Prevalence of Cutaneous Leishmaniasis for Six Years in Al-Muthanna Province, Iraq: ITS1 as Marker of Molecular Identification of Old-World CL.

Abstract

The current study aimed to determine the prevalence of cutaneous leishmaniasis in Al-Muthanna Province, Iraq, as well as to characterize the Leishmania species that cause cutaneous lesions using conventional PCR (polymerase chain reaction) techniques for some patients during seven months of the year 2020. Medical information on Cutaneous leishmaniasis (CL) patients was obtained from archived records at the Al-Muthanna Health Office's public health department (2015 - 2020). In the Al- Hussein Teaching Hospital laboratory, 95 CL samples were collected and examined microscopically with Giemsa stain for molecular characterization. Between 2015 and 2020, 2325 patients (1,184 men and 1,141 women) were studied. Although CL occurred across all ages, the age range of 5 - 14 years had the highest proportion of infections (53%). This study found that most infections occurred between December and February, with the infections peaking in January. Only 63 of the 95 CL detected samples under the microscope were positive for the internal transcribed spacer 1 region (ITS1). L. tropica was found in 39 (61.9%) of the samples, while L. major was found in 24 (38.1%). In CL patients. Although dermal lesions developed in all body regions, a single lesion was the most common. Upper limbs (13 out of 16 samples) (33.3%) were infected with L. tropica, whereas lower limbs (37.5%) (9 out of 14 samples) were infected with L. major. In contrast to L. major, most L. tropica lesions occurred in urban areas. Our study indicated CL is endemic in Al-Muthanna province and the presence of two Leishmania spp. coexisting in the province. The molecular diagnosis is critical in determining the many clinical symptoms of the Leishmania parasite, as well as suitable therapeutic, epidemiological, and control strategies.