First molecular epidemiological study of cutaneous leishmaniasis in Libya.
BACKGROUND
Cutaneous leishmaniasis (CL) is a major public health problem in Libya. The objective of this study was to investigate, for the first time, epidemiological features of CL outbreaks in Libya including molecular identification of parasites, the geographical distribution of cases and possible scenarios of parasite transmission.


RESULTS
We studied 450 patients that came from 49 areas distributed in 12 districts in north-west Libya. The patients' ages ranged from 9 months to 87 years (median age 25 years); 54% of the cases were males. Skin scrapings spotted on glass slides were collected for molecular identification of causative agent. The ribosomal internal transcribed spacer 1 (ITS1) was amplified and subsequently characterized by restriction fragment length polymorphism (RFLP) analysis. In total, 195 samples were successfully identified of which 148 (75.9%) were Leishmania major, and 47 (24.1%) Leishmania tropica. CL cases infected with L. major were found in all CL areas whereas L. tropica cases came mainly from Al Jabal Al Gharbi (46.4%), Misrata (17.8%) and Tarhuna districts (10.7%). A trend of seasonality was noticed for the infections with L. major which showed a clear peak between November and January, but was less pronounced for infections by L. tropica.


CONCLUSIONS
The first molecular study on CL in Libya revealed that the disease is caused by L. major and L. tropica and the epidemiological patterns in the different foci were the same as in other Mediterranean foci of CL.
Faculty of Pharmacy, Al-Quds University, Abu-Dies, Jerusalem, Palestine. aamro@pharm.alquds.edu
Ahmad
A
Amro
Aisha
A
Gashout
Hamida
H
Al-Dwibe
Mohammad
M
Zahangir Alam
Badereddin
B
Annajar
Omar
O
Hamarsheh
Hend
H
Shubar
Gabriele
G
Schönian
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D016172:DNA Fingerprinting; D016054:DNA, Protozoan / Q000235:genetics / Q000302:isolation & purification; D021903:DNA, Ribosomal Spacer / Q000235:genetics / Q000302:isolation & purification; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D018320:Leishmania major / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D007895:Leishmania tropica / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology* / Q000469:parasitology*; D008002:Libya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D058974:Phylogeography; D012150:Polymorphism, Restriction Fragment Length; D019371:Topography, Medical; D055815:Young Adult
D016054:DNA, Protozoan; D021903:DNA, Ribosomal Spacer