3 research outputs found
Molecular and parasitological study of cutaneous leishmaniasis in Bushehr province, southwest of the Islamic Republic of Iran: a cross-sectional study during 2009–2012
Cutaneous leishmaniasis (CL) is one of the
most important parasitic disease in Iran. CL is distributed
among more than half of 31 provinces of Iran. Studies on
epidemiological aspects of the disease and Leishmania
species identification among infected humans are necessary
for providing a comprehensive prevention and control
program thus; this descriptive cross-sectional study
was conducted on all CL suspected patients who referred
to Health Centers of Bushehr province from 2009 to
2012. Physical examinations were carried out in suspected
individuals and CL cases were confirmed by microscopical
examinations. Prepared slides from suspicious cases
of CL were fixed with absolute methanol and stained by
Giemsa 10 %. All the Giemsa-stained slides examined
under a light microscope with high magnification
(1,0009) and classified them based on grading of
Leishmania parasites. DNA from each slide was extracted,
separately. The ribosomal internal transcribed spacer
1 was amplified with specific primers and PCR products
were digested by restrict enzymes (HaeIII), run them in
3 % gel agarose for electrophoresis and visualized on a
UV transilluminator after staining with ethidium bromide.
SPSS version 21 was used for data analyses. A total of
726 suspected CL cases were referred to Health Centers
of Bushehr province from 2009 to 2012 and samples were
only prepared from 188 of the patients whereas 43
(5.9 %) of them were microscopy positive. The most
frequent of CL was observed in November (14 %) and
December (12 %). The most distribution of CL lesions
were observed on hands (32 %), feet (26 %), and face
(21 %), respectively. The highest frequency of CL was
observed in 1–9 years old (30 %). Altogether, 50 % of
the patients showed one skin lesion and 2–10 skin lesions
were occurred in the remained CL patients. Totally, 27
out of 43 (63 %) of the Giemsa stained slides were
positive by PCR–RFLP assay because all the PCR–RFLP
negative slides were prepared 3–4 years ago and kept
without cover slip, and also observed scarce amastigotes
during microscopy observations. Leishmania species were
identified in 21 desirable slides which 14 of them were L.
major and 7 of the remained isolates were identified L.
tropica using PCR–RFLP
Molecular and parasitological study of cutaneous leishmaniasis in Bushehr province, southwest of the Islamic Republic of Iran: a cross-sectional study during 2009–2012
Abstract Cutaneous leishmaniasis (CL) is one of the
most important parasitic disease in Iran. CL is distributed
among more than half of 31 provinces of Iran. Studies on
epidemiological aspects of the disease and Leishmania
species identification among infected humans are necessary
for providing a comprehensive prevention and control
program thus; this descriptive cross-sectional study
was conducted on all CL suspected patients who referred
to Health Centers of Bushehr province from 2009 to
2012. Physical examinations were carried out in suspected
individuals and CL cases were confirmed by microscopical
examinations. Prepared slides from suspicious cases
of CL were fixed with absolute methanol and stained by
Giemsa 10 %. All the Giemsa-stained slides examined
under a light microscope with high magnification
(1,0009) and classified them based on grading of
Leishmania parasites. DNA from each slide was extracted,
separately. The ribosomal internal transcribed spacer
1 was amplified with specific primers and PCR products
were digested by restrict enzymes (HaeIII), run them in
3 % gel agarose for electrophoresis and visualized on a
UV transilluminator after staining with ethidium bromide.
SPSS version 21 was used for data analyses. A total of
726 suspected CL cases were referred to Health Centers
of Bushehr province from 2009 to 2012 and samples were
only prepared from 188 of the patients whereas 43
(5.9 %) of them were microscopy positive. The most
frequent of CL was observed in November (14 %) and
December (12 %). The most distribution of CL lesions
were observed on hands (32 %), feet (26 %), and face
(21 %), respectively. The highest frequency of CL was
observed in 1–9 years old (30 %). Altogether, 50 % of
the patients showed one skin lesion and 2–10 skin lesions
were occurred in the remained CL patients. Totally, 27
out of 43 (63 %) of the Giemsa stained slides were
positive by PCR–RFLP assay because all the PCR–RFLP
negative slides were prepared 3–4 years ago and kept
without cover slip, and also observed scarce amastigotes
during microscopy observations. Leishmania species were
identified in 21 desirable slides which 14 of them were L.
major and 7 of the remained isolates were identified L.
tropica using PCR–RFLP
Treatment Failure in Cutaneous Leishmaniasis Patients Referred to the School of Public Health, Tehran University of Medical Sciences During 2008–2017
Background: Cutaneous leishmaniasis (CL) is a vector borne disease predominantly found in tropical and subtropical countries, including Iran. For more than 6 decades, pentavalent antimonials have been used successfully worldwide for the treatment of leishmaniasis, but over the past few years, clinical resistance to these medications has increased. In this study, we evaluated CL patients who did not show any desirable responses to the anti-leishmanial treatment within a 10-year period (2008 to 2017).
Methods: All patients from different parts of Iran suspected of having cutaneous leishmaniasis, who were referred to the laboratory of leishmaniosis in Tehran University of Medical Sciences from 2008–2017 were parasitological examÂined.
Results: During this period, a total of 1480 suspected CL patients were referred to the laboratory of leishmaniosis. Samples from 655 patients (70.8%) suspected of having CL were positive microscopically. The failure rate in patients treated with anti-leishmaniasis medications for a minimum of three complete treatment periods was 1.83% (12 cases). There was no association between the number and size of skin lesions and patient characteristics. Also, the route of drug administration had no significant effect on the number and size of lesions.
Conclusion: In the present study, treatment failure was found in some confirmed CL patients treated with megluÂmine antimoniate. Over the past few years, it seems that had been increased in resistance to these medications. So, a review of the correct implementation of the treatment protocol and/or a combination therapy may be helpful in preventÂing an increase in the rate of treatment failure