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      Efficiency of noninvasive sampling methods (swab) together with Polymerase Chain Reaction (PCR) for diagnosing American Tegumentary Leishmaniasis

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          ABSTRACT

          Traditional diagnostic methods used to detect American Tegumentary Leishmaniasis, such as histopathology using biopsy samples, culture techniques, and direct search for parasites, have low sensitivity and require invasive collection procedures. This study evaluates the efficiency of noninvasive sampling methods (swab) along with Polymerase Chain Reaction (PCR) for diagnosing American Tegumentary Leishmaniasis using skin and mucous samples from 25 patients who had tested positive for leishmaniasis. The outcome of the tests performance on swab samples was compatible with PCR results on biopsy samples. The findings have also shown that PCR-kDNA test is more efficient than PCR-HSP70 and qPCR tests (sensitivity of 92.3%, 40.7%, and 41%, respectively). Given the high sensitivity of the tests and the fact that the sampling method using swabs affords greater patient comfort and safety, it could be said that this method is a promising alternative to conventional biopsy-based methods for the molecular diagnosis of leishmaniasis.

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          Most cited references30

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          Current diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis.

          Tegumentary leishmaniasis, comprising the cutaneous and mucocutaneous forms, is caused by at least 13 dermotropic species of protozoa of the genus Leishmania, most of which are prevalent in the New World. Although diseases in the Old and New Worlds share similar characteristics, the ultimate manifestations and severity are quite different, with more severe forms associated with mucosal lesions observed in the New World. For the diagnosis and treatment of leishmaniasis, differences based on clinical features, usefulness/sensitivity of diagnostic methods and therapeutic responses are mainly emphasized. We present a critical review of the diagnostic methods, their contribution and the necessity for their improvement/development, particularly in molecular diagnosis aimed at detection and species identification, as well as serodiagnosis. In addition to a review of the drugs currently utilized, we describe differences in their effectiveness in Old and New World leishmaniasis. HIV/Leishmania coinfection is also presented in the context of diagnosis and treatment.
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            Molecular diagnosis of leishmaniasis: current status and future applications.

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              Cutaneous and mucocutaneous leishmaniasis.

              Leishmaniasis is a cluster of diseases caused by protozoa in the genus Leishmania. There are three basic clinical forms: cutaneous, mucocutaneous, and visceral leishmaniasis. The present review focuses on the diagnosis and treatment of cutaneous and mucocutaneous leishmaniasis. Characteristics of both the human host and the parasite species influence the clinical disease manifestations that range from asymptomatic exposure, to self-healing skin ulcers, to life-threatening widespread destructive ulcerations. Whether through medical treatment or through spontaneous resolution, skin ulcerations generally result in disfiguring scars with significant social and economic impact. Tests to confirm the diagnosis should be performed on patients who have recently visited endemic areas and have skin or mucosal manifestations consistent with leishmaniasis. Treatment depends on the species of Leishmania and the risk of widespread or disfiguring disease. Because of increasing trends in global travel, educating health care providers to recognize and treat leishmaniasis in both endemic and non-endemic countries is imperative.
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                Author and article information

                Journal
                Rev Inst Med Trop Sao Paulo
                Rev. Inst. Med. Trop. Sao Paulo
                rimtsp
                Revista do Instituto de Medicina Tropical de São Paulo
                Instituto de Medicina Tropical
                0036-4665
                1678-9946
                01 June 2017
                2017
                : 59
                : e38
                Affiliations
                [(1) ]normalizedCentro Universitário Cesumar orgnameCentro Universitário Cesumar orgdiv1Departamento de Biomedicina Maringá ParanáBraziloriginalCentro Universitário Cesumar, Departamento de Biomedicina, Maringá, Paraná, Brazil
                [(2) ]normalizedUniversidade de São Paulo orgnameUniversidade de São Paulo orgdiv1Faculdade de Medicina orgdiv2Departamento de Moléstias Infecciosas São Paulo São PauloBraziloriginalUniversidade de São Paulo, Faculdade de Medicina, Departamento de Moléstias Infecciosas, São Paulo, São Paulo, Brazil
                [(3) ]orgnameInstituto de Infectologia Emilio Ribas São Paulo São PauloBraziloriginalInstituto de Infectologia Emilio Ribas, São Paulo, São Paulo, Brazil
                [(4) ]normalizedUniversidade de São Paulo orgnameUniversidade de São Paulo orgdiv1Instituto de Medicina Tropical de São Paulo orgdiv2Laboratório de Soroepidemiologia e Imunobiologia São Paulo São PauloBraziloriginalUniversidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Soroepidemiologia e Imunobiologia (LIM 38 HC-FMUSP), São Paulo, São Paulo, Brazil
                Author notes
                Correspondence to: José Angelo Lauletta Lindoso Universidade de São Paulo, Instituto de Medicina Tropical de São Paulo, Laboratório de Soroepidemiologia e Imunobiologia, Av. Dr. Enéas Carvalho de Aguiar, 470, CEP 05403-000, São Paulo, SP, Brazil Tel: +55 11 3061 7023. E-mail: jlindoso@ 123456usp.br
                Article
                00220
                10.1590/S1678-9946201759038
                5459545
                28591266
                72b4ee03-d083-401b-8c60-d9f40909d875

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 September 2016
                : 22 February 2017
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 34, Pages: 1
                Categories
                Original Article

                tegumentary leishmaniasis,polymerase chain reaction,swab,leishmania braziliensis

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