Modification on Direct Agglutination Antigen Preparation for Simplified Sero-Diagnosis of Human and Canine Visceral Leishmaniasis

Background: Visceral leishmaniasis is systematic serous parasitic disease with pub­lic health importance. Zoonotic form of visceral leishmaniasis is wide spread in Mediterranean basin and South America regions. Direct agglutination test (DAT) is an accurate, reliable and non-expensive serological test for the diagnosis of visceral leishmaniasis in human and canines but the antigen preparation involves some limita­tions. This study aimed to compare the conventional production of DAT anti­gen with our modified DAT antigen and then assessed on human and dog pooled sera. Methods: Conventional DAT antigen has been prepared at the School of Public Health, Tehran University of Medical Sciences and some modifications were car­ried out on it, which named as modified DAT antigen. Three positive and one nega­tive human and dog pooled serum were separately used for the comparison of modified DAT with conventional DAT antigen batches with one-month interval for a period of 9 months. Results: A good concordance was observed between modified DAT compared to conventional DAT antigens for the detection of visceral leishmaniasis on human (100%) and dog (94.4%) pooled sera, respectively. Conclusion: Since the modified DAT antigen could be reduced the preparation time from 3 days to several hours and a good degree of agreement was found between modified DAT and convention DAT antigen batches, it can be used as a simple and easy tool for screening and serodiagnosis of human and canine L. infan­tum infection

Therapeutic effect of acupuncture in BALB/c model of cutaneous leishmaniasis

Background: Current research findings demonstrate that acupuncture, a traditional Chinese medicine, has beneficial effects on several acute and chronic infectious and inflammatory diseases. Acupuncture promotes tissue healing and regulates immune response in various disease conditions. Cutaneous leishmaniasis (CL) is a parasitic disease caused by protozoan from genus Leishmania. Acupuncture is supposed to accelerate healing of CL because of common mechanisms involved in the cure of the CL lesions. Materials and Methods: 60  BALB/c mice were experimentally infected with L. major strain MRHO/IR/75/ER and divided into three groups: (1) Treatment group received acupuncture 2 times a week for 5 weeks (10 sessions) with intraperitoneal diazepam as a sedative agent. (2) Diazepam control group only received diazepam the same as the treatment group. (3) Control group did not receive any intervention. Size of the lesions was measured before the experiment, on session 5 and 10 and 4 weeks after the experiment. Parasite burden was evaluated by microscopic assay as well as quantitative real-time polymerase chain reaction technique. Results: Size of the lesions decreased significantly on session 5 in treated group in comparison with session 0 (P = 0.02) while the size of the lesions increased significantly in two control groups on session 5 and 4 weeks after treatment (P = 0.04 and P = 0.01 respectively). Mean parasite burden did not show a significant difference between or within groups on session 0 and 10 by any methods. Conclusions: This investigation showed that acupuncture decreased size of the CL lesions by session 5 in the BALB/c mice model, but did not cause a significant reduction in parasite burden

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 exam­ined. 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 meglu­mine 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 prevent­ing an increase in the rate of treatment failure