Authors:
Address: Tropical Medicine Foundation of Amazonas, Manaus, Brazil.
Journal:

Publication:

abstract

BACKGROUND:

the Amazon region corresponds to approximately 40% of the cases of Leishmaniasis in Brazil. We report a prospective study with 180 patients conducted in a health care unit that diagnoses 10% of the cases of leishmaniasis in the Brazilian Amazon. The study addresses how a combination of procedures improves diagnosis in areas with high prevalence of Leishmania guyanensis.

OBJECTIVES:

to evaluate diagnostic methods in areas with high prevalence of Leishmania guyanensis.

METHODS:

All subjects were amastigote-positive by direct microscopic examination of lesion scarifications. We conducted skin biopsy and histopathology, polymerase chain reaction and parasite cultivation.

RESULTS:

Polymerase chain reaction detected almost ninety percent of infections when two amplification protocols were used (mini-exon and HSP-70). HSP-70 specific polymerase chain reaction matched the sensitivity of parasite cultivation plus histopathology.

CONCLUSION:

The best combination was polymerase chain reaction plus histopathology, which increased diagnostic sensitivity to 94%. Species discrimination by polymerase chain reaction disclosed prevalence of human infections with Leishmania guyanensis of 94% and with Leishmania braziliensis of 6% for this region.

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