Dr. Mohammad Yasser Abji
Molecular diagnosis and epidemiological aspects of cutaneous Leishmaniasis in Aleppo: Current status
For many decades, cutaneous leishmaniasis has been endemic in the Syrian city of Aleppo. Today, the diagnosis of this disease in Syria relies primarily on conventional methods, such as clinical signs and microscopic examination. This study aimed to evaluate the effectiveness of polymerase chain reaction (PCR) in diagnosing suspected cases of cutaneous leishmaniasis. Two PCR protocols were applied: the first (kDNA PCR) for diagnosis and the second (ITS2 PCR) for identifying the parasite species. The results were compared with those obtained using conventional methods, and the association between disease prevalence and certain demographic factors was also investigated.
A total of 105 patients with suspected cutaneous leishmaniasis were examined at the Leishmaniasis Center in Aleppo. The kDNA PCR assay demonstrated a sensitivity of 100%, whereas microscopic examination showed a sensitivity of 76.1%. ITS2 PCR revealed that the predominant species in Aleppo was Leishmania tropica (96.0%). Disease prevalence was higher among males (54.3%), individuals aged 13–25 years (39.1%), and those living under moderate to poor socioeconomic conditions (87.0%). The median number of lesions per patient was three, with the upper extremities (55.4%) and face (35.9%) being the most commonly affected sites.
The study recommends the use of kDNA PCR for the diagnosis of cutaneous leishmaniasis because of its high sensitivity. It also provides the recorded demographic and epidemiological data to health authorities to support their efforts in the treatment and prevention of the disease in the country.