title: The new situation of cutaneous leishmaniasis after Syrian civil war in Gaziantep city, Southeastern region of Turkey.
abstract: Cutaneous leishmaniasis (CL) is an important public health problem with around 2.000 autochthonous reported cases each year in Turkey. Due to the civil war in Syria, Turkey received around three million refugees and they are mainly located at either camps or homes in south/southeastern part of Turkey. In the present study, we aimed to collect samples from CL suspected patients admitting to State Hospital in Gaziantep City and perform parasitological and DNA-based techniques for diagnosis as well as species identification of the parasite for better understanding the prevalence of each species among Turkish and Syrian patients in the region. The collection of samples was carried out between January 2009 and July 2015. The lesion aspiration samples were taken and stained with Giemsa stain followed by microscopical examination for parasitological diagnosis. After the DNA extraction from Giemsa stained slides, real time and semi-nested PCRs both targeting ITS1 region were performed for molecular diagnosis and species identification. A total of 567 people were admitted to the hospital with the suspicion of CL and 263 (46.4%) of them were found to be positive by parasitological examination. One hundred seventy-four (66.15%), 88 (33.46%) and 1 (0.38%) of them were Turkish, Syrians and Afghan, respectively. Slide samples obtained from 34 CL suspected patients were analyzed by PCR and 20 of them were found positive. Eighteen (13 Turkish and 13 Syrians) of the positive samples were identified as L. tropica, while two (1 Turkish and 1 Syrian) of them were L. infantum. In conclusion, the effects of Syrian civil war on the epidemiology of CL in Gaziantep city is demonstrated in the present study. The use of molecular tool in the diagnosis of leishmaniasis is effective, sensitive and time saving which will enable the species typing. Species typing of the causative agent in endemic areas will bring valuable data to epidemiological knowledge.
authors.affiliation: Dr. Ersin Arslan State Hospital, Microbiology Department, Gaziantep, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Özkeklikçi
authors.affiliation: Ege University Faculty of Medicine Department of Parasitology, Bornova, İzmir, Turkey. Electronic address: mehmetk1986@yahoo.com.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Karakuş
authors.affiliation: Ege University Faculty of Medicine Department of Parasitology, Bornova, İzmir, Turkey.
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Özbel
authors.affiliation: Ege University Faculty of Medicine Department of Parasitology, Bornova, İzmir, Turkey.
authors.forename: Seray
authors.initials: S
authors.lastname: Töz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D016054:DNA, Protozoan / Q000737:chemistry; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007891:Leishmania / Q000235:genetics / Q000302:isolation & purification*; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology* / Q000208:ethnology / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D060888:Real-Time Polymerase Chain Reaction; D012036:Refugees / Q000706:statistics & numerical data; D013593:Syria / Q000208:ethnology; D014421:Turkey / Q000453:epidemiology; D014857:Warfare; D055815:Young Adult
chemical_list: D016054:DNA, Protozoan
keywords: Giemsa-stained slides; ITS1; Leishmania; Syrian refugees; Turkey