Cutaneous Leishmaniasis in Khyber Pakhtunkhwa Province of Pakistan: Clinical Diversity and Species-Level Diagnosis (original) (raw)
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A total of 300 samples were collected from suspected patient to find the prevalence of Cutaneous Leishmaniasis as well as Polymerase Chain Reaction (PCR) based identification of respective species in the endemic areas of Dir Lower and Dir Upper (Khyber Pakhtunkhwa Province) Pakistan. These patients including (171) males and (129) females from these areas, irrespective of age, were analyzed using patient’s biopsy samples, slide smears and filter paper impressions from lesions. Kinetoplast kDNA-PCR and (Internal Transcribed Spacer 1(ITS1-PCR) were performed using RV1/RV2 and LITS R/L5.8s primers, respectively. Age group of 0-15 years was found to be the most infected with 47.5% of total cases while age group of 45 years and above showed lowest rate (7.0%). Out of 300 patients, 172 (56.17%) were positive by microscopy, 79.5% (238 Patients) by ITS1-PCR-Assay and 280 (93.5%) were confirmed by kDNA-PCR. It was concluded that cutaneous leishmaniasis in prevalent in local population of Dir district. Furthermore, kDNA-PCR is more sensitive and specific method for identification of the parasite, followed by ITS1-PCR as compared to Microscopy and culturing. Keywords: Clinical Diagnosis, Leishmania, Cutaneous Leishmaniasis, Mucocutaneous Leishmaniasis, Visceral Leishmaniasis, Leishmania tropica, Leishmania major
Cutaneous leishmaniasis caused by Leishmania (L.) major infection in Sindh province, Pakistan
Acta Tropica, 2009
Leishmaniasis is endemic in Pakistan and is widespread throughout the country. Polymerase chain reaction (PCR) was performed to identify the Leishmania species present in cutaneous leishmaniasis (CL) patients from new endemic areas of the central part of Sindh province, Pakistan. The PCR primers used were designed for the identification and differentiation of Leishmania (Leishmania) major and Leishmania (Leishmania) tropica species, and PCR bands at 620 and 830 bp of the parasite-specific kinetoplast DNA sequences was identified for L. (L.) major and L. (L.) tropica, respectively. Among a total of 144 DNA samples purified from the skin biopsies of clinically suspected CL patients, 108 (75%) were positive for PCR amplification. Out of the 108 cases, 105 (97.2%) were determined to be positive for L. (L.) major infection, and 3 (2.8%) were positive for L. (L.) tropica infection. It was concluded that CL caused by L. (L.) major is the main source of infection in the central part of Sindh province in Pakistan. This rapid screening technique could be used for the diagnosis of a large number of samples from skin lesions, which commonly contain other bacterial and fungal infections.
A total of 339 patients with clinically suspected cutaneous leishmaniasis (CL) were studied from March to April, 2010 in three villages of Karak, Khyber Pakhtunkhwa, Pakistan where an epidemic of the disease was in question. Using polymerase chain reaction (PCR), 78.17% (265/339) were observed having CL. Microscopically, however, only 43.06% (146/339) were diagnosed with the disease. This study reports and confirms epidemic of CL in both gender of all ages in the area. Females (70.94%) were noted to be predominantly affected as compared to males (29%). Clinically, 12.38% of patients had more than three lesions, 29.20% had two lesions, while 58.40% had only single lesion. Most lesions were found on exposed surfaces of the body (predominantly hands, face and feet). The present study confirms that PCR was more sensitive than microscopic examination.
Prevalence and comparative analysis of cutaneous leishmaniasis in Dargai region in Pakistan
Pakistan journal of zoology
In the present study, 102 samples of exudates from cutaneous leishmanial lesions were collected from local Pakistanis and Afghan refugees residing in Dargai Tehsil of Malakand Agency Pakistan, and were analyzed. The lesions were more prevalent among the locals (60.79%) compared to refugees (49.21%), and 70.58% male compared to 30.42% female were infected with Leishmania. Infection was more prevalent among youth's ages of 11-20 year old (34.32%) compared to older adults. Exposed parts of the body (face, hands, legs, neck, ears and feet) were the main affected areas. Faces experienced more bites (36.28%), followed by legs (26.48%), and hands (21.57%). Lesions lasting duration of 3-4 months was more prevalent (42.16%).The present research also disclosed some key factors that seem to be responsible for the prevailing rate of incidence.
Journal of entomology and zoology studies, 2016
Cutaneous Leishmaniasis is parasitic disease which causes severe morbidity and mortality. The present study identified the leishmania infection caused by Leishmania tropica in Hangu. A total of 45 samples were examined through PCR, Microscopy which showed 87.61% (99/113), 53.98% (61/113) thus the sensitivity of PCR is very high as compared to microscopy. During the study 186 bp Leishmania tropica was identified through PCR and presence of Leishmania tropica showed the infected person serum through SDS method analysis respectively.
Journal of Parasitic Diseases, 2020
Cutaneous leishmaniasis is a vector borne infection caused by flagellated parasitic protozoans of the genus Leishmania. This is an emergent threat and endemic in areas of tropic and sub-tropics and has a wider geographical distribution. This study was aimed to find the epidemiological aspects of cutaneous leishmaniasis during the recent epidemic in district Karak in 2018-2019. The suspected patients of leishmaniasis from different areas of district Karak were examined. We came across 803 cases during six-month period from August 2018 to January 2019. A major portion ([ 37%; n = 299) of these patients were in age 11-20 years. The infection rate was higher in female (55.3%; n = 803) compared to males (44.6%; n = 803). Both gender and age showed a significant effect on the occurrence of infection. It is concluded that cutaneous leishmaniasis has appeared as a major health issue in district Karak. The current study report CL outbreak in Karak district which need immediate response from the healthcare authorities. In addition, extensive awareness campaigns are needed for timely prevention of such outbreaks.
Prevalence of cutaneous leishmaniasis in Lower Dir District (NWFP), Pakistan
Journal of Pakistan Association of …, 2009
Back ground Cutaneous leishmaniasis (CL) is a common disease in northern areas of Pakistan. Objective To determine the prevalence of CL in Lower Dir and its correlation with age, sex, site and number of lesions. Patients and methods A total of 224 subjects of different age groups were examined. Of the total (224) individuals, 50.89% were found positive for CL. The prevalence of leishmaniasis was also examined in relation to age, sex, site of involvement, number of lesions and nature of the lesions. Results The prevalence of leishmaniasis was 55% in local population and 45% in Afghan refugees (p>0.05). The prevalence of leishmaniasis was the highest in the 1-15 year age group (43.8%) than older age group. The prevalence of leishmaniasis was higher in males (60.5%) than in females (39.5%), with male to female ratio of 1.5:1. The lesions were more frequent on face (34.2%) than the other sites of the body. The majority (56.70%) had single lesion, with a mean number of 2.14 lesions per case (range 1-10 lesions). 58.10% patients presented within first two months (range 1-8 months). The wet lesions were observed more frequently (81.3%) than dry type (18.7%). Also the prevalence rate in patients, previously treated with antimonial drugs was found lower (18.86%) than untreated patients (60.81%). Conclusion Prevalence of cutaneous leishmaniasis was similar in local residents and Afghan refugees, both sexes and age groups. Wet type is more frequently seen than dry type and usually presents as single lesion.
A Brief Review on Infestation of Cutaneous Leishmaniasis in Pakistan
Biomedical Journal of Scientific & Technical Research, 2020
Cutaneous leishmaniasis frequently including only the skin and one and more than one lesions are present on the skin depending on the species of Leishmania, smooth ulcers, flat plaques, nodules or hyperkeratosis wart like ulcers may be observed. The causative agent of cutaneous leishmaniasis is L. tropica which is spreading by Phlebotomus sergenti, P. papatasi, P. caucasicus, P. longipes and P. pedifer in the endemic areas. According to WHO, annually 0.4 million new cases of leishmaniasis occur per year, approximately with almost 400 million people at threat of the disease. The infection is commonly present along the entire Western border of Pakistan. Sindh (area associated with Balochistan), Punjab (Multan and Chakwal) and Northern Areas of Balochistan. In Pakistan, the status of leishmaniasis has been changed. In parts of the country both the cutaneous and the visceral types of the disease are being noticed from various parts of the country, including Khyber Pakhtoonkhwa. This articleis focus on the burden of CL in different areas of Pakistan.