title: A new rural focus of cutaneous leishmaniasis caused by Leishmania tropica in Kenya.
abstract: We have identified a new rural focus of cutaneous leishmaniasis caused by Leishmania tropica in Muruku sublocation, Salama location, Laikipia district, Rift Valley province, Kenya. Based on a few available case histories, previous reports of L. tropica in Kenya indicated a tentative geographical distribution. Recently 6 indigenous Kenyans from the new focus, who had never travelled outside Kenya, developed cutaneous lesions on the face and/or extremities found to contain Leishmania by culture and smear. Most of the patients manifested the typical 'urban' dry sore which grew slowly into a nodule measuring 2 x 1 cm to 9.5 x 3 cm, and after some months formed a central crust surrounded by small satellite papules. After treatment with Pentostam (sodium stibogluconate), about 40% of the sores failed to heal completely, either scarring centrally with fulminating papules at the edges and spreading peripherally, or healing but then recrudescing at the edge of the scar. Stationary-phase promastigotes from culture isolates were analysed by cellulose acetate electrophoresis. Isoenzyme profiles of 6 isolates were compared with those of World Health Organization reference strains using 12 enzyme loci; they were indistinguishable from those of 2 L. tropica reference strains. All 6 case sites lay within a radius of 4 km. Several other suspected cases from the same area are being investigated.
authors.affiliation: Kenya Medical Research Institute, Nairobi.
authors.forename: Y B
authors.initials: YB
authors.lastname: Mebrahtu
authors.forename: P G
authors.initials: PG
authors.lastname: Lawyer
authors.forename: P M
authors.initials: PM
authors.lastname: Ngumbi
authors.forename: G
authors.initials: G
authors.lastname: Kirigi
authors.forename: J
authors.initials: J
authors.lastname: Mbugua
authors.forename: G
authors.initials: G
authors.lastname: Gachihi
authors.forename: K
authors.initials: K
authors.lastname: Wasunna
authors.forename: H
authors.initials: H
authors.lastname: Pamba
authors.forename: J A
authors.initials: JA
authors.lastname: Sherwood
authors.forename: D K
authors.initials: DK
authors.lastname: Koech
mesh_terms: D000293:Adolescent; D000818:Animals; D000967:Antimony Sodium Gluconate / Q000627:therapeutic use; D001132:Arm; D002648:Child; D005148:Facial Dermatoses / Q000469:parasitology; D005260:Female; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D007895:Leishmania tropica / Q000302:isolation & purification; D016773:Leishmaniasis, Cutaneous / Q000188:drug therapy / Q000453:epidemiology* / Q000469:parasitology; D008297:Male; D012424:Rural Population; D012867:Skin / Q000469:parasitology
chemical_list: D000967:Antimony Sodium Gluconate