Combining diagnostic procedures for the management of leishmaniasis in areas with high prevalence of Leishmania guyanensis

The Amazon region corresponds to approximately 40% of the cases of leishmaniasis in Brazil. We report a prospective study with 180 patients conducted in a health care unit that diagnoses 10% of the cases of leishmaniasis in the Brazilian Amazon. The study addresses how a combination of procedures im...

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Published in:Anais brasileiros de dermatología 2011-11, Vol.86 (6), p.1141-1144
Main Authors: Benicio, Ednelza de Almeida, Gadelha, Ellen Pricilla Nunes, Talhari, Anette, Silva, Jr, Roberto Moreira da, Ferreira, Luis Carlos, Santos, Mayara Cristina Cordeiro dos, Mira, Marcelo Távora, Oliveira, Cintia Mara Costa de, Talhari, Carolina, Talhari, Sinésio, Machado, Paulo Roberto, Schriefer, Albert
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Biopsy
Brazil
Child
Child, Preschool
DERMATOLOGY
Female
Humans
Leishmania braziliensis - isolation & purification
Leishmania guyanensis - isolation & purification
Leishmaniasis, Mucocutaneous - diagnosis
Male
Middle Aged
Polymerase Chain Reaction
Prevalence
Prospective Studies
Sensitivity and Specificity
Young Adult
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Summary:The Amazon region corresponds to approximately 40% of the cases of leishmaniasis in Brazil. We report a prospective study with 180 patients conducted in a health care unit that diagnoses 10% of the cases of leishmaniasis in the Brazilian Amazon. The study addresses how a combination of procedures improves diagnosis in areas with high prevalence of Leishmania guyanensis. to evaluate diagnostic methods in areas with high prevalence of Leishmania guyanensis. All subjects were amastigote-positive by direct microscopic examination of lesion scarifications. We conducted skin biopsy and histopathology, polymerase chain reaction and parasite cultivation. Polymerase chain reaction detected almost ninety percent of infections when two amplification protocols were used (mini-exon and HSP-70). HSP-70 specific polymerase chain reaction matched the sensitivity of parasite cultivation plus histopathology. The best combination was polymerase chain reaction plus histopathology, which increased diagnostic sensitivity to 94%. Species discrimination by polymerase chain reaction disclosed prevalence of human infections with Leishmania guyanensis of 94% and with Leishmania braziliensis of 6% for this region.
ISSN:0365-0596
1806-4841
1806-4841
0365-0596
DOI:10.1590/S0365-05962011000600012