Isolation and Molecular Identification of Leishmania spp. in Patients With Cutaneous Leishmaniasis in Golestan Province, Iran

Abstract

Background and aims: Cutaneous leishmaniasis is a major health issue in many parts of Iran.<br />Diagnosis of cutaneous leishmaniasis in a non-endemic area is not as simple as that in endemic foci.<br />The management and treatment of this disease are global dilemmas. The purpose of this study was to<br />identify Leishmania species isolated from human cutaneous leishmaniasis lesions in patients referred<br />to health centers of Golestan province, Iran.<br />Methods: Cutaneous leishmaniasis patients with suspected lesions were clinically examined. History<br />of journey to the endemic areas of zoonotic cutaneous leishmaniasis and/or anthroponotic cutaneous<br />leishmaniasis and the characteristics of their lesion(s) were recorded. Diagnosis of the lesion was done<br />by using direct smear microscopy and conventional polymerase chain reaction.<br />Results: Out of 360 patients, 202 (57.4 %) were male and 158 (42.8 %) were female. A total of 360<br />samples were selected from different cities. The number of infected samples in the cities is as follows:<br />Azad Shahr [3 (1.5%)], Aq Qala [11 (5.7%)], Ali Abad [4 (2.1%)], Bandar Turkmen [3 (1.5%)], Bandar<br />Gaz [2 (1%)], Ramian [3 (1.5%)], Kalaleh [23 (12.1%)], Kord koy [1 (0.5%)], Galikesh [7 (3.7 %)],<br />Gomishan [12 (3.6 %)], Gorgan [13 (6.8 %)], Gonbad Qabus [99 (52.1 %)], Marave Tappe [7 (3.6%)]<br />and Minoodasht [2 (1%)]. In the molecular investigations, 186 (96.8%) samples were observed to<br />acquire rural cutaneous leishmaniasis, 4 (2.1%) to acquire urban cutaneous leishmaniasis and 170<br />(47.2%) to be uninfected.<br />Conclusion: Although history of visiting endemic areas is an important factor to be considered in<br />diagnosis, parasitological confirmation is necessary for the initiation of treatment.