1
|
Quantitative Detection of Leishmania in Rhipicephalus microplus and Amblyomma sabanerae in the Peruvian Amazon Basin. Trop Med Infect Dis 2022; 7:tropicalmed7110358. [PMID: 36355900 PMCID: PMC9698973 DOI: 10.3390/tropicalmed7110358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/28/2022] [Accepted: 11/01/2022] [Indexed: 11/10/2022] Open
Abstract
Leishmaniasis is a disease of public importance with a complex transmission cycle. A quantitative PCR was developed by using the small subunit of the ribosomal RNA gene (SSU rRNA) as a DNA target, which is conserved in all Leishmania species. A TaqMan ® probe was designed to have a high specificity. In all, 22 out of 23 (95.7%) ticks classified as R. microplus tested positive for Leishmania sp. The quantification was between 34.1 and 2197.1 parasites per tick in a range of 12 to 769 fg/uL. In addition, 9 out of 10 (90%) ticks classified as Amblyomma sabanerae tested positive for Leishmania sp. The quantification was between 448.6 and 5428.6 parasites per tick in a range of 157 to 1900 fg/µL. Leishmania sp. was identified in very high percentages in Rhipicephalus microplus and Amblyomma sabanerae from wild Pecari tajacu and Chelonoidis denticulata, in quantities of 34.1 and 5428.6 parasites per arthropod, and this could suggest that the ticks were parasitized by sucking blood from the animals from which they were collected. This is the first report about Leishmania parasites found in wild Rhipicephalus microplus and Amblyomma sabanerae, adding new information about the distribution and epidemiology of the parasite in sylvatic areas.
Collapse
|
2
|
Rodrigues WF, Mendes NS, de Carvalho Ribeiro P, Mendes Filho D, Parreira RC, Chaves KCB, de Abreu MCM, Miguel CB. A critical review of the applicability of serological screening for Leishmaniasis in blood banks in Brazil. J Parasit Dis 2021; 45:109-117. [PMID: 33746394 PMCID: PMC7921252 DOI: 10.1007/s12639-020-01283-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022] Open
Abstract
Leishmaniasis is a group of diseases caused by several species of protozoa. It is a major public health concern in its visceral form, accounting annually for 59,000 deaths, and an estimated 12 million infected patients per year. The importance of VL resides not only in its high incidence and wide distribution but also in the possibility of the disease progressing to the severe and lethal forms, especially in children and immunosuppressed individuals, when associated with malnutrition and concomitant infections. This study is a bibliographical review, aiming to understand the sensitivity and specificity parameters of the tests used to detect Leishmaniasis, as well as to understand if there is any relevance in proposing a serological screening for Leishmaniasis in blood banks. In general, we observed that there are currently several types of tests for detecting Leishmaniasis: parasitological, serological and molecular. In such tests, many serological methods and kits are available for the detection of asymptomatic visceral leishmaniasis, but there is variability in sensitivity and specificity among the methods. The gold standard for the diagnosis of visceral leishmaniasis is the parasitological method, through the aspiration of bone marrow, with higher sensitivity by splenic puncture. Due to the relevance of the disease and the available data from research centers, there is evidence to propose a transfusion serological screening for visceral Leishmaniasis, pointing to the need for further studies.
Collapse
Affiliation(s)
| | - Niege Silva Mendes
- Department of Genetics, Medical School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP Brazil
| | - Patrícia de Carvalho Ribeiro
- Laboratory of Immunology and Experimental Transplantation, Medical School of São José do Rio Preto (FAMERP), São José do Rio Preto, SP Brazil
- Nanocell Institute, Divinópolis, Brazil
| | - Daniel Mendes Filho
- Nanocell Institute, Divinópolis, Brazil
- Department of Physiology, Medical School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP Brazil
| | - Ricardo Cambraia Parreira
- Nanocell Institute, Divinópolis, Brazil
- Biochemistry and Immunology by the Institute of Biological Sciences of the Federal University of Minas Gerais (UFMG), Belo Horizonte, MG Brazil
- University Centre of Mineiros (UNIFIMES), Trindade, GO Brazil
| | | | | | - Camila Botelho Miguel
- University Centre of Mineiros (UNIFIMES), Rua 22, Setor Aeroporto, Mineiros, GO 75.830-000 Brazil
- Tropical Medicine and Infectious Diseases, Federal University of Triângulo Mineiro (UFTM), Uberaba, MG Brazil
| |
Collapse
|
3
|
Pena HP, Belo VS, Xavier-Junior JCC, Teixeira-Neto RG, Melo SN, Pereira DA, Fontes IDC, Santos IM, Lopes VV, Tafuri WL, Romero GAS, da Silva ES. Accuracy of diagnostic tests for American tegumentary leishmaniasis: a systematic literature review with meta-analyses. Trop Med Int Health 2020; 25:1168-1181. [PMID: 32677284 DOI: 10.1111/tmi.13465] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES To analyse the accuracy of American tegumentary leishmaniasis (ATL) diagnostic methods and evaluate the quality of the existing publications by means of a systematic review. METHODS Diagnostic tests evaluated in at least two studies with common reference standards were included in the sensitivity and/or specificity meta-analyses. Quality and susceptibility to bias were analysed using the QUADAS-2 and STARD tools. RESULTS The title and abstract of 3387 publications were evaluated after deduplication resulting from database searches. Thirty-eight studies were included in the review, and 26 of them had results inserted in meta-analyses. The diagnostic methods with the highest pooled sensitivity values were ELISA, polymerase chain reaction (PCR), indirect immunofluorescence reaction and Montenegro's intradermal reaction. Cytometry was assessed in only two studies and presented 100% sensitivity in both. Smear slide microscopy and histopathology showed low pooled values of sensitivity. For specificity, the highest pooled values were identified for PCR. High values were also identified for ELISA, except for studies in which the reference standard for defining negative participants included individuals with Chagas' disease or paracoccidioidomycosis, which also occurred for cytometry. IFR had lower specificities than ELISA. There was a predominance of case-control designs of phase 1 or 2 and only four studies were strongly recommended as evidence generators. Several reference standards were adopted, and different methods were assessed in a small number of studies. CONCLUSION PCR showed the highest accuracy for the diagnosis of ATL, and its use should be encouraged in clinical practice. ELISA is recommended for the screening of suspected individuals, but the possibility of cross-reactions should be considered. New validation studies for the tests evaluated in few publications and studies of phase 3 with appropriate methods are needed.
Collapse
|
4
|
Conter CC, Mota CA, Dos Santos BA, de Souza Braga L, de Souza Terron M, Navasconi TR, Fernandes ACBS, Demarchi IG, de Castro KRR, Aristides SMA, Lonardoni MVC, Teixeira JJV, Silveira TGV. PCR primers designed for new world Leishmania: A systematic review. Exp Parasitol 2019; 207:107773. [PMID: 31605671 DOI: 10.1016/j.exppara.2019.107773] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/07/2019] [Accepted: 10/07/2019] [Indexed: 01/03/2023]
Abstract
Studies of the primers that were designed to detect New World Leishmania were systematically reviewed to report the characteristics of each target, detection limit, specificity of the primers designed and diagnostic sensibility. The papers identified in the databases PubMed and Web of Science involved 50 studies. Minicircle is the most applied target in molecular research for diagnosis, due to its high sensitivity in detecting Leishmania in different clinical samples, a characteristic that can be partially attributed to the higher number of copies of the minicircle per cell. The other molecular targets shown in this review were less sensitive to diagnostic use because of the lower number of copies of the target gene per cell, but more specific for identification of the subgenus and/or species. The choice of the best target is an important step towards the result of the research. The target allows the design of primers that are specific to the genus, subgenus or a particular species and also imparts sensitivity to the method for diagnosis. The findings of this systematic review provide the advantages and disadvantages of the main molecular targets and primers designed for New World Leishmania, offering information so that the researcher can choose the PCR system best suited to their research need. This is a timely and extremely thorough review of the primers designed for New World Leishmania.
Collapse
Affiliation(s)
- Carolina Cella Conter
- Graduate Program in Health Sciences, State University of Maringá, Maringá, Paraná, Brazil
| | - Camila Alves Mota
- Graduate Program in Health Sciences, State University of Maringá, Maringá, Paraná, Brazil
| | | | - Laís de Souza Braga
- Graduate Program in Health Sciences, State University of Maringá, Maringá, Paraná, Brazil
| | | | - Taísa Rocha Navasconi
- Graduate Program in Health Sciences, State University of Maringá, Maringá, Paraná, Brazil
| | | | - Izabel Galhardo Demarchi
- Department of Clinical Analyses and Biomedicine, State University of Maringá, Maringá, Paraná, Brazil
| | | | | | | | | | | |
Collapse
|
5
|
Santos BAD, Reinhold-Castro KR, Conter CC, Neitzke-Abreu HC, Cristóvão EC, Silveira TG, Teodoro U. Multiplex Polymerase Chain Reaction for Detection of Leishmania Sp. in Sandflies of the Paraná River Islands, Southern Brazil. Vector Borne Zoonotic Dis 2018; 18:570-574. [DOI: 10.1089/vbz.2017.2225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bárbara A. dos Santos
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Brazil
| | - Kárin R. Reinhold-Castro
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Brazil
| | - Carolina C. Conter
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Brazil
| | | | - Edilson C. Cristóvão
- Secretaria Municipal de Saúde de Porto Rico, Núcleo de Entomologia, Porto Rico, Brazil
| | - Thaís G.V. Silveira
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Brazil
- Departamento de Análises Clínicas e Biomedicina, Universidade Estadual de Maringá, Maringá, Brazil
| | - Ueslei Teodoro
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Estadual de Maringá, Maringá, Brazil
| |
Collapse
|
6
|
Al-Jawabreh A, Dumaidi K, Ereqat S, Nasereddin A, Azmi K, Al-Jawabreh H, Al-Laham N, Abdeen Z. A comparison of the efficiency of three sampling methods for use in the molecular and conventional diagnosis of cutaneous leishmaniasis. Acta Trop 2018. [PMID: 29522706 DOI: 10.1016/j.actatropica.2018.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In human cutaneous leishmaniasis (CL), the success of positive diagnoses and species identifications depends, primarily, on how biopsies are taken and then processed and examined. The efficiency of three methods of taking skin biopsies from suspect cases of CL was compared using the classical methods of microscopy of stained smears, in vitro culture of tissue aspirate, and internal transcribed spacer region 1 (ITS1)-polymerase chain reaction in diagnosing positive cases and identifying the species of Leishmania causing them. From 1994-2014, biopsy samples from the skin lesions of 2232 CL-suspected patients were collected as unstained smears, as smears stained with Giemsa's stain and on filter paper, and compared in the diagnostic tests employed. Matched comparison based on testing biopsy samples from 100 patients, microscopy, in vitro culture and ITS1-PCR were also conducted to assess the most suitable combination of methods for diagnosing leishmaniases. In the 100-case-matched comparison, the three different types of sample proved to be equally good with no significant difference (P > 0.05). However, skin tissue imprints on filter paper revealed most cases of CL. The kappa statistic for measuring the degree of agreement among the three samples was 89%, which is considered good. Agreement was highest between imprints on filter paper and unstained smears, and lowest was for stained smears. In the overall comparison between the ITS1-PCR and conventional methods, the ITS1-PCR using samples from filter papers was the most sensitive method but the difference was insignificant (P = 0.32). The combination of microscopy together with ITS1-PCR on samples from filter papers increased the sensitivity significantly to 46%, compared to using the methods individually (P = 0.003-0.0008). On comparing the results of the tests done on the samples from the 2232 patients after applying ITS1-PCRs to their samples from filter papers, unstained smears, in vitro culture, microscopy, and stained smears showed, respectively, test sensitivities of 81, 69, 64, 57 and 48%. Of the tests and samples adjudicated, ITS1-PCRs run on skin tissue samples from filter papers proved best for the routine laboratory diagnosis of CL. Adding microscopy of stained smears to it, improved its diagnostic value significantly.
Collapse
Affiliation(s)
- Amer Al-Jawabreh
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Arab American University, Jenin, Palestine; Leishmaniases Research Unit, Jericho, Palestine; Al-Quds Public Health Society, Jerusalem, Palestine,.
| | - Kamal Dumaidi
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, Arab American University, Jenin, Palestine
| | - Suheir Ereqat
- Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Abu Deis, East Jerusalem, Palestine,; Al-Quds Nutrition and Health Research Institute, Al-Quds University, East Jerusalem, Palestine
| | - Abdelmajeed Nasereddin
- Al-Quds Public Health Society, Jerusalem, Palestine,; Al-Quds Nutrition and Health Research Institute, Al-Quds University, East Jerusalem, Palestine
| | - Kifaya Azmi
- Al-Quds Public Health Society, Jerusalem, Palestine,; Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Abu Deis, East Jerusalem, Palestine,; Al-Quds Nutrition and Health Research Institute, Al-Quds University, East Jerusalem, Palestine
| | | | - Nahed Al-Laham
- Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Al-Azhar University, Gaza, Gaza Strip, Palestine
| | - Ziad Abdeen
- Al-Quds Public Health Society, Jerusalem, Palestine,; Al-Quds Nutrition and Health Research Institute, Al-Quds University, East Jerusalem, Palestine
| |
Collapse
|
7
|
New primers for the detection Leishmania species by multiplex polymerase chain reaction. Parasitol Res 2017; 117:501-511. [PMID: 29280072 DOI: 10.1007/s00436-017-5726-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 12/14/2017] [Indexed: 10/18/2022]
Abstract
Leishmaniasis is caused by protozoa of the Leishmania genus, which is divided into subgenus Viannia and Leishmania. In humans, the course of infection largely depends on the host-parasite relationship and primarily of the infective species. The objective of the present study was to design specific primers to the identification of Leishmania species using multiplex PCR. Four primers were designed, based on the GenBank sequences of the kDNA minicircle, amplifying 127 bp for subgenus Viannia, 100 bp for L. amazonensis, and 60 bp for Leishmania donovani complex and L. major. None of the primers amplified Trypanosoma cruzi or L. mexicana. The limit of detection of multiplex PCR was 2 × 10-5 parasites for L. braziliensis, 2 x 10-3 parasites for L. amazonensis, and 1.4 × 10-3 parasites for L. infantum. The high sensitivity of multiplex PCR was confirmed by the detection of parasites in different biological samples, including lesion scrapings, spleen imprinting of a hamster, sandflies, and blood. The multiplex PCR that was developed herein presented good performance with regard to detecting and identifying the parasite in different biological samples and may thus be useful for diagnosis, decision making with regard to the proper therapeutic approach, and determining the geographic distribution of Leishmania species.
Collapse
|
8
|
Gagini T, de Oliveira Schubach A, de Fatima Madeira M, Maria Valete-Rosalino C, Fernandes Pimentel MI, da Silva Pacheco R. Genotypic profiles of Leishmania (Viannia) braziliensis strains from cutaneous leishmaniasis patients and their relationship with the response to meglumine antimoniate treatment: a pilot study. ACTA ACUST UNITED AC 2017; 24:34. [PMID: 28959938 PMCID: PMC5621350 DOI: 10.1051/parasite/2017035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 09/04/2017] [Indexed: 11/20/2022]
Abstract
Background: Forty-four strains isolated from a cohort of cutaneous leishmaniasis (CL) patients who did or did not respond to one course of treatment with meglumine antimoniate were investigated to explore genetic polymorphisms in parasite kinetoplast DNA minicircles. Leishmania (Viannia) braziliensis strains isolated from responder (R) and non-responder (NR) patients who acquired infection in Rio de Janeiro or in other Brazilian states were studied using low-stringency single-specific primer polymerase chain reaction (LSSP-PCR) to identify genetic polymorphisms. Results: Polymorphisms were observed in parasites recovered from patient lesions. No association was found between a specific genotype and R or NR patients. Phenetic analysis grouped the genotypes into three main clusters, with similarity indices varying from 0.72 to 1.00. Although no specific genotype association was detected, at least one group of L. (V.) braziliensis genotypes that circulates in Rio de Janeiro was discriminated in clusters I and III, showing phenotypes of good and poor responses to treatment, respectively. Cluster I comprised parasite profiles recovered from R patients from Rio de Janeiro and in cluster III, NR samples were prevalent. Cluster II comprised 24 isolates, with 21 from Rio de Janeiro and three from other states, equally distributed between R and NR patients. Additionally, we found that parasites sharing all common genetic characteristics acted differently in response to treatment. Conclusions: These results are of clinical-epidemiological importance since they demonstrate that populations of L. (V.) braziliensis that exhibit high levels of genetic similarity also display different phenotypes associated with meglumine antimoniate responses in cutaneous leishmaniasis patients.
Collapse
Affiliation(s)
- Thalita Gagini
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas INI/FIOCRUZ, Manguinhos, Rio de Janeiro, Brazil
| | - Armando de Oliveira Schubach
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas INI/FIOCRUZ, Manguinhos, Rio de Janeiro, Brazil
| | - Maria de Fatima Madeira
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas INI/FIOCRUZ, Manguinhos, Rio de Janeiro, Brazil
| | - Cláudia Maria Valete-Rosalino
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas INI/FIOCRUZ, Manguinhos, Rio de Janeiro, Brazil - Departamento de Otorrinolaringologia e Oftalmologia, Faculdade de Medicina, UFRJ, Hospital Universitário Clementino Fraga Filho, Cidade Universitária - Ilha do Fundão, Rio de Janeiro, Brazil
| | - Maria Inês Fernandes Pimentel
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas INI/FIOCRUZ, Manguinhos, Rio de Janeiro, Brazil
| | - Raquel da Silva Pacheco
- Laboratório de Pesquisa Clínica e Vigilância em Leishmanioses, Instituto Nacional de Infectologia Evandro Chagas INI/FIOCRUZ, Manguinhos, Rio de Janeiro, Brazil
| |
Collapse
|
9
|
Membrive NA, Hisatugo F, Silveira TGV, Teixeira JJV, Reinhold-Castro KR, Teodoro U. Considerations of potential vectors and animal reservoirs in an emerging cutaneous leishmaniasis area in São Domingos ranch, Paraná State in Southearn Brazil. Rev Inst Med Trop Sao Paulo 2017; 59:e64. [PMID: 28876416 PMCID: PMC5587033 DOI: 10.1590/s1678-9946201759064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/05/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to better understand the dynamics of
Leishmania sand flies and reservoirs in São
Domingos ranch, Arapongas municipality, Paraná State, an
anthropic environment in an endemic area of cutaneous leishmaniasis (CL). Sand flies
were collected in wild animal burrows, residences and in the forest, with
Falcão light trap (FA), Shannon trap (SH) and quadrangular
pyramidal trap (QP). The search for Leishmania was made on sand
flies, biological samples of wild rodents and dogs using PCR and culture; while
parasite direct search (DS) was carried out on animal skin lesions; infection of gold
hamsters; and indirect immunofluorescence (IIF) test in dog blood samples. Eighty
eight (88) sand flies were collected with FA traps and 526 sand flies using the SH
trap, with a predominance of Pintomyia fischeri. Six hundred and one
(601) specimens of Brumptomyia brumpti were collected in armadillo
burrows, with the QP trap. Seventeen (17) wild rodents were captured, six of them had
skin lesions with characteristics of Leishmania infection. Even though no positive
test was found for Leishmania, epidemiological surveillance should
be maintained, remembering that the human buildings are situated only 50 m from the
forest. Considering the species of wild animals and sandflies found in São
Domingos, the negative test found do not exclude the existence of the
Leishmania transmission cycle in this preservation area.
Collapse
Affiliation(s)
- Norberto Assis Membrive
- Universidade Estadual de Maringá, Programa de Pós-Graduação em Ciências da Saúde, Maringá, Paraná, Brazil.,Secretaria Municipal de Saúde, Laboratório de Entomologia Médica, Arapongas, Paraná, Brazil
| | - Flora Hisatugo
- Secretaria Municipal de Saúde, Laboratório de Entomologia Médica, Arapongas, Paraná, Brazil
| | | | | | - Kárin Rosi Reinhold-Castro
- Universidade Estadual de Maringá, Programa de Pós-Graduação em Ciências da Saúde, Maringá, Paraná, Brazil
| | - Ueslei Teodoro
- Universidade Estadual de Maringá, Departamento de Análises Clínicas e Biomedicina, Maringá, Paraná, Brazil
| |
Collapse
|
10
|
Abstract
Leishmanides have been rarely reported in the literature. In this study, the authors present a case of a 50-year-old HIV-positive man who developed a generalized cutaneous eruption of papules and plaques in which no microorganism was demonstrated by culture, microscopical examination, immunohistochemistry, or polymerase chain reaction. The patient was eventually diagnosed with laryngeal leishmaniasis, and when treated, the cutaneous lesions greatly improved.
Collapse
|
11
|
Schwarz NG, Loderstaedt U, Hahn A, Hinz R, Zautner AE, Eibach D, Fischer M, Hagen RM, Frickmann H. Microbiological laboratory diagnostics of neglected zoonotic diseases (NZDs). Acta Trop 2017; 165:40-65. [PMID: 26391646 DOI: 10.1016/j.actatropica.2015.09.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 08/03/2015] [Accepted: 09/04/2015] [Indexed: 02/06/2023]
Abstract
This review reports on laboratory diagnostic approaches for selected, highly pathogenic neglected zoonotic diseases, i.e. anthrax, bovine tuberculosis, brucellosis, echinococcosis, leishmaniasis, rabies, Taenia solium-associated diseases (neuro-/cysticercosis & taeniasis) and trypanosomiasis. Diagnostic options, including microscopy, culture, matrix-assisted laser-desorption-ionisation time-of-flight mass spectrometry, molecular approaches and serology are introduced. These procedures are critically discussed regarding their diagnostic reliability and state of evaluation. For rare diseases reliable evaluation data are scarce due to the rarity of samples. If bio-safety level 3 is required for cultural growth, but such high standards of laboratory infrastructure are not available, serological and molecular approaches from inactivated sample material might be alternatives. Multiple subsequent testing using various test platforms in a stepwise approach may improve sensitivity and specificity. Cheap and easy to use tests, usually called "rapid diagnostic tests" (RDTs) may impact disease control measures, but should not preclude developing countries from state of the art diagnostics.
Collapse
|
12
|
Medina LS, Souza BA, Queiroz A, Guimarães LH, Lima Machado PR, M Carvalho E, Wilson ME, Schriefer A. The gp63 Gene Cluster Is Highly Polymorphic in Natural Leishmania (Viannia) braziliensis Populations, but Functional Sites Are Conserved. PLoS One 2016; 11:e0163284. [PMID: 27648939 PMCID: PMC5029894 DOI: 10.1371/journal.pone.0163284] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/05/2016] [Indexed: 01/27/2023] Open
Abstract
GP63 or leishmanolysin is the major surface protease of Leishmania spp. involved in parasite virulence and host cell interaction. As such, GP63 is a potential target of eventual vaccines against these protozoa. In the current study we evaluate the polymorphism of gp63 in Leishmania (Viannia) braziliensis isolated from two sets of American tegumentary leishmaniasis (ATL) cases from Corte de Pedra, Brazil, including 35 cases diagnosed between 1994 and 2001 and 6 cases diagnosed between 2008 and 2011. Parasites were obtained from lesions by needle aspiration and cultivation. Genomic DNA was extracted, and 405 bp fragments, including sequences encoding the putative macrophage interacting sites, were amplified from gp63 genes of all isolates. DNA amplicons were cloned into plasmid vectors and ten clones per L. (V.) braziliensis isolate were sequenced. Alignment of cloned sequences showed extensive polymorphism among gp63 genes within, and between parasite isolates. Overall, 45 different polymorphic alleles were detected in all samples, which could be segregated into two clusters. Cluster one included 25, and cluster two included 20 such genotypes. The predicted peptides showed overall conservation below 50%. In marked contrast, the conservation at segments with putative functional domains approached 90% (Fisher’s exact test p<0.0001). These findings show that gp63 is very polymorphic even among parasites from a same endemic focus, but the functional domains interacting with the mammalian host environment are conserved.
Collapse
Affiliation(s)
- Lilian S. Medina
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Bruno Araújo Souza
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Adriano Queiroz
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Luiz Henrique Guimarães
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Instituto Nacional de Ciência e Tecnologia – Doenças Tropicais (INCT-DT), Brazil
| | - Paulo Roberto Lima Machado
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Instituto Nacional de Ciência e Tecnologia – Doenças Tropicais (INCT-DT), Brazil
| | - Edgar M Carvalho
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Instituto Nacional de Ciência e Tecnologia – Doenças Tropicais (INCT-DT), Brazil
- Centro de Pesquisa Gonçalo Moniz (Fiocruz), Salvador, Bahia, Brazil
| | - Mary Edythe Wilson
- Departments of Internal Medicine and Microbiology, University of Iowa and the VA Medical Center, Iowa City, Iowa, United States of America
| | - Albert Schriefer
- Serviço de Imunologia, Hospital Universitário Professor Edgard Santos, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- Instituto Nacional de Ciência e Tecnologia – Doenças Tropicais (INCT-DT), Brazil
- Departamento de Ciências da Biointeração, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Bahia, Brazil
- * E-mail:
| |
Collapse
|
13
|
Fagundes-Silva GA, Romero GAS, Cupolillo E, Yamashita EPG, Gomes-Silva A, Guerra JADO, Da-Cruz AM. Leishmania (Viannia) naiffi: rare enough to be neglected? Mem Inst Oswaldo Cruz 2016; 110:797-800. [PMID: 26517660 PMCID: PMC4667584 DOI: 10.1590/0074-02760150128] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 07/14/2015] [Indexed: 11/25/2022] Open
Abstract
In the Brazilian Amazon, American tegumentary leishmaniasis (ATL) is endemic and
presents a wide spectrum of clinical manifestations due, in part, to the circulation
of at least seven Leishmania species. Few reports of
Leishmania (Viannia) naiffi infection suggest that its occurrence
is uncommon and the reported cases present a benign clinical course and a good
response to treatment. This study aimed to strengthen the clinical and
epidemiological importance of L. (V.) naiffi in the Amazon Region
(Manaus, state of Amazonas) and to report therapeutic failure in patients infected
with this species. Thirty Leishmania spp samples isolated from
cutaneous lesions were characterised by multilocus enzyme electrophoresis. As
expected, the most common species was Leishmania (V.) guyanensis (20
cases). However, a relevant number ofL. (V.) naiffi patients (8
cases) was observed, thus demonstrating that this species is not uncommon in the
region. No patient infected withL. (V.) naiffi evolved to
spontaneous cure until the start of treatment, which indicated that this species may
not have a self-limiting nature. In addition, two of the patients experienced a poor
response to antimonial or pentamidine therapy. Thus, either ATL cases due to
L. (V.) naiffi cannot be as uncommon as previously thought or
this species is currently expanding in this region.
Collapse
Affiliation(s)
| | | | - Elisa Cupolillo
- Laboratório de Pesquisas em Leishmaniose, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Adriano Gomes-Silva
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| | | | - Alda Maria Da-Cruz
- Laboratório Interdisciplinar de Pesquisas Médicas, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brasil
| |
Collapse
|
14
|
Vásquez Trujillo A, González Reina AE, Góngora Orjuela A, Prieto Suárez E, Palomares JE, Buitrago Alvarez LS. Seasonal variation and natural infection of Lutzomyia antunesi (Diptera: Psychodidae: Phlebotominae), an endemic species in the Orinoquia region of Colombia. Mem Inst Oswaldo Cruz 2014; 108:463-9. [PMID: 23828011 DOI: 10.1590/s0074-0276108042013011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Accepted: 04/10/2013] [Indexed: 11/22/2022] Open
Abstract
Lutzomyia antunesi has been commonly reported in outbreaks of cutaneous leishmaniasis (CL) in the Orinoquia region of Colombia. The bionomics of this species were studied in the municipality of Villavicencio (Meta, Colombia). Sandflies were captured over the course of one week per month for one year in intradomiciliary, peridomiciliary and extradomiciliary housing areas. The captures were performed from 06:00 pm-06:00 am using CDC light traps and the females were processed for polymerase chain reaction (PCR) to detect Leishmania spp. A total of 22,097 specimens and 19 species were captured of which Lu. antunesi (89%) and Lutzomyia walkeri (5%) were the most abundant. Other species recognised as anthropophilic (Lutzomyia panamensis, Lutzomyia gomezi, Lutzomyia flaviscutellata and Lutzomyia fairtigi) were present in very low abundance (< 2%). Natural infection with Leishmania spp was detected using PCR in Lu. antunesi, Lu. panamensis and Lu. flavicutellata, showing infection rates of 1%, 4.8% and 7.5%, respectively. The present paper provides information on various ecological aspects of Lu. antunesi. An analysis of seasonality shows that this species increases in abundance in the hottest months (December, January and February), directly correlating with the maximum temperature and inversely correlating with precipitation. The natural infection rate is associated with the peaks of highest abundance.
Collapse
|
15
|
Phumee A, Kraivichian K, Chusri S, Noppakun N, Vibhagool A, Sanprasert V, Tampanya V, Wilde H, Siriyasatien P. Detection of Leishmania siamensis DNA in saliva by polymerase chain reaction. Am J Trop Med Hyg 2013; 89:899-905. [PMID: 24062485 DOI: 10.4269/ajtmh.12-0612] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Polymerase chain reaction was used to detect Leishmania siamensis DNA from clinical samples collected from six leishmaniasis patients during 2011-2012. The samples used in this study came from bone marrow, blood, buffy coat, saliva, urine, and tissue biopsy specimens. Saliva was a good source for L. siamensis DNA by polymerase chain reaction. L. siamensis DNA was also found in saliva of an asymptomatic case-patient. Levels of L. siamensis DNA in saliva decreased until being undetectable after treatment. These levels could be used as a marker to evaluate efficacy of the treatment. A larger study is needed to evaluate this method as a screening and survey tool to study the silent background of Leishmania infection among the at-risk population.
Collapse
Affiliation(s)
- Atchara Phumee
- Medical Sciences Program, Department of Parasitology, Division of Dermatology, and Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand; Bumrungrad International Hospital, Bangkok, Thailand; Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand; Excellence Center for Emerging Infectious Diseases, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
| | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Benicio EDA, Nunes Gadelha EP, Talhari A, Silva Jr RMD, Ferreira LC, Santos MCCD, Mira MT, Oliveira CMCD, Talhari C, Talhari S, Machado PR, Schriefer A. Combining diagnostic procedures for the management of leishmaniasis in areas with high prevalence of Leishmania guyanensis. An Bras Dermatol 2011; 86:1141-4. [DOI: 10.1590/s0365-05962011000600012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 11/16/2010] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND: The Amazon region corresponds to approximately 40% of the cases of leishmaniasis in Brazil. We report a prospective study with 180 patients conducted in a health care unit that diagnoses 10% of the cases of leishmaniasis in the Brazilian Amazon. The study addresses how a combination of procedures improves diagnosis in areas with high prevalence of Leishmania guyanensis. OBJECTIVES: to evaluate diagnostic methods in areas with high prevalence of Leishmania guyanensis. METHODS: All subjects were amastigote-positive by direct microscopic examination of lesion scarifications. We conducted skin biopsy and histopathology, polymerase chain reaction and parasite cultivation. RESULTS: Polymerase chain reaction detected almost ninety percent of infections when two amplification protocols were used (mini-exon and HSP-70). HSP-70 specific polymerase chain reaction matched the sensitivity of parasite cultivation plus histopathology. CONCLUSION: The best combination was polymerase chain reaction plus histopathology, which increased diagnostic sensitivity to 94%. Species discrimination by polymerase chain reaction disclosed prevalence of human infections with Leishmania guyanensis of 94% and with Leishmania braziliensis of 6% for this region
Collapse
|
17
|
Haouas N, Garrab S, Gorcii M, Khorchani H, Chargui N, Ravel C, Mezhoud H, Babba H. Development of a polymerase chain reaction-restriction fragment length polymorphism assay for Leishmania major/Leishmania killicki/Leishmania infantum discrimination from clinical samples, application in a Tunisian focus. Diagn Microbiol Infect Dis 2011; 68:152-8. [PMID: 20846587 DOI: 10.1016/j.diagmicrobio.2010.06.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Revised: 06/05/2010] [Accepted: 06/08/2010] [Indexed: 11/26/2022]
Abstract
Topoisomerase II gene of Leishmania genus was used to develop a molecular tool for detection and species differentiation of Leishmania from clinical samples. Identification was achieved by a polymerase chain reaction followed by digestion with 2 restriction endonucleases BstU1 and Taq1. Despite the relatively low sensitivity, it is able to differentiate between 3 complexes responsible for cutaneous leishmaniasis.
Collapse
Affiliation(s)
- Najoua Haouas
- Laboratory of Parasitology-Mycology (99UR/08-05), Department of Clinical Biology B, Faculty of Pharmacy, Monastir, Tunisia.
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Characterization of Leishmania spp. causing cutaneous leishmaniasis in Manaus, Amazonas, Brazil. Parasitol Res 2010; 108:671-7. [PMID: 21072540 PMCID: PMC3040821 DOI: 10.1007/s00436-010-2139-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Accepted: 09/30/2010] [Indexed: 11/06/2022]
Abstract
In the State of Amazonas, American tegumentary leishmaniasis is endemic and presents a wide spectrum of clinical variability due to the large diversity of circulating species in the region. Isolates from patients in Manaus and its metropolitan region were characterized using monoclonal antibodies and isoenzymes belonging to four species of the parasite: Leishmania (Viannia) guyanensis, 73% (153/209); Leishmania (Viannia) braziliensis, 14% (30/209); Leishmania (Leishmania) amazonensis, 8% (17/209); and Leishmania (Viannia) naiffii, 4% (9/209). The most prevalent species was L. (V.) guyanensis. The principal finding of this study was the important quantity of infections involving more than one parasite species, representing 14% (29/209) of the total. The findings obtained in this work regarding the parasite are further highlighted by the fact that these isolates were obtained from clinical samples collected from single lesions.
Collapse
|
19
|
Ampuero J, Rios AP, Carranza-Tamayo CO, Romero GAS. Genus-specific kinetoplast-DNA PCR and parasite culture for the diagnosis of localised cutaneous leishmaniasis: applications for clinical trials under field conditions in Brazil. Mem Inst Oswaldo Cruz 2010; 104:992-7. [PMID: 20027466 DOI: 10.1590/s0074-02762009000700009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2009] [Accepted: 09/02/2009] [Indexed: 11/22/2022] Open
Abstract
The positivities of two methods for the diagnosis of localised cutaneous leishmaniasis (CL) were estimated in 280 patients enrolled in a clinical trial. The trial was conducted in an endemic area of Leishmania (Viannia) braziliensis and trial participants were patients with skin ulcers and positive leishmanin skin tests. Patients underwent aspirative skin punctures of the ulcerated lesions and lymph nodes for in vitro cultures, which were processed under field conditions at the local health centre. Skin lesion biopsies were tested at a reference laboratory using kinetoplastid DNA (kDNA)-PCR to detect DNA. The median time required to obtain a positive culture from the skin samples was seven days and the contamination rate of the samples was 1.8%. The positivities of the cultures from skin lesions, kDNA-PCR and the combination of the two methods were 78.2% (95% CI: 73-82.6%), 89.3% (95% CI: 85.1-92.4%) and 97.1% (95% CI: 94.5-98.5%). We conclude that parasite culture is a feasible method for the detection of Leishmania in field conditions and that the combination of culture and PCR has a potential role for the diagnosis of CL in candidates for clinical trials.
Collapse
Affiliation(s)
- Julia Ampuero
- Núcleo de Medicina Tropical, Universidade de Brasília, Brasília, DF, Brasil
| | | | | | | |
Collapse
|
20
|
Fagundes A, Schubach A, Paula CCD, Bogio A, Antonio LDF, Schiavoni PB, Monteiro VDS, Madeira MDF, Quintella LP, Valete-Rosalino CM, Vasconcellos EDCFE, Azeredo-Coutinho RBGD, Pacheco RS, Marzochi MCA, Marzochi KBF. Evaluation of polymerase chain reaction in the routine diagnosis for tegumentary leishmaniasis in a referral centre. Mem Inst Oswaldo Cruz 2010; 105:109-12. [DOI: 10.1590/s0074-02762010000100018] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 12/21/2009] [Indexed: 11/21/2022] Open
|
21
|
Santos AMD, Noronha EF, Ferreira LAM, Carranza-Tamayo CO, Cupolillo E, Romero GAS. Efeito de uma formulação hidrofílica de paromomicina tópica na leishmaniose cutânea em pacientes com contra-indicações de tratamento com antimonial pentavalente. Rev Soc Bras Med Trop 2008; 41:444-8. [DOI: 10.1590/s0037-86822008000500002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Accepted: 09/01/2008] [Indexed: 11/22/2022] Open
Abstract
Descrevem-se o efeito terapêutico e os eventos adversos associados com o uso tópico de paromomicina 10% em gel na leishmaniose cutânea. Quinze pacientes com leishmaniose cutânea cumpriram os critérios de inclusão descritos a seguir: contra-indicação para o uso de antimoniato de meglumina, intradermorreação de Montenegro positiva e até quatro lesões ulceradas. A fórmula foi prescrita duas vezes ao dia por 20 dias. Quatorze pacientes estiveram disponíveis para a avaliação do desfecho terapêutico e a proporção de cura foi de 21,4% (3/14), 50% melhoraram até a epitelização completa e a proporção de falha foi de 28,6%. Nove pacientes que não apresentaram cura inicialmente foram re-tratados. Oito receberam uma nova série de paromomicina tópica e um foi tratado com antimoniato de meglumina. Dois pacientes não receberam novo tratamento e tiveram melhora lenta e contínua. Cinco de oito pacientes retratados com paromomicina tópica alcançaram a cura clínica, e três apresentaram falha, incluindo um paciente que tinha apresentado melhora com o primeiro tratamento. Os eventos adversos foram leves e locais em 53,3% dos pacientes e nunca levaram à suspensão do tratamento.
Collapse
|
22
|
Rotureau B, Ravel C, Couppié P, Pratlong F, Nacher M, Dedet JP, Carme B. Use of PCR-restriction fragment length polymorphism analysis to identify the main new world Leishmania species and analyze their taxonomic properties and polymorphism by application of the assay to clinical samples. J Clin Microbiol 2006; 44:459-67. [PMID: 16455899 PMCID: PMC1392689 DOI: 10.1128/jcm.44.2.459-467.2006] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
At least 13 characterized Leishmania species are known to infect humans in South America. Five of these parasites are transmitted in the sylvatic ecotopes of the whole French Guianan territory and responsible for cutaneous leishmaniasis. For the diagnosis of cutaneous leishmaniasis, restriction fragment length polymorphism (RFLP) analyses have shown promising results. Thus, the end of the small subunit and internal transcribed spacer 1 of the rRNA genes were sequenced and targeted by PCR-RFLP analysis in the 10 main New World (NW) Leishmania species from the two subgenera. Then, the procedure was tested on 40 samples from patients with cutaneous leishmaniasis, and its results were compared with those of conventional methods. (i) The results of this simple genus-specific method were in agreement with those of previous isoenzyme analyses. (ii) This method distinguished the most medically relevant Leishmania species with only one enzyme (RsaI). (iii) This method could be performed directly on human biopsy specimens (sensitivity of 85.7%). Performing NW Leishmania species typing rapidly and easily in the field constitutes a very valuable improvement for detection of Leishmania spp. Revealing great diversity with several enzymes, this method could also be useful for taxonomic, ecological, and epidemiological studies in space and time.
Collapse
Affiliation(s)
- Brice Rotureau
- Laboratoire Hospitalo-universitaire de Parasitologie et Mycologie Médicale, Equipe EA 3593, UFR de Médecine de l'Université des Antilles et de la Guyane, Campus Saint-Denis, BP 718, 97336 Cayenne, Guyane Française
| | | | | | | | | | | | | |
Collapse
|
23
|
Scarisbrick JJ, Chiodini PL, Watson J, Moody A, Armstrong M, Lockwood D, Bryceson A, Vega-López F. Clinical features and diagnosis of 42 travellers with cutaneous leishmaniasis. Travel Med Infect Dis 2006; 4:14-21. [PMID: 16887720 DOI: 10.1016/j.tmaid.2004.11.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2004] [Accepted: 10/13/2004] [Indexed: 11/17/2022]
Abstract
BACKGROUND Leishmania species that occur within different geographical areas may cause different clinical manifestations, virulence and drug sensitivity. Patients/Methods. All patients with a clinical diagnosis of cutaneous leishmaniasis seen at the Hospital for Tropical Diseases from 1997 to 2000 were identified and clinical details recorded onto a database, with emphasis on clinical presentation, risk factors, travel history and laboratory diagnosis. RESULTS Forty-two patients were identified, 23 of whom had travelled to New World and 19 to Old World countries. Clinical presentation typically consisted of a single nodule with ulceration. In 50% infection was caused by L. (Viannia) braziliensis. PCR was performed in specimens from 34 patients and species identification was possible in 32 cases (sensitivity 94%), the two PCR negative patients had amastigotes demonstrated by histology and culture. Patients were treated with established therapies. Seventy one percent were cured by treatment, 12% had a spontaneous cure, 7% were lost to follow-up and the remaining 10% required a second-line therapy. No relapses were reported during a mean follow-up period of 27 months. CONCLUSIONS Our study highlights the need for comprehensive investigations and the advantages of PCR in the diagnosis of patients with suspected leishmaniasis in non-endemic regions of the world.
Collapse
Affiliation(s)
- J J Scarisbrick
- Department of Dermatology, Middlesex Hospital, Mortimer Street, London W1N 8AA, UK.
| | | | | | | | | | | | | | | |
Collapse
|
24
|
Oliveira JGS, Novais FO, de Oliveira CI, da Cruz Junior AC, Campos LF, da Rocha AV, Boaventura V, Noronha A, Costa JML, Barral A. Polymerase chain reaction (PCR) is highly sensitive for diagnosis of mucosal leishmaniasis. Acta Trop 2005; 94:55-9. [PMID: 15777720 DOI: 10.1016/j.actatropica.2004.12.003] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2004] [Revised: 10/04/2004] [Accepted: 12/16/2004] [Indexed: 11/25/2022]
Abstract
We evaluated the use of polymerase chain reaction (PCR) for diagnosis of mucosal leishmaniasis (ML) in an endemic area in Acre, Brazil, where Leishmania braziliensis is present. Leishmania DNA was detected 34 of 35 cases, yielding a positivity rate of 97.1%, which was higher than the positivity rates for all of the other diagnostic methods studied, namely Montenegro skin test (MST), anti-Leishmania serological testing and microscopic examination of lesion biopsy specimens. These findings have led us to propose guidelines for the diagnosis of ML that use PCR as the principal method of parasitological confirmation of cases.
Collapse
|
25
|
Abstract
Leishmaniasis remains a major world health problem that continues to increase in incidence. This review considers epidemiology, clinical features, diagnosis and current treatment options. Recent developments in the treatment of simple cutaneous leishmaniasis are discussed followed by speculation about future therapies.
Collapse
|
26
|
de Oliveira CI, Báfica A, Oliveira F, Favali CBF, Correa T, Freitas LAR, Nascimento E, Costa JM, Barral A. Clinical utility of polymerase chain reaction-based detection of Leishmania in the diagnosis of American cutaneous leishmaniasis. Clin Infect Dis 2003; 37:e149-53. [PMID: 14614687 DOI: 10.1086/379610] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2003] [Accepted: 08/01/2003] [Indexed: 11/03/2022] Open
Abstract
We evaluated the use of polymerase chain reaction (PCR) for diagnosis of American cutaneous leishmaniasis (ACL) in an area in Bahia, Brazil, where Leishmania braziliensis is endemic. Leishmania DNA was detected in 50 cases, yielding a positivity rate of 100%, which was higher than the rates for all of the other diagnostic methods studied--namely, the Montenegro skin test, anti-Leishmania serological testing, and microscopic examination of lesion biopsy specimens. These findings have led us to propose guidelines for the diagnosis of ACL that use PCR as the principal means of parasitological confirmation of cases.
Collapse
|