Determination of the feeding behavior of Phlebotomus sergenti using multiplex PCR and tent-baited traps in a new focus of Anthroponotic Cutaneous Leishmaniasis in the southeast of Iran

As a neglected tropical disease (NTDs), Leishmaniasis is among the nine most important diseases in the world and has a wide geographical distribution in Africa, Asia, America and Europe (Postigo, 2010; Salam et al., 2014; Torres-Guerrero et al., 2017). This tropical and sub-tropical disease occurs in 140 countries and over 1 billion people are at risk of the disease worldwide (Hotez and Kamath, 2009; WHO, 2017). Leishmaniasis is caused by obligate intracellular amastigotes (Genus: Leishmania), about 20 species of which are pathogenic for humans (Hotez and Kamath, 2009; Oryan and Akbari, 2016; Torres-Guerrero et al., 2017; WHO, 2017).

Phlebotomine sand flies are blood-feeding insects transmitting various Leishmania species (Family: Trypanosomatidae) to humans and animals (Maroli et al., 2013).

There are two clinical forms of Leishmaniasis in Iran, including Cutaneous and Visceral Leishmaniasis. Leishmania Tropica causes Anthroponotic Cutaneous Leishmaniasis. The main vector is Ph. sergenti and humans and dogs are the primary and secondary reservoir hosts, respectively. The causative agent of Zoonotic Cutaneous Leishmaniasis is Leishmania major, the main vector is Phlebotomus papatasi and different species of rodents act as reservoirs of the diseases. Anthroponotic Cutaneous Leishmaniasis (ACL) and Zoonotic Cutaneous Leishmaniasis (ZCL) are endemic in many parts of Iran (Postigo, 2010).

The blood preference of sand flies is crucial to identify potential reservoir hosts of Leishmania parasites (Gebresilassie et al., 2015). Some sand flies prefer a particular host for blood feeding, while others are opportunistic and their blood-feeding depends on the hosts' availability and population in a region (Agrela et al., 2002). Despite the importance of host blood preferences of sand flies in leishmaniasis prevention programs, there is no study about this issue according to molecular methods along with Forage Ratio (FR) and Host feeding Index (HFI) parameters and also baited tent traps in Iran.

Bam County, located in Kerman Province, is the most important focus of Anthroponotic Cutaneous Leishmaniasis in southeast Iran (Sharifi et al., 2015). Studies revealed that Ph. sergenti is the main vector, with humans the primary and dogs as the secondary reservoir hosts of ACL in this region (Yaghoobi-Ershadi, 2008; Yaghoobi-Ershadi et al., 2002). Dehbakri District is one of the new foci of ACL in Bam County. The present study was conducted to explore the host preference of Ph. sergenti by two methods: the first was to analyze the blood in sand flies' stomachs and subsequently calculate the Forage Ratio and Host Feeding Indices and the second was to collect sand flies using bed net traps with different animal hosts as bait. The results of this study can help health systems in diseases prevention and control programs against ACL in the study area.

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