MOLECULAR EPIDEMIOLOGY OF CUTANEOUS LEISHMANIASIS IN SOUTHERN BELT OF KHYBER PAKHTUNKHWA, PAKISTAN

† contributed equally ABSTRACT Cutaneous leishmaniasis is a vector-born disease caused by the flagellate parasite Leishmania tropica. Diagnosis by PCR is becoming a ʹgold standardʹ technique. This study was aimed to investigate the prevalence of Cutaneous Leishmaniasis and to determine the usefulness of kDNA-PCR for the diagnosis of Leishmania tropica. Exudates smears/ skin biopsy of 133 suspected individuals of Cutaneous Leishmaniasis were included in this study. All the samples were analysed with microscope and kDNA-PCR for detection of Lesihmania tropica. The study population in the endemic regions suggested the highest sensitivity of 78.8% of CL in men than women 72.2% by kDNA-PCR. While the microscopy findings were 60.5% in males and 40.4% in females, followed by 94.1% confirmation by kDNA-PCR and 70.5% detection by microscopy in male's age group 21-30 years while 75.0% kDNA-PCR confirmation and 41.6% microscopy positivity in same age group of females. Face was found to be more infected 88.5% with lesion duration 4-6 months having sensitivity of 85.2% by kDNA-PCR as compared to 65.4% detection but sensitivity of 61.8% by microscopy. The highest epidemics 86.4% and 61.4% of Lesihmania tropica were found in North Waziristan Agency by kDNA-PCR and microscopy respectively. For sampling methods, kDNA-PCR showed greater sensitivity 81.4% for dermal scraping than 69.9% Whatman sterile paper.