Studies on atypical cutaneous leishmaniasis in Sri Lanka

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Although leishmaniasis is not considered to be epidemic in Sri Lanka, cutaneous leishmaniasis cases were confirmed by NNN culture and/or Giemsa-stained smears in 2003. The skin lesions of these cutaneous leishmaniasis patients were generally a few in number, and were small, blister in appearance, non-ulcerative, even lesions lasted 1.5 to 36 months. To identify pathogenic species, the nucleotide sequences of a part of the actin-encoding gene which is highly conserved among eukaryotes, the mini-exon gene which is unique in the genus Leishmania, and cysteine protease B gene which is useful for L.infantumlL. donovani discrimination were analyzed using isolated parasites. Interestingly, the comparison of the nucleotide sequences of Sri Lanka isolates with those of reference strains of Leishmania spp. showed the highest homology with that of L.donovani s.1., a principal pathogenic species of visceral leishmaniasis. Kalazar detect dipstick for visceral leishmaniasis, which is antibody detect … More ion assay to rK39 antigen and highly sensitive for visceral leishmaniasis caused by L.donovani s.1. was done and all patients were negative. The results confirm that the prevalent dermotropic parasite in Sri Lanka belongs to the L. donovani s.1. In addition, the sand fly fauna of Sri Lanka was investigated. Although, the identification of vector sand flies is important for the planning of control against this disease in any given endemic site, it has not been achieved yet in Sri Lanka. Five hundred and eighty four sand flies were collected in total. Identification of sand flies was performed based on morphological features. P.argentipes were widely distributed in the island whereas P.stantoni were collected only in Golle district. Since P.argentipes is know to be the vector of L. donovani causing visceral leishmaniasis in India, P.argentipes might be the most possible candidate vector of human cutaneous leishmaniasis in Sri Lanka. The present study described at the first time an endemic of cutaneous leishmaniasis caused by L.donovani s.1.. Less