Molecular epidemiology of leishmaniasis in Asia (focus on cutaneous infections).

PURPOSE OF REVIEW: Leishmaniasis has a wider geographical distribution than before. This review focuses on molecular epidemiological studies of new foci of cutaneous leishmaniasis in South and Southeast Asia. RECENT
FINDINGS: In Pakistan, the main causative agent in southern dry areas was determined as Leishmania major followed by Leishmania tropica. There was no correlation between the skin lesion types and the causative species. In the western Indian Himalayas, L. tropica and Leishmania donovani have been reported as the causative pathogens. In Nepal, molecular methods revealed the first case of L. major cutaneous leishmaniasis. Microsatellite analysis of Sri Lankan strains isolated from cutaneous leishmaniasis patients identified L. donovani strains that were closely related to a group of visceral L. donovani isolates from India, Bangladesh, and Nepal. In Taiwan, a third case of indigenous cutaneous leishmaniasis was reported, and the parasite was L. tropica.
SUMMARY: The distribution of cutaneous leishmaniasis has expanded definitively in South and Southeast Asia. Because the possible sandfly vector species are distributed widely over the disease endemic areas, further epidemiological studies are required. Microsatellite analysis of the parasites will be a powerful tool for population genetic and epidemiological studies of Leishmania species in Asia.