شناسایی گونه‌های عامل Leishmaniasis پوستی در شهرستان درگز

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 استاد، گروه انگل‌شناسی و قارچ‌شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

2 استاد، گروه ایمونولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

3 استادیار، گروه انگل‌شناسی و قارچ‌شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

4 دانشجوی کارشناسی ارشد، گروه انگل شناسی و قارچ شناسی، دانشکده ی پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

5 دانشیار، گروه انگل‌شناسی و قارچ‌شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران

چکیده

مقدمه: Leishmaniasis پوستی، از بیماری‌های انگلی پوستی است که در بسیاری مناطق جهان به ویژه ایران به صورت اندمیک وجود دارد. هر چند روش میکروسکوپی روش متداول تشخیص بیماری می‌باشد، اما تشخیص گونه‌های عامل Leishmaniasis به صورت میکروسکوپی و یا از طریق یافته‌های بالینی امکان پذیر نیست. برای این منظور، روش‌های مولکولی از اهمیت ویژه‌ای برخوردار هستند.روش‌ها: در این مطالعه، شناسایی گونه‌ی عامل Leishmaniasis پوستی در شهرستان درگز به روش Polymerase chain reaction (PCR) با هدف قرار دادن ژن کینتوپلاست Kinetoplast-DNA (kDNA) مورد بررسی قرارگرفت. این مطالعه بر روی 94 نمونه‌ی گرفته شده از بیماران مشکوک به Leishmaniasis مراجعه کننده به مراکز درمانی شهرستان درگز انجام شد. لام‌ها به روش گیمسا (Gimsa) رنگ‌آمیزی شدند و مورد بررسی مستقیم قرار گرفتند. PCR با استفاده از پرایمرهای اختصاصی DNA کینتوپلاست انجام شد و نتایج به دست آمده، توسط نرم‌افزار آماری SPSS و آزمون 2χ تجزیه و تحلیل گردید.یافته‌ها: در بین 94 مراجعه کننده‌ی مشکوک به Leishmania، لام میکروسکوپی 82 نفر (2/87 درصد) از بیماران و با روش مولکولی 85 نفر (4/90 درصد) از بیماران مثبت شدند که تعداد 63 مورد (1/74 درصد) Leishmania major و 22 مورد (9/25 درصد) Leishmania tropica بودند. با در نظر گرفتن روش kDNA-PCR به عنوان یک روش استاندارد، ویژگی روش مستقیم میکروسکوپی 100 درصد و حساسیت آن 96 درصد محاسبه گردید. در این مطالعه، بین ابتلا به بیماری و فصل بروز (045/0 = P)، محل سکونت (004/0 = P)، جدید یا کهنه بودن ساختمان مسکونی (003/0 = P) و همچنین، نزدیکی به محل زندگی جوندگان (025/0 = P) رابطه‌ی معنی‌داری وجود داشت. بیشترین رخداد زخم‌های ناشی از Leishmania در نواحی دست و صورت بود.نتیجه‌گیری: شهرستان درگز به عنوان کانون Zoonotic leishmaniasis مطرح بوده است؛ نتایج این مطالعه نشان می‌دهد کانون‌های جدیدی از Anthroponotic leishmaniasis نیز در این منطقه وجود دارد. Leishmania major عامل غالب بروز Leishmaniasis پوستی در این شهرستان بود ولی Leishmania tropica نیز به مقادیر کمتری در آن وجود داشت.

کلیدواژه‌ها

عنوان مقاله [English]

Identification of Cutaneous Leishmaniasis Species in the Dargaz City, Iran

نویسندگان [English]

  • Abdolmajid Fata 1
  • Abdolrahim Rezaei 2
  • Elham Moghaddas 3
  • Faezeh Sadat Mousavi-Vafa 4
  • Seyed Aliakbar Shamsian 5
1 Professor, Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2 Professor, Department of Immunology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3 Assistant Professor, Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
4 MSc Student, Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
5 Associate Professor, Department of Parasitology and Mycology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
چکیده [English]

Background: Cutaneous leishmaniasis is a parasitic skin disease that is endemic in many parts of the world, particularly in Iran. Although the microscopic technique is a common method of diagnosis of leishmaniasis, species of leishmania cannot be differentiated by this method. So, molecular methods have special importance.Methods: In this study, kinetoplast-DNA polymerase chain reaction (kDNA-PCR) method was used to diagnose the leishmania species in Dargaz city, Iran. Direct slide smears were obtained from skin lesions of 94 patients suspected to the leishmaniasis referred to health centers of this city. Smears were stained using Gimsa method. PCR method was performed using specific kDNA primers. Data were analyzed using SPSS software.Findings: Among 94 subjects with skin ulcers suspected to cutaneous leishmaniasis, 82 (87.2%) were positive by direct microscopic smear and 85 (90.4%) by PCR in which 22 patients (26%) had Leishmania tropica and 63 (74%) had Leishmania major. Sensitivity and specificity of direct microscopic examination were calculated as 96% and 100%, respectively. There were statistically significant differences between disease occurrence and seasons (P = 0.045), habitat (P = 0.004), new or old building (new or old) (P = 0.003), and distance to rodents' living sites (P = 0.025).Conclusion: Dargaz city is a known site of zoonotic leishmaniasis in Iran; but this study shows that there are some new sites of anthroponotic leishmaniasis in this city, too. Leishmania major is the dominant species in Dargaz city but there is Leishmania tropica foci in this area, too.

کلیدواژه‌ها [English]

  • Cutaneous leishmaniasis
  • Leishmania. tropica
  • Leishmania.major
  • Polymerase chain reaction
  • Iran

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مجله دانشکده پزشکی اصفهان
دوره 34، شماره 413 - شماره پیاپی 413
بهمن و اسفند 1395
صفحه 1582-1589

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سابقه مقاله

  • تاریخ دریافت: 27 شهریور 1395
  • تاریخ بازنگری: 07 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

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