An overview of a diagnostic and epidemiologic reappraisal of cutaneous leishmaniasis in Iran (original) (raw)
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THE PREVALENCE OF CUTANEOUS LEISHMANIASIS IN EAST OF AHVAZ COUNTY, SOUTH-WESTERN IRAN
Objectives: Cutaneous Leishmaniasis (CL) is a zoonotic parasitological disease. This disease cause always important health challenges for the human communities. It is common in many parts of the globe. This research was designed to determine the epidemiology of CL in East of Ahvaz County during 2003-2013. Methods: This was a descriptive cross-sectional study. The disease was diagnosed based on clinical examination and microscopic observation of the parasite in the ulcer site. The patient's Information such as age, gender, number and sites of ulcer (s) on the body, month and residence area were recorded. Data analysis was performed using SPSS software. Results: Totally, 2287 cases were detected during 2003 – 2013. About 53.4% patients were male and 46.4% female. The highest frequency infected age groups were observed in 10-19 years old (n=550 ,24%). Nearly 37 % of the patients had one and 38.1% had three ulcers. The most common location of ulcers were on hands (n=1022, 44.7%) and then on feet (n=501, 21.9%). Totally 1877 of the patients were infected in rural areas. Based on the appearance of the lesion it was found that 410 cases (17.9%) were of the dry type and 1877 cases (82.1%) were wet type. Concluaions: Such high prevalence and incidence rates are alarming and require control and prevention measures. Further epidemiological studies of CL are suggested.
PubMed, 2015
Background: Cutaneous leishmaniasis (CL) remains a serious public health concern in Kerman Province, eastern Iran. This study was aimed to conduct a comprehensive review and highlights various aspects of CL in the province of Kerman. Methods: This article mainly focuses on the studies published in the past 26 years on CL in the province. Current data for the present status were obtained through the provincial health system. Results: Bam was the most infected district (63.6%), followed by Kerman (24.7%) and other districts to a less extent. Leishmania tropica is the major causative agent (95.5%) of CL in Kerman province, however, L. major accounts for 4.5% of the total cases. Bam, Kerman and southern districts of Kerman province were purely anthroponotic CL (ACL), while Rafsanjan, Baft, and Sirjan showed both ACL and zoonotic CL (ZCL). In contrast, Orzoieh district was merely endemic to ZCL type. Phlebotomus sergenti was the main vector in ACL foci while Ph. papatasi was the major vector in the ZCL district of Orzoieh. Localized CL was the most prevalent form (80%) of the disease, while leishmaniasis recidivans was the most uncommon clinical manifestation (18.7%). Conclusion: Due to recent rises in CL disease both in regard of increases in incidence rate and expansion of the disease to new foci, and presence of various risk factors in the province, control measures and health strategies should have high priorities to help treat the existing cases and prevent the expansion of the disease to new areas.
Transactions of the Royal Society of Tropical Medicine and Hygiene, 2012
During 2002-2009, 466 cases of cutaneous leishmaniasis (CL) were reported from Jenin District, Palestine, affecting both genders. The average annual incidence was 23 cases per 100 000 inhabitants, increasing with age in children. Most cases presented a single lesion, generally on the face. Diagnosis and species identification was done by applying internal transcribed spacer 1 (ITS1) RFLP analysis to 47 isolates, of which 44 (93.6%) were Leishmania tropica and 3 (6.4%) were L. major. RFLP analysis was also performed on 256 skin tissue scrapings spotted onto filter papers, showing that 138 (53.9%) were positive, of which 50.7% were infected with L. tropica, 17.4% with L. major and 2.9% with L. donovani s.l., and 29.0% could not be identified. This is the first report from Palestine on human CL caused by L. infantum. Nine of the strains of L. tropica were subjected to multilocus enzyme electrophoresis, six of which belonged to the zymodeme MON-137 and three to a new zymodeme (MON-307). This separation was corroborated by excreted factor serotyping. This observation modifies the classical epidemiological view of CL in Palestine. Jenin District is an active focus of CL caused by L. tropica, where Phlebotomus sergenti, the putative vector, is abundant. These data suggest that CL is a zoonotic infection, but an animal reservoir has not been found.
Molecular epidemiological study of cutaneous leishmaniasis in the east north of Iran
Asian Pacific Journal of Tropical Disease, 2014
Background: Cutaneous leishmaniasis (CL) represents the most frequent vector borne parasitoses in Iran. The objective of this study was to determine the epidemiological features of CL including human infection and the reservoir host in the city of Bushehr, Bushehr Province, Iran during 2010-2011. Methods: Studies on human infection was carried out on 2962 school children aged 7-14 years old from 60 primary schools and among 400 households with a total population of 1568 in four infected districts of the city in December 2010. Serosity materials from patients on glass slides were collected for molecular identification of causative agent. Rodents were caught by Sherman traps and examined for identification of the parasite. Results: Prevalence of scars and ulcers among the inhabitants were 5.86% and 0.12% respectively. Molecular study indicated the presence of two coexisting species: Leishmania major and L. tropica among patients. The scar rate was 1.24% but no ulcers were seen among the students. Nineteen rodents were caught and identified as Tatera indica (47.4%) and Rattus norvegicus (52.6%). Specimens from 7 T. indica and 9 R. norvegicus were examined by two techniques, microscopic examination and nested-PCR. Out of 7 T. indica, 14.3% were infected with L. major and 42.9% with L. turanica by nested-PCR. Out of 9 R. norvegicus 22.2% were infected with L. turanica and 11.1% with L. gerbilli. Conclusion: Based on this survey L. major and L. tropica are the causative agents of the disease among patients and T. indica plays a predominant role in the dissemination of L. major in the city.
PubMed, 2013
Background: Cutaneous leishmaniasis (CL) represents the most frequent vector borne parasitoses in Iran. The objective of this study was to determine the epidemiological features of CL including human infection and the reservoir host in the city of Bushehr, Bushehr Province, Iran during 2010-2011. Methods: Studies on human infection was carried out on 2962 school children aged 7-14 years old from 60 primary schools and among 400 households with a total population of 1568 in four infected districts of the city in December 2010. Serosity materials from patients on glass slides were collected for molecular identification of causative agent. Rodents were caught by Sherman traps and examined for identification of the parasite. Results: Prevalence of scars and ulcers among the inhabitants were 5.86% and 0.12% respectively. Molecular study indicated the presence of two coexisting species: Leishmania major and L. tropica among patients. The scar rate was 1.24% but no ulcers were seen among the students. Nineteen rodents were caught and identified as Tatera indica (47.4%) and Rattus norvegicus (52.6%). Specimens from 7 T. indica and 9 R. norvegicus were examined by two techniques, microscopic examination and nested-PCR. Out of 7 T. indica, 14.3% were infected with L. major and 42.9% with L. turanica by nested-PCR. Out of 9 R. norvegicus 22.2% were infected with L. turanica and 11.1% with L. gerbilli. Conclusion: Based on this survey L. major and L. tropica are the causative agents of the disease among patients and T. indica plays a predominant role in the dissemination of L. major in the city.
Cutaneous Leishmaniasis in Saudi Arabia: A Comprehensive Overview
Vector-Borne and Zoonotic Diseases, 2017
Despite the great efforts by health authorities in Kingdom of Saudi Arabia (KSA), Cutaneous leishmaniasis (CL) continues to be a major public health problem in the country. Many risk factors make KSA prone to outbreaks and epidemics; among these, rapid urbanization and the huge population movement are the most important. The disease is endemic in many parts of KSA, with the majority of cases concentrated in six regions, including Al-Qaseem, Riyadh, Al-Hassa, Aseer, Ha'il, and Al-Madinah. Leishmania major (L. major) and Leishmania tropica (L. tropica) are the main dermotropic species, and Phlebotomus papatasi (vector of L. major) and Phlebotomus sergenti (vector of L. tropica) are the proved vectors of the disease. Psammomys obesus and Meriones libycus have been defined as the principal reservoir hosts of zoonotic CL in Al-Hassa oasis, Al-Madinah, and Al-Qaseem provinces. Clinically, males are affected more than females, and there is no variation between the Saudis and expatriates in terms of number of reported cases, but the disease tends to run a more severe course among non-Saudis. Face is the most commonly affected site, and ulcerative pattern accounts for 90% of lesions. Despite local and international recommendations of using laboratory diagnostics to confirm CL cases, most cases in KSA are diagnosed and treated on clinical grounds and local epidemiology. However, systemic parenteral sodium stibogluconate (SSG) is the first line of therapy and used to treat all CL patients irrespective of their clinical presentation or the incriminated species. In brief, more efforts are needed to combat this disease. Several aspects of the disease require more evaluation through encouragement of national and regional studies. Development of evidence based national diagnostic and management guidelines, as well as algorithms, is urgently needed to improve the practice of diagnosing and treating CL in KSA.
Acta Tropica, 2015
Highlights ►We conducted the first epidemiological and molecular study in the new cutanuous leishmaniasis focus of Settat province in Morocco ►553 cases were reported between 2007 and 2012. Most of cases were from El Borouj sector. ►The high prevalence of lesion was recorded among children under 11 years old ► The lesions were typically small and dry ► L. tropica MON-102 were identified by PCR ITS1 and isoenzyme technique on starch gel electrophoresis ABSTRACT Anew emerging focus of human cutaneous leishmaniasis (HCL) caused by Leishmaniatropica was identified within the province of Settat. This study was performed in order to analyse the reasons of the extension of CL in this area, and to describe the clinico-epidemiological characteristic of this emerging focus during 2007-2012. A total of 553 suspected cases of CL were diagnosed in laboratory of Settat, controlled and confirmed in reference national laboratory of leishmaniasis in Rabat. Leishmania parasite is found in 356 cases.Most of them (33.89 %) wererecorded in localities of OuledGhalem (110 cases) andLaamarcha (102cases) of El Borouj sector. The lesions were typically small, dry and mostly located on the face and extremities. Majority of infection (25 %) was recorded among children under 11 years old, and female (72%). Strains of L. tropica were identified by PCR ITS1 from positive slides and zymodeme MON-102 was typed using isoenzyme technique on starch gel electrophoresis.
Cutaneous Leishmaniasis in El-Madinna Manowra region, Saudi Arabia in 2012
Bangladesh Journal of Medical Science, 2013
Objective: Leishmaniasis is a parasitic disease causing major public health problem in form of visceral and cutaneous types. The cutanoue leishmaniasis is caused by L. tropica, in low-land areas without reservoir; Arthroponatic leishmaniasis (ACL), Zoonotic Cutaneous Leishmaniasis (ZCL), in highland. This case report involved; 25 years old Egyptian active young single male adult, stayed in Utama (75 Km far from El-Madina Manowra on the road to Makkah). He presented with three skin lesions on his arms occurred within the last 1-3 months. on examination revealed; volcano-like indurated ulcers which clinically suspected as leishmania lesions. Materials and Methods: Laboratory investigations were involved; skin smear using Giemsa stain, Leishmanin test (LST), polymerase chain reaction (PCR), sequencing and phylogenitic analysis BLAST (NCBI). Results: Microscopy positive LDB (leishmanin donovani bodies), Leishmanin test (LST) was negative. PCR positive L. major. Sequence alignment were 100% with nine Iranian isolates and one Tunisian isolate. After one month of treatment with Pentostam (Sodium stibogluconate) local injections at the site of lesions the lesion progressed from ulcer to scar. Conclusion: L. major is a major species causing cutaneous leishmaniasis in Al-Medina Manowra region in Saudi Arabia. The usage of the polymerase chain reaction (PCR) is a useful diagnostic tool and help to identify the causative species.
Molecular diagnosis of leishmaniosis in the Paraná state of southern Brazil
Experimental Dermatology, 2008
Abstract: The objective of the present study was to establish a polymerase chain reaction (PCR) technique for the diagnosis of cutaneous and mucocutaneous leishmaniosis from autochthonous cases in the state of Paraná in southern Brazil as well as imported cases. We sought to determine its utility and accuracy compared with smears and present culture methods. To standardize PCR samples, skin and mucosal punch biopsies from human lesions were performed on patients living in different regions of the Paraná state (76 cases) and other endemic areas of Brazil and Argentina (7 cases). For PCR standardization, two pairs of primers (MP1L/MP3H and B1/B2) were utilized for amplification of the conserved sequences in the minicircle of kinetoplast DNA (kDNA) for the Leishmania braziliensis complex. Two other primer pairs (b1/b2 and a1/a2) were species-specific for L. (V.) braziliensis and L. (V.) amazonensis, respectively. After differential diagnosis, eight patients had clinical diagnosis of the cutaneous ulcer changed to others pathologies such as syphilis, baso-cellular carcinoma, varicose ulcer, ecthyma and paracoccidioidomycosis. Of the 75 patients with cutaneous (CL) and mucocutaneous (MCL) lesions who provided samples, 47 (46 CL + 1 MCL) were diagnosed with leishmaniosis by smear and 57 (52 LC + 5 MCL) were diagnosed by culture methods. In contrast, our PCR technique presented higher accuracy when compared to the direct examination and culture of parasites. PCR is applicable both for CL where all 61 lesions were diagnosed, and MCL where 12 of 14 lesions were diagnosed. This molecular biology technique is also a faster and more specific diagnostic method compared with present parasitological procedures.
Iranian journal of parasitology, 2013
Cutaneous leishmaniasis (CL) is a major health problem in many parts of Iran, although diagnosis of CL especially in the endemic area is easy, but treatment and management of the disease is a global dilemma. Diagnosis of CL in non-endemic area is not as simple as in endemic foci. In this study, the status and the proportions of CL induced by Leishmania major and L. tropica among CL suspected patients referred to the Center for Research and Training in Skin Diseases and Leprosy, (CRTSDL) during 2008 to 2011 are described. CL patients with suspected lesions were clinically examined. History of trip to zoonotic CL and/or anthroponotic CL endemic areas and the characteristics of their lesion(s) were recorded. Diagnosis of the lesion was done using direct smear microscopy, culture and conventional polymerase chain reaction (PCR). A total of 404 (M = 256, F = 148) patients with 776 lesions were recruited and parasitologically examined. The results showed that 255 of the patients with 613 ...