Identification of Leishmania major and Other Causative Species in Syrian Patients Infected with Cutaneous Leishmaniasis

Abstract

Background: Leishmaniasis presents in three main clinical forms: Cutaneous (CL), Visceral (VL), and Mucocutaneous (MCL). In Hatay, CL is generally caused by L. infantum and L. tropica, with L. major appearing less frequently. Following the 2011 migration wave from Syria, we aimed to identify the causative Leishmania species, particularly L. major, among Syrian patients living in households and tent cities in Hatay, Turkey.

Methods: Smear preparations from 250 Syrian patients diagnosed with CL at Hatay Mustafa Kemal University, Turkey between 2011 and 2019 were retrospectively analyzed. DNA was isolated from these preparations, and molecular typing was performed by Real-Time Polymerase Chain Reaction (RT-PCR) using primers and probes specific to the ITS1 gene region.

Results: Molecular analysis revealed that 182 (72.8%) of 250 Syrian patients were infected with L. tropica, 59 (23.6%) with L. infantum/donovani, and 9 (3.6%) with L. major. While L. tropica and L. major are known causative species in Syria, the detection of L. infantum cases suggests the possibility of local transmission by sand flies, the primary vector in the Hatay region, during the patients' stay in tent cities.

Conclusion: The findings highlight the distribution of different Leishmania species among the Syrian population in Hatay. Implementing species-specific treatment protocols and maintaining effective notification and control activities are crucial for preventing the further spread of Cutaneous Leishmaniasis in the region.