Identification of Cutaneous Leishmaniasis Species in the Dargaz City, Iran

Abstract

Background: Cutaneous leishmaniasis is a parasitic skin disease that is endemic in many parts of the world, particularly in Iran. Although the microscopic technique is a common method of diagnosis of leishmaniasis, species of leishmania cannot be differentiated by this method. So, molecular methods have special importance. Methods: In this study, kinetoplast-DNA polymerase chain reaction (kDNA-PCR) method was used to diagnose the leishmania species in Dargaz city, Iran. Direct slide smears were obtained from skin lesions of 94 patients suspected to the leishmaniasis referred to health centers of this city. Smears were stained using Gimsa method. PCR method was performed using specific kDNA primers. Data were analyzed using SPSS software. Findings: Among 94 subjects with skin ulcers suspected to cutaneous leishmaniasis, 82 (87.2%) were positive by direct microscopic smear and 85 (90.4%) by PCR in which 22 patients (26%) had Leishmania tropica and 63 (74%) had Leishmania major. Sensitivity and specificity of direct microscopic examination were calculated as 96% and 100%, respectively. There were statistically significant differences between disease occurrence and seasons (P = 0.045), habitat (P = 0.004), new or old building (new or old) (P = 0.003), and distance to rodents' living sites (P = 0.025). Conclusion: Dargaz city is a known site of zoonotic leishmaniasis in Iran; but this study shows that there are some new sites of anthroponotic leishmaniasis in this city, too. Leishmania major is the dominant species in Dargaz city but there is Leishmania tropica foci in this area, too.

Keywords

• Cutaneous leishmaniasis
• Leishmania. tropica
• Leishmania.major
• Polymerase chain reaction
• Iran