The emergence of Leishmania major and Leishmania donovani in southern Turkey

Transactions of the Royal Society of Tropical Medicine and Hygiene (Impact Factor: 1.84). 01/2014; 108(3). DOI: 10.1093/trstmh/trt119
Source: PubMed


In southern Turkey, Leishmania tropica and L. infantum are both the causative agents of cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL), respectively. However, L. major and L. donovani were known to exist after the influx of Syrian refugees.
Between the years of July 2003 and July 2013, a total of 167 smears and 113 bone marrow samples were taken from CL and VL-suspected cases, respectively. Samples were analysed through real-time PCR and ITS1 DNA sequencing.
One hundred and seven 64% (107/167) smears and 56% (63/113) bone marrow samples were positive for leishmaniasis according to the real-time PCR. Three different Leishmania species were found in the 107 CL cases by real-time PCR: 42% (45/107) L. tropica, 36.5% (39/107) L. infantum and 21.5% (23/107) L. major. In addition, three different Leishmania species were identified in the 63 VL cases: 60.3% (38/63) L. infantum, 30.2% (19/63) L. donovani and 9.5% (6/63) L. tropica using real-time PCR. The results of real-time PCR were confirmed with Leishmania ITS1 DNA sequencing.
This study revealed that in southern Turkey, L. major and L. donovani were the aetiological agents of CL and VL, respectively. It was assumed that emergence of L. major and L. donovani was due to influx of Syrian refugees, as well as the effects of global warming.

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Available from: Ismail Soner Koltas, Apr 16, 2014
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    • "In addition to this, two strains isolated from two VL patients were identified as " Leishmania major variant " four differing from Friedlin strain of Leishmania major in the sequences of N-acetylglucosamine-1-phosphotransferase (NAGT) genes with four bases substitutions (Akman et al., 2000). Recently L. major and L. donovani were also reported as causative agents of CL in East Mediterranean Region of Turkey (Koltas et al., 2014). South and Southeast Anatolia regions are endemic for CL, while human VL and CanL have been mainly seen along the Aegean, Mediterranean coasts and Central Anatolia Region (Ok et al., 2002). "

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    • "long time. Recently, L. major and L. donovani were also recorded as causative agents of CL in Adana province in east part of Mediterranean Region of Turkey (Koltas et al., 2014). The prevalence of the CanL was reported as between 1% and 37% in Mediterranean Basin countries including Turkey (Gradoni et al., 1995). "
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    • "These three isolates were later analyzed using MLEE and detected as Leishmania donovani zymodeme MON- 309 (Gouzelou et al., 2012). Recently, Leishmania major and L. donovani as causative agents of CL were reported in Adana Province, one of the major cities in C ¸ ukurova Plain (Koltas et al., 2014). Although VL cases in children and adults are only sporadically reported in the area (Kursun et al., 2013), hundreds of human CL cases continue to occur every year, most of them suffering from relatively small, non-ulcerating lesions (local health authorities record). "
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