Cutaneous leishmaniasis in Yemen: clinicoepidemiologic features and a preliminary report on species identification

Abstract

Objective To study the clinicoepidemiologic profile of cutaneous leishmaniasis (CL) in Yemen (Hajjah and adjacent regions) and to identify the Leishmania species responsible.Methods All 136 cases [96 (70.6%) males and 40 (29.4%) females] were subjected to detailed analysis. The diagnosis was based on positive slit skin smear and histopathologic studies when needed. In four cases, in vitro culture and Leishmania characterization by isoenzyme electrophoresis of 15 isoenzymes were attempted.Results Most of the patients (107; 78.7%) were residents of the Hajjah Governorate. The majority of the patients had a single noduloulcerative lesion on the face. Slit skin smear was positive for parasites in 128 (94%) cases (highly positive in 63 cases) and four Leishmania isolates were obtained. The isoenzyme characterization results revealed L. tropica to be the species responsible, and zymodeme analysis showed that one strain belonged to zymodeme MON137, and three strains belonged to two previously undescribed zymodemes similar to zymodeme MON71.

Molecular Characterization of Leishmania Species Isolated from Cutaneous Leishmaniasis in Yemen

“…Almost two decades later, Khatri and his colleagues detected Leishmania amastigotes in 128 cases of CL from northern Yemen. Of these, four CL cases were characterized using the isoenzyme electrophoresis technique and L. tropica was identified in all these cases [14]. In their study, 49% of skin smears were highly positive compared to 27% of CL cases in our study.…”

“…The most common form of leishmaniasis in Yemen is CL which is mutilating, disfiguring and sometimes disabling in the case of multiple lesions. The clinical pattern of the disease showed variation in the severity and duration and low response to treatment in some cases [8], [13], [14] raising the possibility of the existence of different Leishmania species causing CL. In addition, the current routine method using microscopic examination of Giemsa stained smears for the diagnosis of leishmaniasis does not enable species identification.…”

Cutaneous leishmaniasis in North-Western Yemen: A clinicoepidemiologic study and Leishmania species identification by polymerase chain reaction–restriction fragment length polymorphism analysis

“…Similar observations have been recorded in the past. 5,[14][15][16] In 3 of these patients, L infantum, L tropica, and L donovani were identified in individual cases. In the patient with diffuse induration of the face, the causative species was L tropica.…”

“…CL is widespread in Yemen. Although there have been a few previous reports, [1][2][3][4][5] the extent of CL has not been fully documented. An analysis of the clinicoepidemiologic profile of CL and the results of the Leishmania molecular typing are presented.…”

Cutaneous leishmaniasis: cryosurgery using carbon dioxide slush in a resource‐poor country

“…Playing outdoors increases the risk for children, as the Leishmania parasite is transmitted by the bite of a sandfly. Old World cutaneous leishmaniasis (CL) has different forms: localized, chronic relapsing, and diffuse 1,2,4 . Localized CL begins as an asymptomatic papule or papules at the site of the sandfly bite 2 .…”