E. Chouihi - Academia.edu (original) (raw)
Papers by E. Chouihi
Bulletin de la Societe de pathologie exotique, 2008
The epidemiological situation of leishmaniasis in Tunisia is characterised by the co-existence in... more The epidemiological situation of leishmaniasis in Tunisia is characterised by the co-existence in a very limited territory (165,000 km2, Sahara included), of 4 clinical forms: the infantile visceral leishmaniasis (VL) and 3 cutaneous leishmaniasis (CL) forms (sporadic, zoonotic and chronic). In addition to the useful epidemiological data, identification of the causative parasitic species is essential to determine the geographic distribution of each form and to select appropriate therapeutic procedure and suitable control measures. 226 Leishmania isolates, 135 human's coming from 59 VL cases and 76 CL cases and 91 canine's were identified by the isoenzyme electrophoresis reference technique. Results confirm the endemicity of the 4 forms mentioned above. The sporadic CL, confined to the North of the country is principally caused by L. infantum MON-24 (72.2%). VL which has reached the southern ridge in the central area of Tunisia, in the governorate of Kairouan (36 typed isolat...
Veterinary Parasitology, 2014
Dogs are the main reservoir host of Leishmania infantum, etiologic agent of human visceral leishm... more Dogs are the main reservoir host of Leishmania infantum, etiologic agent of human visceral leishmaniasis (HVL) and canine visceral leishmaniasis (CVL). Transmission of L. infantum to humans and dogs is mainly through the bite of infected sand flies. In the Western Mediterranean basin, Phlebotomus perniciosus is the main vector of L. infantum. However, occasional vertical transmission of L. infantum has been reported. This study investigated L. infantum vertical transmission in offspring of experimentally infected dogs. Among 14 surviving puppies from three female beagle dogs that developed CVL following an experimental infection with L. infantum, one was tested positive by indirect immunofluorescence antibody test, by PCR and by xenodiagnosis with a high parasite burden in the spleen at 14 months old. None of the remaining puppies were tested positive for L. infantum. These findings strongly suggest that infected puppies following vertical transmission can sustain infection and contribute in infecting sand flies with L. infantum. Any strategy for controlling CVL should take into consideration the vertical transmission of L. infantum.
Bull Soc Pathol …, 2008
... 9. AYADI A, BEN ISMAIL R & BEN RACHID MS Extension de l'aire de transmissi... more ... 9. AYADI A, BEN ISMAIL R & BEN RACHID MS Extension de l'aire de transmission du kala azar à Leishmania infantum vers le centre et le sud de la Tunisie. Arch Inst Pasteur Tunis, 1991, 68, 269-73. 10. BELHAJ S, PRATLONG F, TOUMI NH, KALLEL K, MAHJOUB H et al. ...
Archives de l'Institut Pasteur de Tunis
The anti-sandflies and, insecticides impregnated collars are actually mentioned as the main mean ... more The anti-sandflies and, insecticides impregnated collars are actually mentioned as the main mean for prevention and control of Canine leishmaniasis. An evaluation of the Scalibor collar was undertaken in leishmaniasis active sites in Tunis area, (northern Tunisia). Eighty leishmaniasis free dogs (42 collared and 38 as control dogs) were submitted to a serological detection using ELISA technique for anti-Leishmania antibodies before and after transmission season in 2005 and 2006. Seroconversions were detected by ELISA and controlled by indirect immunofluorescence antibodies test. Confirmation of infection in seroconverted dogs was based on the detection of the parasite by culture in NNN medium or detection of parasite's DNA by real time PCR. Among 38 control dogs, 6 (15.8%) were infected by Leishmania infantum during the study period against zero in the collar group; the difference is statistically significant (p=0.02). This result is an additional confirmation of the prophylactic properties of Scalibor protector band against canine leishmaniosis.
Archives de l'Institut Pasteur de Tunis, 2008
The anti-sandflies and, insecticides impregnated collars are actually mentioned as the main mean ... more The anti-sandflies and, insecticides impregnated collars are actually mentioned as the main mean for prevention and control of Canine leishmaniasis. An evaluation of the Scalibor collar was undertaken in leishmaniasis active sites in Tunis area, (northern Tunisia). Eighty leishmaniasis free dogs (42 collared and 38 as control dogs) were submitted to a serological detection using ELISA technique for anti-Leishmania antibodies before and after transmission season in 2005 and 2006. Seroconversions were detected by ELISA and controlled by indirect immunofluorescence antibodies test. Confirmation of infection in seroconverted dogs was based on the detection of the parasite by culture in NNN medium or detection of parasite's DNA by real time PCR. Among 38 control dogs, 6 (15.8%) were infected by Leishmania infantum during the study period against zero in the collar group; the difference is statistically significant (p=0.02). This result is an additional confirmation of the prophylacti...
Acta Tropica, 2014
Canine visceral leishmaniasis (CVL) is endemic in the Mediterranean basin. In Tunisia, CVL is spa... more Canine visceral leishmaniasis (CVL) is endemic in the Mediterranean basin. In Tunisia, CVL is spatially associated with human visceral leishmaniasis (HVL) affecting mostly children younger than 5 years old. In this study, seroprevalence of Leishmania infantum infection in dogs was assessed in highly endemic districts of the governorate of Kairouan where more than 50% of HVL cases in Tunisia were reported. An entomological investigation was also carried out in two endemic districts (Bouhajla and Haffouz) to assess sand fly fauna and infection status of sand flies with Leishmania. A total of 191 serum samples were collected from healthy dogs and tested for anti-L. infantum antibodies by indirect immunofluorescence antibody test (IFAT). Overall seroprevalence for L. infantum was 26.7% being highest among dogs in the district of Bouhajla (52.7%) and the lowest in the district of Chbika (5.2%). In dogs, seroprevalence did not differ significantly based on gender or age, with dogs younger than 1 year showing a higher seroprevalence compared to older dogs. These findings suggest strong force of infection in naïve animals in holoendemic regions leading to emerging high incidence of HVL. Concomitant to the high CVL prevalence observed in the Bouhajla district, a significantly high cumulative HVL incidence also was observed in this district. Phlebotomus perniciosus and Phlebotomus longicuspis were the most abundant sand fly species in Bouhajla and Haffouz districts. The rate of Leishmania-DNA infection in sand flies was 9.4%. This finding points to spatial correlation between the occurrence of disease in humans, a high rate of infection in dogs and a high abundance of P. pernicious and P. longicuspis. Thus, CVL is the main risk factor for transmission to humans and subsequently, it is an important parameter for controlling transmission to humans.
Veterinary Parasitology, 2014
Dogs are the main reservoir host of Leishmania infantum, etiologic agent of human visceral leishm... more Dogs are the main reservoir host of Leishmania infantum, etiologic agent of human visceral leishmaniasis (HVL) and canine visceral leishmaniasis (CVL). Transmission of L. infantum to humans and dogs is mainly through the bite of infected sand flies. In the Western Mediterranean basin, Phlebotomus perniciosus is the main vector of L. infantum. However, occasional vertical transmission of L. infantum has been reported. This study investigated L. infantum vertical transmission in offspring of experimentally infected dogs. Among 14 surviving puppies from three female beagle dogs that developed CVL following an experimental infection with L. infantum, one was tested positive by indirect immunofluorescence antibody test, by PCR and by xenodiagnosis with a high parasite burden in the spleen at 14 months old. None of the remaining puppies were tested positive for L. infantum. These findings strongly suggest that infected puppies following vertical transmission can sustain infection and contribute in infecting sand flies with L. infantum. Any strategy for controlling CVL should take into consideration the vertical transmission of L. infantum.
Pathologie Biologie, 2009
Les leishmanioses, cutanée et viscérale, représentent les maladies vectorielles les plus fréquent... more Les leishmanioses, cutanée et viscérale, représentent les maladies vectorielles les plus fréquentes en Tunisie. Leur confirmation biologique est nécessaire avant l'administration des traitements contraignants, coûteux et toxiques qui leurs sont réservés. Une évaluation rétrospective de l'apport des cultures de leishmanies sur milieu NNN dans le diagnostic des leishmanioses a été réalisée sur les données de 375 cultures ayant intéressé 214 cas de LC (leishmaniose cutanée) et 125 de LV (leishmaniose viscérale) recrutés consécutivement à l'institut Pasteur de Tunis entre 1995 et 2007. La sensibilité globale au cours de la LC a été de 68,2 % ; elle était significativement supérieure avec les prélèvements de LC zoonotique (78,8 %) par rapport à ceux de LC sporadique (54,9 %) ; p < 0,001. Cette différence s'explique par la pousse plus aisée sur le milieu NNN de Leishmania (L.) major, agent de la première forme nosogéographique comparativement à L. infantum, particulièrement son zymodème MON-24, agent de la seconde. Au cours de la LV, la sensibilité des couches leucocytaires était non différente de celle des moelles osseuses (MO) (58,2 % versus 70,8 %, p = 0,1) témoignant de l'intérêt des prélèvements sanguins qui permettent d'éviter la traumatisante ponction de MO. Aussi bien au cours de la LC que la LV, le classique examen direct s'est révélé le plus sensible, respectivement 89,7 et 93,4 % ( p < 0,001 et p < 0,001). Cependant, la pratique systématique de la culture, en parallèle avec l'incontournable examen direct, est recommandée. En effet, en plus de redresser certains diagnostics, 22 cas dans notre série, la culture permet l'isolement et l'identification isoenzymatique de la souche parasitaire impliquée, ce qui permet de disposer des données épidémiologiques indispensables à la compréhension des cycles parasitaires et la mise en place des mesures de contrôle appropriées. Comme toutes les cultures, celles des leishmanies sont également confrontées au problème de contamination, dont le taux a été dans notre étude de 5,9 %. Conformément aux prévisions, la contamination a concerné davantage les prélèvements cutanés, soumis à la surinfection, 8,4 % que ceux de sang ou de MO (2,5 % ; p = 0,015). # 2008 Elsevier Masson SAS. Tous droits réservés.
American Journal of Tropical Medicine and Hygiene, 2009
Forty-two patients with visceral leishmaniasis in Tunisia were treated with meglumine antimoniate... more Forty-two patients with visceral leishmaniasis in Tunisia were treated with meglumine antimoniate and followed-up for clinical improvement and blood parasite load determined by quantitative real-time polymerase chain reaction (PCR). Parasite loads before treatment ranged from 27 to 5.3 x 10(7) parasites/mL. At the end of treatment, parasite load decreased significantly in 39 cured patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The decrease in parasite load after treatment was greater than 99% for 34 patients and PCR results became negative in 23 of them. Two patients without clinical improvement showed no or slight decreases in parasite load (209 versus 202 parasites/mL and 1,765 versus 146 parasites/mL). One patient showed had a relapse seven months after showing a good response to treatment. His parasitemia remained high despite a sharp decrease (5.2 x 10(5) versus 5.9 x 10(3) parasites/mL).
![Research paper thumbnail of [Epidemiology of Leishmania (L.) infantum, L. major and L. killicki in Tunisia: results and analysis of the identification of 226 human and canine isolates]](https://attachments.academia-assets.com/44968110/thumbnails/1.jpg)
](Bulletin de la Société de pathologie exotique (1990), 2008
The epidemiological situation of leishmaniasis in Tunisia is characterised by the co-existence in... more The epidemiological situation of leishmaniasis in Tunisia is characterised by the co-existence in a very limited territory (165,000 km2, Sahara included), of 4 clinical forms: the infantile visceral leishmaniasis (VL) and 3 cutaneous leishmaniasis (CL) forms (sporadic, zoonotic and chronic). In addition to the useful epidemiological data, identification of the causative parasitic species is essential to determine the geographic distribution of each form and to select appropriate therapeutic procedure and suitable control measures. 226 Leishmania isolates, 135 human's coming from 59 VL cases and 76 CL cases and 91 canine's were identified by the isoenzyme electrophoresis reference technique. Results confirm the endemicity of the 4 forms mentioned above. The sporadic CL, confined to the North of the country is principally caused by L. infantum MON-24 (72.2%). VL which has reached the southern ridge in the central area of Tunisia, in the governorate of Kairouan (36 typed isolat...
Bulletin de la Societe de pathologie exotique, 2008
The epidemiological situation of leishmaniasis in Tunisia is characterised by the co-existence in... more The epidemiological situation of leishmaniasis in Tunisia is characterised by the co-existence in a very limited territory (165,000 km2, Sahara included), of 4 clinical forms: the infantile visceral leishmaniasis (VL) and 3 cutaneous leishmaniasis (CL) forms (sporadic, zoonotic and chronic). In addition to the useful epidemiological data, identification of the causative parasitic species is essential to determine the geographic distribution of each form and to select appropriate therapeutic procedure and suitable control measures. 226 Leishmania isolates, 135 human's coming from 59 VL cases and 76 CL cases and 91 canine's were identified by the isoenzyme electrophoresis reference technique. Results confirm the endemicity of the 4 forms mentioned above. The sporadic CL, confined to the North of the country is principally caused by L. infantum MON-24 (72.2%). VL which has reached the southern ridge in the central area of Tunisia, in the governorate of Kairouan (36 typed isolat...
Veterinary Parasitology, 2014
Dogs are the main reservoir host of Leishmania infantum, etiologic agent of human visceral leishm... more Dogs are the main reservoir host of Leishmania infantum, etiologic agent of human visceral leishmaniasis (HVL) and canine visceral leishmaniasis (CVL). Transmission of L. infantum to humans and dogs is mainly through the bite of infected sand flies. In the Western Mediterranean basin, Phlebotomus perniciosus is the main vector of L. infantum. However, occasional vertical transmission of L. infantum has been reported. This study investigated L. infantum vertical transmission in offspring of experimentally infected dogs. Among 14 surviving puppies from three female beagle dogs that developed CVL following an experimental infection with L. infantum, one was tested positive by indirect immunofluorescence antibody test, by PCR and by xenodiagnosis with a high parasite burden in the spleen at 14 months old. None of the remaining puppies were tested positive for L. infantum. These findings strongly suggest that infected puppies following vertical transmission can sustain infection and contribute in infecting sand flies with L. infantum. Any strategy for controlling CVL should take into consideration the vertical transmission of L. infantum.
Bull Soc Pathol …, 2008
... 9. AYADI A, BEN ISMAIL R & BEN RACHID MS Extension de l'aire de transmissi... more ... 9. AYADI A, BEN ISMAIL R & BEN RACHID MS Extension de l'aire de transmission du kala azar à Leishmania infantum vers le centre et le sud de la Tunisie. Arch Inst Pasteur Tunis, 1991, 68, 269-73. 10. BELHAJ S, PRATLONG F, TOUMI NH, KALLEL K, MAHJOUB H et al. ...
Archives de l'Institut Pasteur de Tunis
The anti-sandflies and, insecticides impregnated collars are actually mentioned as the main mean ... more The anti-sandflies and, insecticides impregnated collars are actually mentioned as the main mean for prevention and control of Canine leishmaniasis. An evaluation of the Scalibor collar was undertaken in leishmaniasis active sites in Tunis area, (northern Tunisia). Eighty leishmaniasis free dogs (42 collared and 38 as control dogs) were submitted to a serological detection using ELISA technique for anti-Leishmania antibodies before and after transmission season in 2005 and 2006. Seroconversions were detected by ELISA and controlled by indirect immunofluorescence antibodies test. Confirmation of infection in seroconverted dogs was based on the detection of the parasite by culture in NNN medium or detection of parasite's DNA by real time PCR. Among 38 control dogs, 6 (15.8%) were infected by Leishmania infantum during the study period against zero in the collar group; the difference is statistically significant (p=0.02). This result is an additional confirmation of the prophylactic properties of Scalibor protector band against canine leishmaniosis.
Archives de l'Institut Pasteur de Tunis, 2008
The anti-sandflies and, insecticides impregnated collars are actually mentioned as the main mean ... more The anti-sandflies and, insecticides impregnated collars are actually mentioned as the main mean for prevention and control of Canine leishmaniasis. An evaluation of the Scalibor collar was undertaken in leishmaniasis active sites in Tunis area, (northern Tunisia). Eighty leishmaniasis free dogs (42 collared and 38 as control dogs) were submitted to a serological detection using ELISA technique for anti-Leishmania antibodies before and after transmission season in 2005 and 2006. Seroconversions were detected by ELISA and controlled by indirect immunofluorescence antibodies test. Confirmation of infection in seroconverted dogs was based on the detection of the parasite by culture in NNN medium or detection of parasite's DNA by real time PCR. Among 38 control dogs, 6 (15.8%) were infected by Leishmania infantum during the study period against zero in the collar group; the difference is statistically significant (p=0.02). This result is an additional confirmation of the prophylacti...
Acta Tropica, 2014
Canine visceral leishmaniasis (CVL) is endemic in the Mediterranean basin. In Tunisia, CVL is spa... more Canine visceral leishmaniasis (CVL) is endemic in the Mediterranean basin. In Tunisia, CVL is spatially associated with human visceral leishmaniasis (HVL) affecting mostly children younger than 5 years old. In this study, seroprevalence of Leishmania infantum infection in dogs was assessed in highly endemic districts of the governorate of Kairouan where more than 50% of HVL cases in Tunisia were reported. An entomological investigation was also carried out in two endemic districts (Bouhajla and Haffouz) to assess sand fly fauna and infection status of sand flies with Leishmania. A total of 191 serum samples were collected from healthy dogs and tested for anti-L. infantum antibodies by indirect immunofluorescence antibody test (IFAT). Overall seroprevalence for L. infantum was 26.7% being highest among dogs in the district of Bouhajla (52.7%) and the lowest in the district of Chbika (5.2%). In dogs, seroprevalence did not differ significantly based on gender or age, with dogs younger than 1 year showing a higher seroprevalence compared to older dogs. These findings suggest strong force of infection in naïve animals in holoendemic regions leading to emerging high incidence of HVL. Concomitant to the high CVL prevalence observed in the Bouhajla district, a significantly high cumulative HVL incidence also was observed in this district. Phlebotomus perniciosus and Phlebotomus longicuspis were the most abundant sand fly species in Bouhajla and Haffouz districts. The rate of Leishmania-DNA infection in sand flies was 9.4%. This finding points to spatial correlation between the occurrence of disease in humans, a high rate of infection in dogs and a high abundance of P. pernicious and P. longicuspis. Thus, CVL is the main risk factor for transmission to humans and subsequently, it is an important parameter for controlling transmission to humans.
Veterinary Parasitology, 2014
Dogs are the main reservoir host of Leishmania infantum, etiologic agent of human visceral leishm... more Dogs are the main reservoir host of Leishmania infantum, etiologic agent of human visceral leishmaniasis (HVL) and canine visceral leishmaniasis (CVL). Transmission of L. infantum to humans and dogs is mainly through the bite of infected sand flies. In the Western Mediterranean basin, Phlebotomus perniciosus is the main vector of L. infantum. However, occasional vertical transmission of L. infantum has been reported. This study investigated L. infantum vertical transmission in offspring of experimentally infected dogs. Among 14 surviving puppies from three female beagle dogs that developed CVL following an experimental infection with L. infantum, one was tested positive by indirect immunofluorescence antibody test, by PCR and by xenodiagnosis with a high parasite burden in the spleen at 14 months old. None of the remaining puppies were tested positive for L. infantum. These findings strongly suggest that infected puppies following vertical transmission can sustain infection and contribute in infecting sand flies with L. infantum. Any strategy for controlling CVL should take into consideration the vertical transmission of L. infantum.
Pathologie Biologie, 2009
Les leishmanioses, cutanée et viscérale, représentent les maladies vectorielles les plus fréquent... more Les leishmanioses, cutanée et viscérale, représentent les maladies vectorielles les plus fréquentes en Tunisie. Leur confirmation biologique est nécessaire avant l'administration des traitements contraignants, coûteux et toxiques qui leurs sont réservés. Une évaluation rétrospective de l'apport des cultures de leishmanies sur milieu NNN dans le diagnostic des leishmanioses a été réalisée sur les données de 375 cultures ayant intéressé 214 cas de LC (leishmaniose cutanée) et 125 de LV (leishmaniose viscérale) recrutés consécutivement à l'institut Pasteur de Tunis entre 1995 et 2007. La sensibilité globale au cours de la LC a été de 68,2 % ; elle était significativement supérieure avec les prélèvements de LC zoonotique (78,8 %) par rapport à ceux de LC sporadique (54,9 %) ; p < 0,001. Cette différence s'explique par la pousse plus aisée sur le milieu NNN de Leishmania (L.) major, agent de la première forme nosogéographique comparativement à L. infantum, particulièrement son zymodème MON-24, agent de la seconde. Au cours de la LV, la sensibilité des couches leucocytaires était non différente de celle des moelles osseuses (MO) (58,2 % versus 70,8 %, p = 0,1) témoignant de l'intérêt des prélèvements sanguins qui permettent d'éviter la traumatisante ponction de MO. Aussi bien au cours de la LC que la LV, le classique examen direct s'est révélé le plus sensible, respectivement 89,7 et 93,4 % ( p < 0,001 et p < 0,001). Cependant, la pratique systématique de la culture, en parallèle avec l'incontournable examen direct, est recommandée. En effet, en plus de redresser certains diagnostics, 22 cas dans notre série, la culture permet l'isolement et l'identification isoenzymatique de la souche parasitaire impliquée, ce qui permet de disposer des données épidémiologiques indispensables à la compréhension des cycles parasitaires et la mise en place des mesures de contrôle appropriées. Comme toutes les cultures, celles des leishmanies sont également confrontées au problème de contamination, dont le taux a été dans notre étude de 5,9 %. Conformément aux prévisions, la contamination a concerné davantage les prélèvements cutanés, soumis à la surinfection, 8,4 % que ceux de sang ou de MO (2,5 % ; p = 0,015). # 2008 Elsevier Masson SAS. Tous droits réservés.
American Journal of Tropical Medicine and Hygiene, 2009
Forty-two patients with visceral leishmaniasis in Tunisia were treated with meglumine antimoniate... more Forty-two patients with visceral leishmaniasis in Tunisia were treated with meglumine antimoniate and followed-up for clinical improvement and blood parasite load determined by quantitative real-time polymerase chain reaction (PCR). Parasite loads before treatment ranged from 27 to 5.3 x 10(7) parasites/mL. At the end of treatment, parasite load decreased significantly in 39 cured patients (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The decrease in parasite load after treatment was greater than 99% for 34 patients and PCR results became negative in 23 of them. Two patients without clinical improvement showed no or slight decreases in parasite load (209 versus 202 parasites/mL and 1,765 versus 146 parasites/mL). One patient showed had a relapse seven months after showing a good response to treatment. His parasitemia remained high despite a sharp decrease (5.2 x 10(5) versus 5.9 x 10(3) parasites/mL).
Bulletin de la Société de pathologie exotique (1990), 2008
The epidemiological situation of leishmaniasis in Tunisia is characterised by the co-existence in... more The epidemiological situation of leishmaniasis in Tunisia is characterised by the co-existence in a very limited territory (165,000 km2, Sahara included), of 4 clinical forms: the infantile visceral leishmaniasis (VL) and 3 cutaneous leishmaniasis (CL) forms (sporadic, zoonotic and chronic). In addition to the useful epidemiological data, identification of the causative parasitic species is essential to determine the geographic distribution of each form and to select appropriate therapeutic procedure and suitable control measures. 226 Leishmania isolates, 135 human's coming from 59 VL cases and 76 CL cases and 91 canine's were identified by the isoenzyme electrophoresis reference technique. Results confirm the endemicity of the 4 forms mentioned above. The sporadic CL, confined to the North of the country is principally caused by L. infantum MON-24 (72.2%). VL which has reached the southern ridge in the central area of Tunisia, in the governorate of Kairouan (36 typed isolat...