Showing 8 results for Cutaneous Leishmaniasis
Shirani-Bidabadi L, Mahmoudi M, Saberi S, Zolfaghari-Baghbaderani A, Nilforoushzadeh Ma, Abdoli H, Moatar F, Hejazi Sh,
Volume 66, Issue 11 (2-2009)
Abstract
Background: Though many therapeutic modalities have been suggested but still no definite treatment for Cutaneous Leishmaniasis is available. Many compounds including Alkaloid, Quinones, Iridoids, Terpenes, Indole analogue have been documented to have antileishmania activity invitro. On the other hand, the aforementioned compounds can be found in the herbs including Thyme, Yarrow. Propolis is a brown color substance that is collected by honey bee from plants. Regarding the lack of data about the possible efficacy of these herbs against leishmaniasis, we have decided to evaluate and compare the efficacy of herbal extract of Thyme, Yarrow, Propolis and systemic glucantime against cutaneous leishmaniasis in Balb/c, and to formulate drugs without harmful chemical material and without side effect.
Methods: During three weeks of inoculation of parasite in base tail of mice, lesions will appear in the inoculation site. The animals divided into seven groups. We used mix alchoholic extract solution two times a day, checked lesions weekly for six week and measured size of lesion in the base of tail with kulis- vernieh.
Results: We observed significant difference between mean of lesion diameter before and after treatment in control, Yarrow and Thyme groups (p<0.05). Paired t test showed no significant difference between mean of lesion diameter after treatment between treatment and glucantime groups (p>0.05).
Conclusion: Alchoholic extract to Thyme and Yarrow have good effect on lesions treatment, we suggest repeat of this study with Thyme and Yarrow extract in gel or cream base in first stage of lesions appearance.
Khalili M, Nourollahi-Fard Sr,
Volume 67, Issue 3 (6-2009)
Abstract
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Background: Leishmaniasis
is a parasitic infectious disease which causes skin sores. There is no
effective laboratory screening tests for leishmaniasis. Some diagnostic
techniques exist that allow parasite detection and species identification by
special culture and microscopy, biochemical (Isoenzymes), immunologic
(immunoassays), and molecular (PCR) approaches. Specific major objectives of
this study was to genotyping of Leishmania species in Bam and Shiraz city.
Methods: A total of 83
samples of Leishmania were collected from patients clinically suspected of cutaneous
leishmaniasis. The geographic distributions of the samples were 55 samples from
Bam and 28 from Shiraz city. For this propose samples of skin and bloods were
blotted on filter paper. Genomic DNA extracted with a Genomic DNA extraction
kit (AccuPrep, BIONEER). Aliquots of extracted DNA were kept at -20°C.
region of ITS1 amplified with the published Leishmania-specific primers. 15-20mL of these amplicons,
containing the amplified ITS1 region, was digested for 2h with HaeIII.
Results: All 55 samples from
Bam were considered as L. tropica and the positive samples from Shiraz
considered as L. tropica and just one sample was L. major which was belonged to
a patient had previously traveled to Isfahan and Khuzestan.
Conclusion: In
the current study a PCR technique was employed for amplification of Leishmania DNA
directly in biological materials. Characterization of genus of Leishmania using
RFLP-PCR method is too sensitive and too rapid, and there is no need for culturing
the parasite for diagnosis.
Fariba Jaffary , Mohammad Ali Nilforoushzadeh , Nazli Ansari , Marzieh Rahimi ,
Volume 67, Issue 10 (1-2010)
Abstract
Background: Cutaneous leishmaniasis is a major health problem in Iran and especially Isfahan province is considered as an endemic area for this disease. Regarding the previous report of positive effects of Cassia fistula boiled extract in the treatment of cutaneous leishmaniasis, this study was designed to evaluate the effect of combination therapy with intralesional meglumine antimoniate and Cassia fistula fruit gel compared to placebo in this disease.
Methods: 140 patients with cutaneous leishmaniasis referring to Skin Disease and Leishmaniasis Research Center of Isfahan (SDLRC) were randomly allocated in two groups. One group received intralesional meglumine antimoniate injection and Cassia fistula fruit gel and the second group were treated with intralesional meglumine antimoniate and placebo gel. Improvement was defined as complete cure, partial cure and treatment failure.
Results: At 12 week, 47 patients treated with intralesional meglumine antimoniate and topical Cassia fistula fruit gel achieved complete cure (67.1%) compared to 29(41.4%) patients in placebo treated group. There was significant difference in cure rate between two treatment groups of this study (p<0.001). Nine patients (19%) in each group suffered from adverse effects of the treatment such as itching and erythema. There was no significant difference in this regard between two groups (p=0.82).
Conclusions: The results of this study shows the efficacy of Cassia fistula fruit gel in increasing the cure rate of cutaneous leishmaniasis lesions achieved by intralesional meglumine antimoniate. Combination therapy of intralesional meglumine antimoniate and Cassia fistula fruit gel could be suggested as a choice for the treatment of acute cutaneous leishmaniasis lesions.
Mesgarian F, Rahbarian N, Mahmoud Radi M, Hajaran H, Shahbaz F, Mesgarian Z, Taghipour N,
Volume 68, Issue 4 (7-2010)
Abstract
Background: Cutaneous Leishmaniasis is endemic in plenty of Iranian provinces. This study aimed to determine the epidemiological status of the cutaneous Leishmaniasis outbreak, isolation and identification of the parasite using a PCR method in burden rural areas of Gonbad-e-Qabus County, north Iran.
Methods: Data was collected on the prevalence of scars and ulcers over a period of three months among 6990 inhabitants of five villages around Gonbad-e-Qabus county,north Iran, during 2006-2007. Cultured promastigotes were identified using PCR technique. ITS1 and ITS2 of Non Coding Transcribed region at ribosomal DNA of 46 Leishmania isolates were amplified and the PCR products were separated by electrophoresis in 1.5% agarose gel (200 mA, 140 V), visualized by staining with ethidium bromide, and photographed. To confirm the PCR findings, six Leishmanis isolates were injected individually into two BALB/c mice.
Results: Among 6990 inhabitants of the five villages, 62.9% had scars and 0.5% had active lesions. The most highly infected age group was 0-10 years and nobody was infected in individuals more than fifty years of age. Individuals 11 to 20 years of age were the most highly infected age group. The results showed that from 46 isolates, all (100%) were L. major in comparison to reference strains and all of them could produce ulcer at the base tail of BALB/c mice, 4-12 weeks after inoculation.Conclusions: According to this study, cutaneous Leishmaniasis due to Leishmania major is endemic in Gonbad-e-Qabus county, north Iran. The results were confirmed by active lesions induced in BALB/c mice.
Fariba Jaffary , Latifeh Abdellahi , Mohammad Ali Nilforoushzaheh ,
Volume 75, Issue 6 (9-2017)
Abstract
Cutaneous leishmaniasis (CL) is an endemic parasitic disease of major health impact in many parts of the world and is caused by several species of the protozoan parasite Leishmania. Antimonial compounds (i.e glucantime and pentostam) are the first-line treatment for cutaneous leishmaniasis with emerging drug resistance as a problem. The control of Leishmania is further complicated by the emergence of drug-resistant parasites. In the clinical settings, resistance to SbV containing drugs is now well established and it was found to occur in South America, Europe, the Middle East and most notably in India. Clinical resistance to organic pentavalent antimonials, in the form of sodium stibogluconate (pentostam) or N-methylglucamine antimoniate (glucantime), has long been recognized. However, it is unknown whether the clinical failure of chemotherapy is attributable to the development of drug resistance mechanisms in the parasite or to a variety of host factors that might also contribute to low drug response. Reported rate of drug-resistance to antimonial compounds in Iran varies from 9.4% to 94.2% and there is not any comprehensive study on this issue. Indeed, in the endemic region treatment with SbV fails in more cases; thus, in general patients infected with resistant parasites are unresponsive although exceptions have been reported. This article aims to review the mechanisms of drug resistance to these compounds. The main resistance factors include genetical, enzymatic, intracellular (such as apoptosis and cytoskeleton changes) and resistance proteins. Also, mechanisms related to drug transport and intracellular activation are discussed. Various methods of drug resistance detection such as culture and molecular methods (i.e polymerase chain reaction) are reviewed. Although the exact mechanism of action glucantime is not clear, it seems that protein and gene factors involved in cellular drug entry are the main causes of drug resistance. Cross-sectional studies on meglumine antimoniate resistance in endemic areas of cutaneous leishmaniasis in Iran are highly recommended. Also, studies for evaluation of alternatives therapies for antimonial resistant cases are required.
Fariba Jaffary , Mohammad Ali Nilforoushzadeh , Latifeh Abdellahi , Hadis Tahmasebi Poor,
Volume 76, Issue 3 (6-2018)
Abstract
Background: Despite advances in diagnosis and treatment, leishmaniasis is now considered a severe public health problem, particularly in developing countries, such as Iran. Leishmaniasis is among the six most important, parasitic diseases of the world affecting 88 countries in almost every continent. The disease is complex with different clinical presentations such as visceral, cutaneous and mucocutaneous forms. Cutaneous leishmaniasis (CL) is the most common form of the disease in Iran. Antimony compounds are the first line treatment of CL. The treatment of leishmaniasis in endemic areas relies on chemotherapy, and in several parts of the world the mainstay remains the pentavalent antimony (SbV)-containing drugs Pentostam (sodium stibogluconate) and Glucantime (meglumine). There is no comprehensive study on treatment failure rate of this compounds. This study was designed to evaluate treatment failure rate and possible involving factors of antimonial resistance in CL to facilitate and improve treatment strategies of this disease.
Methods: All patients with CL referred to Skin Disease and Leishmaniasis Research Center (SDLRC), from October 2011 to October 2013, treated with antimony compounds were assessed in this study. Patient characteristics (gender, age and place of residence), number, type and location of the lesions, comorbidities and type of treatment were recorded and analyzed.
Results: Rate of treatment failure with Meglusan was 4.3%. Failure rate in men and in patients with previous history of cutaneous leishmaniasis was more than women or patients without CL history (P= 0.000, 0.024 respectively). The results of this study showed that treatment failure was higher in patients with systemic treatment than intralesional (IL) or combination therapy (both IL and systemic treatment) group but this difference was not statistically significant. Also, size and number of the lesions, wound infection, the patient's age, location, education and occupation do not have a significant correlation with treatment failure.
Conclusion: Greater treatment failure rate of Meglusan compared to Glucantime (4.3% versus< 1%, respectively) is an important issue to be considered in CL therapeutic strategy.
Behzad Jafarinia, Roya Rashti, Razieh Halvaei Zadeh , Javad Moazen, Hamid Kalantari ,
Volume 76, Issue 12 (3-2019)
Abstract
Background: Leishmaniasis is a zoonosis disease. About 350 million people are at risk of developing a disease, with 1.5 to 2 million new cases every year in the world. The aim of this study was to determine the space-time clusters of cutaneous leishmaniasis in north of Khuzestan Province, Iran.
Methods: In this cross-sectional study, the annual cutaneous leishmaniasis incidence per 100,000 individuals in each county was determined for the past five years. Reported from 2011 to 2015 in North of Khuzestan Province, Iran. Geographical information system (GIS) and spatial scan statistic method were used to identify spatial clusters of cutaneous leishmaniasis cases at the county level. Pure retrospective temporal analysis scanning was performed to detect the temporal clusters of cutaneous leishmaniasis cases with high rates using the discrete Poisson model. The space-time cluster was detected with high rates through the retrospective space-time analysis scanning using the discrete Poisson model.
Results: The overall cutaneous leishmaniasis incidence increased from 2011 to 2015. A total of 3 high-risk counties were determined through Local Moran’s I analysis from 2011 to 2015. Local Moran’s I enabled the detection of the spatial autocorrelation for a county with its adjacent county. The method of spatial scan statistics identified different 11 significant spatial clusters. The space-time clustering analysis determined that the most likely cluster included 11 counties, and the time frame was October 2014. The secondary cluster included one counties in October 2014. The tertiary cluster included six counties, and the time frame was from June 2014 to November 2015.
Conclusion: Spatial and temporal clusters of cutaneous leishmaniasis have increased in the northern region of Khuzestan Province, and most clusters have occurred in November.
Amir Hamta, Abedin Saghafipour, Ehssan Mozaffari, Zahra Salemi ,
Volume 78, Issue 6 (9-2020)
Abstract
Background: Currently, cutaneous leishmaniasis (CL) as a parasitic disease is treated with Glucantime and Pentostam in most of the endemic countries. This study aimed to identify factors affecting the glucantime therapy duration rate in patients with CL using a survival analysis model.
Methods: This retrospective descriptive-analytic study was conducted on 1017 CL patients that were referred to the urban and rural comprehensive health centers of Qom Province under the supervision of Qom University of Medical Sciences, Qom, Iran, from April 2014 to March 2019 through the census. The recovery time was measured by the Kaplan-Meier method, and then the survival function was plotted based on each variable. The Log-Rank test was applied to analyze the differences among variables, and after the evaluation of the PH assumption by Shoenfeld residuals, a stepwise forward Cox progressive regression was used to determine factors affecting intralesional or systematic treatment duration in the patients involved with cutaneous leishmaniasis.
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Results: The recovery rate of lesions in cutaneous leishmaniasis cases was found to be 96.7% by the intralesional treatment and 93% by the systematic one. The mean recovery time for cutaneous leishmaniasis patients was 8.00 weeks for the intralesional treatment and 18.00 days for the systematic treatment. The only significant variable in the intralesional treatment was observed on cases with thigh lesions, meaning that those patients who had CL lesions on their thighs experienced a significant reduction in their recovery time. Furthermore, the lesion variable was also significant (P=0.039) as the recovery chance of those patients who had four or more CL lesions was 30% less.
Conclusion: The existence of lesions on CL patients’ thighs and a low number of lesions in CL patients can decrease the recovery time. The use of the Cox regression model in medical studies is more appropriate because not only does it consider the occurrence of the event but also it can reveal the occurrence time of the disease.
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