of Leishmania are endemic, causing human cutaneous leishmaniasis (CL). L. major is responsible of zoonotic CL and is localized in areas south of the Atlas Mountains (Rioux et al., 1986) where regular epidemics, with more than 2000 cases are reported (Ministry of Health, 2008). In the North of the country, some sporadic cases of CL due to L. infantum were observed (Lemrani et al., 1999; Rhajaoui, 2009). L. tropica has the largest geographic distribution and is considered a major public health threat (Ministry of Health, 2008); this form was reported for the first time in 1989 (Marty et al., 1989), since this first case a large eco- epidemiological study led to the detection of a large focus in central and southern areas of the country. Recently, Morocco is known for the emergence of several new foci in the north Guessous-Idrissi (Guessous-Idrissi et al., 1997; Rhajaoui et al., 2004, 2007) and L. ∗ Corresponding author at: Institut Pasteur du Maroc, 1 Place Louis Pasteur Casablanca Maroc, Morocco. Tel.: +212 661 46 48 18; fax: +212 522 26 09 57. E-mail addresses: meryem.lemrani@pasteur.ma, meryem.lemrani@gmail.com (M. Lemrani). tropica has been found in some regions previously known for trans- mission of L. major (Rhajaoui, 2009). L. tropica is considered to be purely anthroponotic, however, more recently it has become clear that in some cases L. tropica could be zoonotic (Guessous-Idrissi et al., 1997). In the province of Azilal, FJ region has become an epidemic focal point for CL. It seems obvious that FJ was free from CL before 1990; the first cases recorded by the provincial delegation of health go back to 1986 and 1987 in Tanant, at 16 km from FJ. Early in 2000, sev- eral provincial centers declared some scattered cases in FJ. During the period 2006–2009, we registered about 500 cases of CL in this region (Arroub et al., 2012), the efforts done by the Ministry of Health between 2006 and 2009 have stabilized the number of cases in the region, nevertheless, the disease is still persistent and the number of cases can increase at any time. In our previous work focused on the eco-epidemiological and socioeconomic study, we have described CL in FJ as a rural domes- tic form, characterized by affecting the whole family nucleus, due to the fact that dwellings are located near the natural focus of trans- mission; thus propitiating the vector’s arrival in the house (Arroub et al., 2012). Based on clinical symptoms, we suggested that the 0001-706X/$ – see front matter © 2013 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.actatropica.2013.03.005