Molecular Identification of Cutaneous Leishmaniasis Species in the Northcentral Iranian Province of Alborz: Is There a New  Focus on Cutaneous Leishmaniasis in the Province?

Susan  Sheikhi; Aliehsan  Heidari; Mehdi  Mohebali; Hossein  Keshavarz; Amir  Heidari; Monireh  Sezavar; Behnaz  Akhoundi; Amir  Bairami

doi:10.18502/ijpa.v18i2.13191

Susan Sheikhi Department of Medical Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
Aliehsan Heidari Department of Medical Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
Mehdi Mohebali Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
Hossein Keshavarz Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
Amir Heidari Department of Cardiovascular, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Monireh Sezavar Department of Experimental Sciences, School of Allied Medicine, Alborz University of Medical Sciences, Karaj, Iran
Behnaz Akhoundi Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Iran
Amir Bairami Department of Medical Parasitology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran

DOI: https://doi.org/10.18502/ijpa.v18i2.13191

Keywords: Cutaneous Leishmaniasis; Iran; Leishmania major; Leishmania tropica

Abstract

Background: Cutaneous leishmaniasis (CL) is an endemic infection in the Middle East, including Iran that is also spreading to new foci. We aimed to determine the leishmaniasis species causing CL in Alborz province.

Methods: Overall, out of 55-suspected CL patients referred to health centers in Alborz Province, north central Iran in 2019, 40 patients had positive smear for CL based on optical microscopy. The internal transcribed spacer 1 (ITS1) of nuclear ribosomal DNA (rDNA) was amplified by PCR. Leishmania species were identified by PCR–restriction fragment length polymorphism (PCR-RFLP) using BshF I (Hae III) enzyme.

Results: Out of the 40 positive patients with CL, 34 cases (85%) had been caused by Leishmania (L) major and six (15%) by L. tropica. Fifteen patients had no history of traveling to the disease endemic areas, of which nine were Iranians. Skin lesions and scars caused by CL were mostly observed on the hands and face. Moreover, more than two skin lesions were observed in 22 cases (55%), all of which were infected with L. major. A single skin ulcer was seen in 18 (45%) of the CL patients.

Conclusion: Climate change, reduced rainfall, and demographic changes such as migration into Alborz Province and the increasing marginalization of the population and their entry to settle in new areas might have caused natural transmission of both L. tropica and L. major in this province.