Abstract
Background and Objective
 Cutaneous leishmaniasis (CL) remains a serious public health concern in some parts of Iraq. The aims of this study to diagnose the Leishmania sp. causative agent of CL in some parts of Iraq, by different parasitological, cultural, and molecular methods. It was carried during the period October 2014 to February 2015.
 Materials and Methods
 One hundred-sixty one of skin samples were examined by direct Giemsa-smeared, culture on NNN medium and Nested – PCR methods in different age groups.
 Results
 The results of our study showed that 110 (68.3%) gave positives by Giemsa-smeared, 104 (64.6%) by culture and 67 (100%) by Nested – PCR. Our results appeared that there was slight gender predilection ; CL cases were more frequent in males (62.1%) than females (37.9%). Also, the type of infection showed that disease was in wet type 133(82.6%) more than in dry type 28 (17.4%). It was found that 98 (60.9%) of CL cases were in contact with rodents while 63(39.1%) of cases were not. 
 Conclusions
 CL disease is endemic in many parts of Iraq with high incidence and expanding to new foci that is considered a public health threat which needs special attention. Women appeared to be better equipped than men to contain the infection and its clinical consequences, but the sex factor tended to lessen at higher levels of exposure.
Highlights
Background and ObjectiveCutaneous leishmaniasis (CL) remains a serious public health concern in some parts of Iraq
CL disease is endemic in many parts of Iraq with high incidence and expanding to new foci that is considered a public health threat which needs special attention
Leishmaniasis are parasitic diseases transmitted by sandflies via bitting, affecting largely the poorest of the poor, mainly in developing countries; 350 million people are considered at risk of contracting leishmaniasis and some 2 million new cases occur yearly in 88 countries.[1,2]
Summary
One-hundred sixty-one skin samples were examined by direct Giemsa-smeared culture on NNN medium and Nested – PCR methods in different age groups. Skin lesion was smeared on glass slides, air dried and fixed with methanol for a few seconds. Giemsa - smears and culture are routinely used in the laboratory for diagnosing leishmaniasis and do not differentiate Leishmania species and their sensitivity less than molecular methods.[30] It is possible that infections of Leishmania parasites will be missed due to disparate growth rates of different parasites in the cultures.[31] The molecular approach is both sensitive and specific.[24,31] In this study we set up a well-documented, Nested PCR to detect Leishmania species in clinical cutaneous samples and compared this method with classical methods
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