Joseph Wambugu Gitari1, Samson Muuo Nzou2, Fred Wamunyokoli1, Esther Kinyeru3, Yoshito Fujii4, Satoshi Kaneko5, Matilu Mwau6. 1. Department of Molecular Biology and Biotechnology, Pan African University Institute of Basic Sciences, Technology and Innovation, Nairobi, Kenya. 2. Center for Infectious Parasitic Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya; Nagasaki University, Institute of Tropical Medicine, Kenya Medical Research Institute Project (NUITM-KEMRI Project), Nairobi, Kenya. Electronic address: nzoumuuo@gmail.com. 3. Ministry of Health, Nakuru County Government, Kenya. 4. Institute of Tropical Medicine, Eco-epidemiology Department (NEKKEN), Nagasaki University, Japan. 5. Nagasaki University, Institute of Tropical Medicine, Kenya Medical Research Institute Project (NUITM-KEMRI Project), Nairobi, Kenya; Institute of Tropical Medicine, Eco-epidemiology Department (NEKKEN), Nagasaki University, Japan. 6. Center for Infectious Parasitic Diseases Research, Kenya Medical Research Institute, Nairobi, Kenya.
Abstract
OBJECTIVES: This study sought to determine the endemic Leishmania species, the clinical features of cutaneous leishmaniasis (CL) in the Central Rift Valley in Kenya and to give an account on unresponsiveness to treatment in the region. METHODS: Participants were clinically identified and grouped into untreated, classical and recidivate based on clinical manifestation and clinical data. Leishmaniasis recidivans lesions were scaly hyperemic papules that appeared before the classic lesion had healed or after healing. The demographics and socio-economic data were recorded and lesion scraping samples screened through microscopy and Internal Transcribed Spacer 1-PCR. Leishmania species were identified using Restriction Fragment Length Polymorphism. RESULTS: A total of 52 participants were sampled, of which, 44.2% of the cases were recidivate and L. tropica the only species identified. All patients had been treated using sodium stibogluconate (SSG) which is the recommended first-line drug in Kenya. 60% of the patients experienced prolonged exposure to the drug (>30 days). CONCLUSION: L. tropica is the endemic Leishmania species for CL leading to classical and leishmaniasis recidivans. Treatment of CL in the area is not effective hence, alternative measures/therapy should be considered to cope with the unresponsiveness.
OBJECTIVES: This study sought to determine the endemic Leishmania species, the clinical features of cutaneous leishmaniasis (CL) in the Central Rift Valley in Kenya and to give an account on unresponsiveness to treatment in the region. METHODS:Participants were clinically identified and grouped into untreated, classical and recidivate based on clinical manifestation and clinical data. Leishmaniasis recidivans lesions were scaly hyperemic papules that appeared before the classic lesion had healed or after healing. The demographics and socio-economic data were recorded and lesion scraping samples screened through microscopy and Internal Transcribed Spacer 1-PCR. Leishmania species were identified using Restriction Fragment Length Polymorphism. RESULTS: A total of 52 participants were sampled, of which, 44.2% of the cases were recidivate and L. tropica the only species identified. All patients had been treated using sodium stibogluconate (SSG) which is the recommended first-line drug in Kenya. 60% of the patients experienced prolonged exposure to the drug (>30 days). CONCLUSION:L. tropica is the endemic Leishmania species for CL leading to classical and leishmaniasis recidivans. Treatment of CL in the area is not effective hence, alternative measures/therapy should be considered to cope with the unresponsiveness.
Authors: Mohammad Reza Aflatoonian; Iraj Sharifi; Behnaz Aflatoonian; Mehdi Bamorovat; Amireh Heshmatkhah; Zahra Babaei; Pooya Ghasemi Nejad Almani; Mohammad Ali Mohammadi; Ehsan Salarkia; Abbas Aghaei Afshar; Hamid Sharifi; Fatemeh Sharifi; Ahmad Khosravi; Mehrdad Khatami; Nasir Arefinia; Alireza Fekri; Saeideh Farajzadeh; Ali Khamesipour; Mehdi Mohebali; Mohammad Mehdi Gouya; Mohammad Reza Shirzadi; Rajender S Varma Journal: PLoS Negl Trop Dis Date: 2019-06-12