Molecular Characterization of <i>Leishmania</i> Species among Patients with Cutaneous Leishmaniasis in Asir Province, Saudi Arabia
Yasser Alraey,
Rasha Alhweti,
Hatim Almutairi,
Abdulrahman Abdullah Al-Qahtani,
Mohammed Ibrahim Alshahrani,
Mohammed Hussin Asiri,
Abdulrhman Mousa Alhammas,
Saeed Jubran Alwagdi,
Abdulaziz Alshahrani,
Abdulaziz Alouffi,
Aymen M. Madkhali,
Waleed S. Al-Salem,
Ahmed A. Al-Qahtani,
Ahmed Saif,
Sami Ben Hadj Ahmed,
Elyes Zhioua
Affiliations
Yasser Alraey
Department of Clinical Laboratory Sciences, Central Research Laboratory, College of Applied Medical Sciences, King Khalid University, Abha 61321, Saudi Arabia
Rasha Alhweti
Jazan Veterinary Diagnostic Laboratory, Jazan 45142, Saudi Arabia
Hatim Almutairi
Public Health Authority, Riyadh 12212, Saudi Arabia
Abdulrahman Abdullah Al-Qahtani
Vector-Borne and Zoonotic Diseases Administration, Saudi Ministry of Health, Abha 61321, Saudi Arabia
Mohammed Ibrahim Alshahrani
Vector-Borne and Zoonotic Diseases Administration, Saudi Ministry of Health, Abha 61321, Saudi Arabia
Mohammed Hussin Asiri
Vector-Borne and Zoonotic Diseases Administration, Saudi Ministry of Health, Abha 61321, Saudi Arabia
Abdulrhman Mousa Alhammas
Vector-Borne and Zoonotic Diseases Administration, Saudi Ministry of Health, Abha 61321, Saudi Arabia
Saeed Jubran Alwagdi
Vector-Borne and Zoonotic Diseases Administration, Saudi Ministry of Health, Abha 61321, Saudi Arabia
Abdulaziz Alshahrani
Vector-Borne and Zoonotic Diseases Administration, Saudi Ministry of Health, Abha 61321, Saudi Arabia
Abdulaziz Alouffi
King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia
Aymen M. Madkhali
Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia
Waleed S. Al-Salem
Public Health Authority, Riyadh 12212, Saudi Arabia
Ahmed A. Al-Qahtani
Department of Infection and Immunity, Research Center, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
Ahmed Saif
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran 66624, Saudi Arabia
Sami Ben Hadj Ahmed
Department of Clinical Laboratory Sciences, Central Research Laboratory, College of Applied Medical Sciences, King Khalid University, Abha 61321, Saudi Arabia
Elyes Zhioua
Unit of Vector Ecology, Pasteur Institute of Tunis, Tunis 1002, Tunisia
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.
