Filter paper performance in PCR for cutaneous leishmaniasis diagnosis

Abstract INTRODUCTION: The objective of this study was to evaluate the performance of filter paper (FP) for lesion scraping collection in a polymerase chain reaction (PCR) for cutaneous leishmaniasis (CL) diagnosis. METHODS: Lesion scrapings from 48 patients were collected and analyzed for PCR. RESULTS: PCR with FP detected up to three Leishmania braziliensis promastigotes. Considering the direct search by microscopy or PCR of samples collected in STE buffer as standards, the sensitivity of PCR with FP was 100%. CONCLUSIONS: FP can be useful for CL diagnosis in remote regions, allowing high sensitivity in the detection of the parasite by PCR.

Epidemiological and clinical characteristics of cutaneous leishmaniasis and their relationship with the laboratory data, south of Brazil

OBJECTIVE: To evaluate clinical, epidemiological and laboratorial aspects for the understanding of the disease characteristics and its relationship with diagnostic tests. METHODS: A retrospective, descriptive and analytical study involving 2,660 American cutaneous leishmaniasis (ACL) suspected patients from southern Brazil was undertaken between April 1986 and December 2005. Data on population characteristics and laboratory tests were obtained. Diagnostic laboratory tests used were direct search for Leishmania spp. (DS), Montenegro skin test (MST) and indirect immunofluorescent assay (IFA). RESULTS: 62.3 percent of patients were positive for at least one laboratory test. DS test was positive in 65.1 percent; MST in 92.3 percent and IFA in 70.0 percent. Although Cohen's Kappa test did not reveal any agreement with laboratory diagnosis for ACL, the association between MST and IFA tests increased positiveness to 98.9 percent; MST and DS to 97.2 percent; and IFA and DS to 85 percent. IFA and MST positiveness were higher among patients with < 2-month lesion-evolution time. Most ACL patients were male (72.6 percent) in the age range of 15-49 years, featuring lesions during two months or less (53.9 percent) and a cutaneous form of the disease (88.0 percent). CONCLUSION: Findings suggest that for the adequate identification of ACL cases a combination of laboratory tests that involves the association of MST with at least another test should be used.

Polymerase chain reaction with lesion scrapping for the diagnosis of human American tegumentary leishmaniasis

The objective of this work was to compare the polymerase chain reaction (PCR) using lesion scrapping with other conventional techniques for the diagnosis of the American tegumentary leishmaniasis (ATL). For this, patients with cutaneous lesions suspected to be ATL were studied. The DNA was amplified with the MP1L/MP3H primers. From the 156 studied patients, 79 (50.6 percent) presented positive parasite direct search (PD), 81 (51.9 percent) had positive Montenegro skin test (MST), and 90 (57.7 percent) presented PD and/or MST positive. The PCR was positive in all of the positive-PD patients (100 percent sensitivity), in 91.1 percent of the positive PD and/or MST patients, and in 27.3 percent of the patients that presented negative PD and positive MST. The PCR positivity was similar to the PD (P = 0.2482) and inferior to the MST (P = 0.0455), and to the PD/MST association (P = 0.0133). The high PCR sensitivity, and positivity in those cases where the PD was negative, highlights the importance of this technique as an auxiliary tool for the diagnosis of ATL.

Controle de parasitores intestinais na comunidade do Núcleo Habitacional Santa Felicidade de Maringá, Paraná, Brasil / Control of intestinal parasitoses in the community of Núcleo Habitacional Santa Felicidade of Maringá, state of Paraná, Brazil

Relata-se a experiência do desenvolvimento de projeto envolvendo diagnóstico e controle de parasitoses intestinais junto aos moradores do Núcleo Habitacional Santa Felicidade, em Maringá. 0 projeto compreendeu avaliação do perfil socioeconômico das familias, investigação da prevalência de parasitoses intestinais, atividades de educação sanitária e tratamento dos individuos infectados. Infecções por protozoários e/ou por helmintos foram encontradas em 47,0 por cento e em 49,4 por cento da população examinada. Exames parasitológicos de fezes, realizados após tratamento, revelaram que foram baixas as taxas de cura obtidas. Embora o projeto tenha permitido o levantamento da real situação das parasitoses intestinais, bem como o tratamento de parte dos indivíduos infectados e a troca entre o saber acadêmico e o saber popular, os resultados da intervenção proposta não foram satisfatórios. As dificuldades encontradas e o baixo impacto das medidas propostas sobre o controle das parasitoses intestinais podem estar associados ao baixo nível social e econômico em que vive essa comunidade. Ações outras que resultem em melhora no nível educacional e consequentemente no nível econômico das famílias são necessárias junto a essa comunidade