Isolation and Molecular Identification of Leishmania spp. in Patients With Cutaneous Leishmaniasis in Golestan Province, Iran

Background and aims: Cutaneous leishmaniasis is a major health issue in many parts of Iran. Diagnosis of cutaneous leishmaniasis in a non-endemic area is not as simple as that in endemic foci. The management and treatment of this disease are global dilemmas. The purpose of this study was to identify Leishmania species isolated from human cutaneous leishmaniasis lesions in patients referred to health centers of Golestan province, Iran. Methods: Cutaneous leishmaniasis patients with suspected lesions were clinically examined. History of journey to the endemic areas of zoonotic cutaneous leishmaniasis and/or anthroponotic cutaneous leishmaniasis and the characteristics of their lesion(s) were recorded. Diagnosis of the lesion was done by using direct smear microscopy and conventional polymerase chain reaction. Results: Out of 360 patients, 202 (57.4 %) were male and 158 (42.8 %) were female. A total of 360 samples were selected from different cities. The number of infected samples in the cities is as follows: Azad Shahr [3 (1.5%)], Aq Qala [11 (5.7%)], Ali Abad [4 (2.1%)], Bandar Turkmen [3 (1.5%)], Bandar Gaz [2 (1%)], Ramian [3 (1.5%)], Kalaleh [23 (12.1%)], Kord koy [1 (0.5%)], Galikesh [7 (3.7 %)], Gomishan [12 (3.6 %)], Gorgan [13 (6.8 %)], Gonbad Qabus [99 (52.1 %)], Marave Tappe [7 (3.6%)] and Minoodasht [2 (1%)]. In the molecular investigations, 186 (96.8%) samples were observed to acquire rural cutaneous leishmaniasis, 4 (2.1%) to acquire urban cutaneous leishmaniasis and 170 (47.2%) to be uninfected. Conclusion: Although history of visiting endemic areas is an important factor to be considered in diagnosis, parasitological confirmation is necessary for the initiation of treatment.