Molecular epidemiology of human cutaneous leishmaniasis in Jericho and its vicinity in Palestine from 1994 to 2015.
Cutaneous leishmaniases (CL) are vector-borne parasitic diseases endemic in many countries of the Middle East including Palestine. Between 1994 and 2015, 2160 clinically suspected human cases of CL from the Jericho District were examined. Stained skin tissue smears and aspirates were checked by microscopy and cultured for promastigotes, respectively. For leishmanial species identification, amplification products from a PCR-ITS1 followed by RFLP analysis using Hae III. Data were analyzed using Epi Info free-software. The overall infection rate was 41.4% (895/2160), 56.3% (504/895) of the cases were male, 43.7% (391/895) female, 60.5% (514/849) children under age 14, 41.3% (259/627) of the cases were caused by Leishmaniamajor and 57.3% (359/627) by Leishmaniatropica. The case numbers peaked in 1995, 2001, 2004, and 2012. Statistically-significant clusters of cases caused by L. major were restricted to the Jericho District; those caused by L. tropica were from the districts of Jericho, Bethlehem, Nablus and Tubas. CL is seasonal and trails the sand fly season. Distribution of cases was parabolic with fewest in July. The monthly total number of cases of CL and just those caused by L. major correlated significantly with temperature, rainfall, relative humidity, evaporation, wind speed and sunshine (P<0.05, r2=0.7-0.9 and P<0.05, r2=0.5-0.8, respectively). Cases caused by L. tropica, significantly, had a single lesion compared to cases caused by L. major (P=0.0001), which, significantly, had multiple lesions (P=0.0001). This and previous studies showed that CL is present in all Palestinian districts. The surveillance of CL has increased public awareness and molecular biological methodology for leishmanial species identification is an essential addition to classical diagnosis. The overall results are discussed, correlated to climatic and environmental changes and large-scale human activities.
Leishmaniases Research Unit, Jericho, Palestine; Al-Quds Public Health Society, Jerusalem, Palestine; Department of Medical laboratory Sciences, Faculty of Allied Health Sciences, Arab American University in Jenin, Palestine; Al-Quds Nutrition and Health Research Institute, Al-Quds University, East Jerusalem, Palestine. Electronic address: islahjr@yahoo.com.
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Al-Jawabreh
Department of Medical laboratory Sciences, Faculty of Allied Health Sciences, Arab American University in Jenin, Palestine.
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Dumaidi
Al-Quds Public Health Society, Jerusalem, Palestine; Al-Quds Nutrition and Health Research Institute, Al-Quds University, East Jerusalem, Palestine; Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Abu Deis, East Jerusalem, Palestine.
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Ereqat
Leishmaniases Research Unit, Jericho, Palestine; Al-Quds Public Health Society, Jerusalem, Palestine.
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Al-Jawabreh
Al-Quds Public Health Society, Jerusalem, Palestine; Al-Quds Nutrition and Health Research Institute, Al-Quds University, East Jerusalem, Palestine.
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Nasereddin
Al-Quds Public Health Society, Jerusalem, Palestine; Al-Quds Nutrition and Health Research Institute, Al-Quds University, East Jerusalem, Palestine; Biochemistry and Molecular Biology Department, Faculty of Medicine, Al-Quds University, Abu Deis, East Jerusalem, Palestine.
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Azmi
Laboratory Department, Arab Health Center, Jerusalem, Palestine.
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Barghuthy
Ministry of Health, Ramallah, Palestine.
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Sawalha
Leishmaniases Research Unit, Jericho, Palestine.
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Salah
Al-Quds Public Health Society, Jerusalem, Palestine; Al-Quds Nutrition and Health Research Institute, Al-Quds University, East Jerusalem, Palestine.
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Abdeen
D000818:Animals; D018912:Arabs; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D016054:DNA, Protozoan / Q000235:genetics; D005260:Female; D006801:Humans; D006813:Humidity; D018320:Leishmania major / Q000235:genetics / Q000254:growth & development / Q000472:pathogenicity*; D007895:Leishmania tropica / Q000235:genetics / Q000254:growth & development / Q000472:pathogenicity*; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology* / Q000473:pathology* / Q000635:transmission; D008297:Male; D017720:Molecular Epidemiology; D011576:Psychodidae / Q000469:parasitology*; D011891:Rain; D014919:Wind
D016054:DNA, Protozoan
Cutaneous leishmaniasis; Jericho; L. major; L. tropica; Palestine