Cutaneous Leishmaniasis in the Nalut District, Libyan Arab Jamahiriya: A Clinico-epidemiologic Study andLeishmaniaSpecies Identification

Abstract

Cutaneous leishmaniasis (CL), an endemic disease in the littoral zones of the Mediterranean area, the Middle East, East Africa, and especially in Libya, has not been fully documented. The present study clarifies the clinico-epidemiologic profile of CL and the molecular genotyping of the Leishmania spp. in the Nalut district, Libya. Two hundred and twenty-three CL patients were examined at the out-patient clinics of Nalut Hospital from March 2006 to February 2007. CL was diagnosed by clinical, microscopic, culture, polymerase chain reaction (PCR), and PCR-restriction fragment length polymorphism (RFLP) analyses. The disease was observed year-round, with the highest prevalence between November and February. Fifty-nine percent of patients were younger than 20 yr. Nodulo-ulcerative lesions, indurated ulcers, papulo-ulcerative lesions, and subcutaneous nodular lesions were observed in 170, 25, 15, and 13 patients, respectively. Two hundred patients (89.7%) had dry type of lesions, whereas 23 patients (10.3%) presented a wet type of lesion. One hundred and fifty-nine (71.3%) of 223 patients were confirmed positive for CL by the presence of the amastigote form of Leishmania by stained Giemsa smear, and 170 (76.2%) were positive according to the presence of the promastigote form of Leishmania by culture in RPMI 1640 medium supplemented with 10% fetal bovine serum (FBS). PCR confirmed 203 (91.0%) positive cases. Genotyping of Leishmania spp. by RFLP analysis revealed that L. tropica was the most common species at all ages, and L . infantum was second under 20 yr of age. In summary, CL is endemic in the Nalut district, Libya; PCR was the most sensitive parasite diagnostic test, and L. tropica was the most common species.

Clinico-Epidemiological Patterns of Cutaneous Leishmaniasis Patients Attending the Anuradhapura Teaching Hospital, Sri Lanka

“…Dry type CL lesions were common in this study group, in agreement with previous studies conducted in Sri Lanka [12], India [30], Libya [31], and in Syria [32]. However, females had more wet lesions than males.…”

Cutaneous Leishmaniasis in North Africa: a review

“…However, recent molecular identifications revealed that cases due to L. tropica are prevalent in many North-Western districts such as Nalut, Misrata, Jabal El Gharbi, and Tarhouna [3, 13] (Fig. 1).…”

One-year prospective study of pediatric cutaneous leishmaniasis: a neglected tropical disease in sub Himalayan region, India

“…3 The global prevalence of the disease is 12 million cases and 350 million people are considered at risk of contracting the infection. 4 In India, disease is prevalent in specific areas of Bihar, West Bengal, Uttar Pradesh, Assam, deserts of Rajasthan and the foothills of Sikkim. 5 CL affects various age groups depending on the infecting Leishmania species, geographic location, host specific immunity and disease reservoir.…”