Molecular Characterization of Leishmania Species among Patients with Cutaneous Leishmaniasis in Asir Province, Saudi Arabia

Abstract

Anthroponotic cutaneous leishmaniais (ACL) and zoonotic cutaneous leishmaniasis (ZCL) caused by Leishmania tropica and Leishmania major, respectively, are endemic vector-borne diseases in southern Saudi Arabia. In 2021, an outbreak of cutaneous leishmaniasis occurred in the province of Asir. The main objective of our investigation was to analyze the epidemiological features of CL in southern Saudi Arabia. The ministry of health recorded 194 CL patients between January and December 2021 from the Asir province. Our findings showed that the majority of CL patients (87.1%) originated from the governorates of Khamis-Mushait and Abha. Most of the patients were males (62.3%). While CL affected all age groups, those under 13 years old were the most affected (38.1%). For both genders, CL patients were mostly Saudi citizens (90.7%) compared to non-Saudi expatriates. The majority of CL patients (75.2%) suffered from a single lesion, and the majority of lesions (61.3%) were located on the face. The seasonal prevalence of CL showed two peaks, a small one in July–August and a larger one in March. Of a total of 194 Giemsa slides samples, 188 showed positive amplification of Leishmania ITS1 gene. Based on PCR-RFLP and PCR-HMR, 183 patients showed positive amplification of L. tropica and five patients showed positive amplification of L. major. Phylogenetic analysis revealed a clear distinct separation between L. major and L. tropica sequences. Our results provided strong evidence of the pre-domination of L. tropica, the main etiological agent of ACL in Asir province. We reported for the first time the presence of L. major, an etiological agent of ZCL in the study areas. The co-circulation of ACL and ZCL highlighted the complexity of the epidemiology of CL in southern Saudi Arabia, and subsequently, further studies to identify competent vectors and reservoir hosts for the establishment of control strategies are needed.

Genomic Distribution of Pro-Virulent cpdB-like Genes in Eubacteria and Comparison of the Enzyme Specificity of CpdB-like Proteins from Salmonella enterica, Escherichia coli and Streptococcus suis

“…Three of them, with score 1185, corresponded to the genome of Digitaria exilis , a nutritious cereal known as white fonio that constitutes a vital crop of West Africa [ 75 ]. The fourth one, with score 457, corresponded to the genome of Leishmania major , a protozoan parasite with the ability to invade macrophages and that causes cutaneous leishmaniasis [ 76 , 77 ].…”

Handheld Ultra-Fast Duplex Polymerase Chain Reaction Assays and Lateral Flow Detection and Identification of Leishmania Parasites for Cutaneous Leishmaniases Diagnosis

“…In this study, we aimed at developing a simple, rapid, sensitive and specific DNAbased test to detect and identify the most frequent Leishmania parasites causing cutaneous leishmaniasis (CL) in the OW: L. major, L. tropica and L. infantum. Previous studies used conventional PCR complemented by additional steps like RFLP [12] or sequencing [13] or other single-step PCR-based methods, like PCR-HRM [16] and real-time PCR [15], to identify Leishmania species. However, these used technologies that are not adapted for POC testing.…”

“…donovani for CL [15]. Another study based on PCR High-Resolution Melting analysis (HRM) was also established to distinguish between L. major and L. tropica in cutaneous lesions [16]. However, all these techniques are lengthy, require sophisticated equipment and need to be performed in well-equipped laboratories.…”