Six-Year Study on Cutaneous Leishmaniasis in Al-Muthanna, Iraq: Molecular Identification Using ITS1 Gene Sequencing.

BACKGROUND: The current study aimed to determine the prevalence of cutaneous leishmaniasis (CL) in Al-Muthanna province (Iraq) and to characterize the Leishmania species that cause cutaneous lesions through conventional polymerase chain reaction techniques in some patients during the first 7 months of the year 2020. MATERIALS AND METHODS: Medical information on patients with CL was obtained from archived records at the Al-Muthanna Health Office's Public Health Department (2015-2020). In the Al-Hussein Teaching Hospital laboratory, 95 CL samples were collected and examined microscopically for molecular characterization using Giemsa staining. RESULTS: Between 2015 and 2020, 2,325 patients (1,184 men and 1,141 women) were enrolled. Although CL occurred across all age groups, those aged range of 5-14 years had the highest proportion of infections (53.0%). This study found that most infections occurred between December and February, peaking in January. Only 63 of 95 CL samples were positive for the Internal Transcribed Spacer 1 region. L. tropica was found in 39 samples (61.9%), whereas L. major was found in 24 samples (38.1%), in CL patients. Although dermal lesions develop in all body regions, a single lesion is the most common. The upper limbs (13 of 16 samples, 33.3%)were infected with L. tropica, whereas the lower limbs (9 of 14 samples, 37.5%) were infected with L. major. In contrast to L. major, most L. tropica lesions occur in urban areas. CONCLUSION: Our study indicates that CL is endemic in the Al-Muthanna province and that two Leishmania spp. coexist in the province. Molecular diagnosis is a vital component in determining many clinical symptoms of the Leishmania parasite as well as implementing suitable therapeutic, epidemiological, and control strategies.

In vivo comparative study of the efficacy of ß-sitosterol, ketoconazole 2% and mupirocin for the treatment cutaneous leishmaniosis.

Cutaneous leishmaniosis (CL) is an important parasitic disease characterized by specific skin lesion, includes the vector that cause the CL and treatment in general. The study aimed to identify the effect of three different drugs which are ß-sitosterol, ketoconazole 2% and mupirocin in the treatment of cutaneous leishmaniosis. The study was conducted at Dermatological Unit of Al Hussein Teaching Hospital/Thi-Qar/Iraq from October to November 2021. The patients presented with a lesion will be involved in this study and its involved isolation of parasites from the lesion of patients and the parasite was replicated in (NNN) media then the inoculum was concentered. A total of 40 male of mice (Mus musculus) of BALB/c strain injected by parasite suspension, after the appearance of lesion, ß-sitosterol, ketoconazole 2% and mupirocin was applied on a lesions daily for 2 weeks, the statistical analysis was done by SPSS program. In the current study, the ß-sitosterol was most effective in the treatment of skin leishmanial lesion than the other drugs with mean is (11.9±1.449 mm) in compared with the other drugs under P-value < 0.046 with the complete recovery. ß-sitosterol was highly effect on the L. tropica infections with complete recovery and no scar appearance than ketoconazole and mupirocin and can be used for treatment of the disease lesion.

The role of intestinal protozoa in chronic obstructive pulmonary disease exacerbation.

Chronic obstructive pulmonary disease (COPD) is a common respiratory disease with episodes of exacerbation. Variable factors including infectious pathogen can predispose for this exacerbation. The aim of this study is to evaluate the role of intestinal protozoa in COPD exacerbation. A total of 56 patients with COPD were included in this study. Patients were categorized into two groups based on the frequency of exacerbation during the last 6 months: those with ≤1 exacerbation (32 patients) and those with ≥2 exacerbations (24 patients). Stool specimens from each patient were collected two times (one week interval) examined for intestinal parasite. In univariate analysis, rural residence and parasitic infection were more common among patients with frequent exacerbation (45.83% and 33.33%, respectively) than patients with non-frequent exacerbation (18.75% and 9.38%, respectively) with significant differences. However, in multivariate analysis, only body mass index >25 kg/m2 (OR=4.59, 95%CI=1.18-17.86, P=0.028) and parasitic infection (OR=5.51, 95%CI=1.01-30.18, P=0.049) were independently associated with COPD exacerbation. These data indicate a significant association between frequent COPD exacerbation and infection with some intestinal protozoa. However, the cause-effect relationship is debatable.

Evaluation of IL-2, IL-4 and IL-10 levels in patients with giardiosis.

The aim of this study was to determine IL-2, IL-4 and IL-10 levels, in patients with giardiosis and to compare their interleukins levels with healthy controls. A total of 375 patients (211 males, 164 females) in Thi-Qar Province, southern of Iraq were examined. Twenty-four (16 males, 8 females) patients confirm to have giardiosis and 20 healthy control group were withdrawn (5) ml of venous blood to conduct immunological tests to determine the quantitative for level of IL-2, IL-4 and IL-10 in a manner (ELISA). The result showed, the overall infection rate of G. lamblia was 6.40%, according to gender, higher infection rate was recorded in males 7.58% compared to the females rate 4.87% no significant differences were observed between gender. The highest rates of giardiosis observed in age group (30-45), which reached 7.04% and there is no significant difference showed in the infection of different ages under study (P≤0.05). The results showed a significant increases in the level of interleukins and the amount of IL-2, IL- 4 and IL-10 in patients (26.90, 17.43 and 14.71), respectively, was higher than those of healthy control (13.32, 10.25 and 10.55). The conclusion of this study demonstrated that the rate of infection was higher in males than in females and the age group (30-45) have the highest infection rates. The levels of interleukins (IL-2, IL-4 and IL10) were increased in the infected patient when compared to healthy persons, from this, we can deduce that pro-inflammatory and antiinflammatory interleukins have an important role in the infection of Giardia lamblia.