An overview of a diagnostic and epidemiologic reappraisal of cutaneous leishmaniasis in Iran

Abstract

Cutaneous leishmaniasis (CL) is a widespread tropical infection which has a high incidence rate in Iran. Leishmania tropica, the causative agent of anthroponotic cutaneous leishmaniasis (ACL), and Leishmania major, which causes zoonotic cutaneous leishmaniasis (ZCL), are endemic in various parts of Iran with a high incidence rate. The aim of this study was to evaluate the reappraisal of the diagnosis and epidemiology of CL in Iran, by different clinical, parasitological and molecular assays among patients suspected of CL referred to the Department of Parasitology, at the Pasteur Institute of Iran during 2006-2009. Two hundred samples from patients with ulcerative skin lesions were collected, clinical analyses were applied, data questionnaire was completed and samples were examined for CL by using both direct microscopic and culture methods. Moreover, PCR assay was applied for detection of Leishmania species in CL isolates resulting from parasitological assay. Clinical observation revealed that the majority (58%) of lesions was single; double lesions were observed in 22% of patients, and only 20% of CL had multiple lesions. Out of 200 patients, Leishman body was observed in 77 samples (38.5%) by direct smear and 40% by cultivation assay. Most patients (21.3%) had a travel history to the Isfahan province, one of the most important endemic areas of CL located in center of Iran. PCR assay by kDNA indicated 32 and 18 out of 50 isolates respectively had similar patterns with standard L. major and L. tropica. In conclusion, clinical manifestations and an appropriate diagnostic assay with a parallel molecular characterization of CL may lead to a screening evaluation of disease, prognosis, treatment and control strategies.

APPLICABILITY OF kDNA-PCR FOR ROUTINE DIAGNOSIS OF AMERICAN TEGUMENTARY LEISHMANIASIS IN A TERTIARY REFERENCE HOSPITAL

“…The in vitro culture presented a lower percentage of positivity and/or parasite isolation (19.3%, Table 1), than those described by other authors, which ranged from 30.3% to 81.5% 9 17 18 23 . The low sensitivity of the in vitro culture test was evidenced in Table 2 were 77 contaminated or negative samples by this method were positive by kDNA-PCR.…”

Cutaneous Leishmaniasis of the Eyelid: A Case Report

“…Many of the clinical presentations are typical and present no diagnostic difficulties [4]. The most commonly involved sites are exposed areas.…”

Detection of species and molecular typing of Leishmania in suspected patients by targeting cytochrome b gene in Zahedan, southeast of Iran

“…Zoonotic CL (ZCL) and anthroponotic CL (ACL) are both reported in Iran, mostly caused by Leishmania major and Leishmania tropica , respectively [ 9 ]. ZCL is endemic in various regions such as south-west and central of Iran with a high incidence rate and different reservoir hosts [ 10 ]. Due to differences in preventing and controlling methods used, clinical course, prognosis, and the method of treatment in applied against different species; the identification of species is of particular importance.…”