Epidemiological and clinical features of cutaneous leishmaniases in Jenin District,Palestine, including characterisation of the causative agents in clinical samples

Date
2012-07-24
Authors
Azmi, Kifaya
Schönian, Gabriele
Nasereddin, Abedelmajeed
Schnur, Lionel F.
Sawalha, Samir
Ereqat, Suheir
Amro, Ahmad
Qaddomi, Sharif E.
Abdeen, Ziad
Journal Title
Journal ISSN
Volume Title
Publisher
Elsevier
Abstract
During 2002–2009, 466 cases of cutaneous leishmaniasis (CL) were reported from Jenin District, Palestine, affecting both genders. The average annual incidence was 23 cases per 100 000 inhabitants, increasing with age in children. Most cases presented a single lesion, generally on the face. Diagnosis and species identification was done by applying internal transcribed spacer 1 (ITS1) RFLP analysis to 47 isolates, of which 44 (93.6%) were Leishmania tropica and 3 (6.4%) were L. major. RFLP analysis was also performed on 256 skin tissue scrapings spotted onto filter papers, showing that 138 (53.9%) were positive, of which 50.7% were infected with L. tropica, 17.4% with L. major and 2.9% with L. donovani s.l., and 29.0% could not be identified. This is the first report from Palestine on human CL caused by L. infantum. Nine of the strains of L. tropica were subjected to multilocus enzyme electrophoresis, six of which belonged to the zymodeme MON-137 and three to a new zymodeme (MON-307). This separation was corroborated by excreted factor serotyping. This observation modifies the classical epidemiological view of CL in Palestine. Jenin District is an active focus of CL caused by L. tropica, where Phlebotomus sergenti, the putative vector, is abundant. These data suggest that CL is a zoonotic infection, but an animal reservoir has not been found.
Description
Keywords
Cutaneous leishmaniasis, Leishmania tropica, Epidemiology, Polymerase chain reaction, Zymodeme, Palestine
Citation