Molecular identification of Leishmania species during an outbreak of re-emerged cutaneous leishmaniasis in the south west of Iran during 2015-2016 and Implication to Health Policy

Background:The term re-emerging infectious diseases have been included on a group of diseases that have existed before but are rapidly increasing in incidence or changing their geographic range. Dezful and suburbs as the second cities of Khuzestan Province from southwestern Iran was an endemic area of cutaneous leishmaniasis (CL) with low incidence rates during last decade but the disease rapidly increased and reached from 372 new cases in 1994 to 1917 cases in 2015 thus CL was considered as a re-emerging parasitic disease in the area. Since principal agent of the re-emerging CL in the areas was unknown thus, this study was designed because accurate diagnosis and molecular characterization of Leishmania species could be useful for the control of the disease.Methods:A total of 196 microscopically confirmed slides from CL patients referred to Dezful Health Center were randomly collected during 2015-2016. After DNA extraction from microscopically positive slides, PCR-RFLP assay were performed on 61 eligible specimens using Ribosomal Internal Transcribed Spacer1 (ITS1) gene and HAEIII restriction enzyme. Afterward, their profiles were analyzed for identification of Leishmania species.Results:Samples were randomly collected from 196 acute CL cases containing 110 (56.2%) men and 86 (43.8%) women. Most infections were among 1-7 (33.06%) years old. Altogether, 60% of cases had only one lesion on their bodies as 50% of the lesions were appeared on the hands. One hundred and sixty cases (82.7%) were referred in the cold seasons (autumn and winter). The results of PCR-RFLP on 61 eligible isolates showed that 60(98.37%) of them were identified as L. major and only one (1.63%) of them was L. tropica.Conclusion: Our findings indicate L. major was principal agent of the re-emerged CL in Dezful and suburbs and the disease was determined as zoonotic form. It is necessary to increase the awareness and alertness among physicians and public health managers and also inter sectorial collaborations before any soar of gerbils population particularly Tatera indica as primary reservoir hosts around the studied areas are necessary.

کلیدواژه ها:

Cutaneous leishmaniasis ، ITS1 ، PCR-RFLP ، Iran