BACKGROUND Leishmaniasis caused by Leishmania martiniquensis infection has
been reported in human and domestic animals of Martinique Island, Germany,
Switzerland, USA, Myanmar and Thailand. The peculiar clinical features of
disseminated cutaneous and visceral forms co-existence render the urgent need of
specific diagnostic tool to identify the natural sand fly vectors for effective
prevention and control strategies. Loop-mediated isothermal amplification (LAMP)
of 18S rRNA gene as well as polymerase chain reaction (PCR) of
minicircle kinetoplast DNA gene (PCR-mkDNA) have never been
applied to detect L. martiniquensis and L.
siamensis in sand fly vectors.OBJECTIVE The present study was aimed to validate malachite green-LAMP (MG-LAMP) and
PCR-mkDNA techniques to detect L. martiniquensis in sand fly
vectors, compared with the conventional PCR of internal transcribed spacer
1 (PCR-ITS1).METHODS We compared the validity of LAMP of 18S rRNA gene and PCR-mkDNA,
to PCR-ITS1 in simulation model of L. martiniquensis infection in
Sergentomyia gemmea sand flies. Attributable to the
sensitivity and specificity, PCR-mkDNA was consecutively applied to detect
L. martiniquensis in 380 female sand fly individuals captured
in the newly identified affected region of Lamphun Province, Thailand.FINDINGS AND MAIN CONCLUSIONS Results showed that PCR-mkDNA could detect at least one promastigote per sand
fly, which was 10-time superior to LAMP and PCR-ITS1. In addition, PCR-mkDNA was
more specific, able to differentiate L. martiniquensis from other
viscerotropic Leishmania species, such as L.
siamensis, L. (L.) donovani, and L. (L.)
infantum. Consecutively, mass screening of L.
martiniquensis in 380 female sand fly individuals by PCR-mkDNA was
implemented in a new affected area of Thailand where a patient with
leishmaniasis/HIV co-infection resides; however Leishmania DNA
was undetected. In conclusion, PCR-mkDNA is a promising tool for molecular mass
screening of L. martiniquensis infection in outbreak areas where
several species of Leishmania and sand flies co-exist.