Molecular Characterization of <i>Leishmania</i> Species among Patients with Cutaneous Leishmaniasis in Asir Province, Saudi Arabia

• Published in: Pathogens
• Main Authors: Yasser Alraey, Rasha Alhweti, Hatim Almutairi, Abdulrahman Abdullah Al-Qahtani, Mohammed Ibrahim Alshahrani, Mohammed Hussin Asiri, Abdulrhman Mousa Alhammas, Saeed Jubran Alwagdi, Abdulaziz Alshahrani, Abdulaziz Alouffi, Aymen M. Madkhali, Waleed S. Al-Salem, Ahmed A. Al-Qahtani, Ahmed Saif, Sami Ben Hadj Ahmed, Elyes Zhioua
• Format: Article
• Language: English
• Published: MDPI AG 2022-12-01
• Subjects: anthroponotic cutaneous leishmaniasis; zoonotic cutaneous leishmaniasis; <i>Leishmania tropica</i>; <i>Leishmania major</i>; co-circulation; molecular identification
• Online Access: https://www.mdpi.com/2076-0817/11/12/1472

Anthroponotic cutaneous leishmaniais (ACL) and zoonotic cutaneous leishmaniasis (ZCL) caused by <i>Leishmania tropica</i> and <i>Leishmania major</i>, respectively, are endemic vector-borne diseases in southern Saudi Arabia. In 2021, an outbreak of cutaneous leishmaniasis occurred in the province of Asir. The main objective of our investigation was to analyze the epidemiological features of CL in southern Saudi Arabia. The ministry of health recorded 194 CL patients between January and December 2021 from the Asir province. Our findings showed that the majority of CL patients (87.1%) originated from the governorates of Khamis-Mushait and Abha. Most of the patients were males (62.3%). While CL affected all age groups, those under 13 years old were the most affected (38.1%). For both genders, CL patients were mostly Saudi citizens (90.7%) compared to non-Saudi expatriates. The majority of CL patients (75.2%) suffered from a single lesion, and the majority of lesions (61.3%) were located on the face. The seasonal prevalence of CL showed two peaks, a small one in July–August and a larger one in March. Of a total of 194 Giemsa slides samples, 188 showed positive amplification of <i>Leishmania</i> ITS1 gene. Based on PCR-RFLP and PCR-HMR, 183 patients showed positive amplification of <i>L. tropica</i> and five patients showed positive amplification of <i>L. major</i>. Phylogenetic analysis revealed a clear distinct separation between <i>L. major</i> and <i>L. tropica</i> sequences. Our results provided strong evidence of the pre-domination of <i>L. tropica</i>, the main etiological agent of ACL in Asir province. We reported for the first time the presence of <i>L. major</i>, an etiological agent of ZCL in the study areas. The co-circulation of ACL and ZCL highlighted the complexity of the epidemiology of CL in southern Saudi Arabia, and subsequently, further studies to identify competent vectors and reservoir hosts for the establishment of control strategies are needed.