BACKGROUND: The control of cutaneous leishmaniasis (CL) is facilitated by knowledge of factors associated with the treatment failures in endemic countries. The aim of this evaluation was to identify the potential risk determinants which might affect the significance of demographic and clinical characteristics for the patients with anthroponotic CL (ACL) and the outcome of meglumine antimoniate (MA) (Glucantime) treatment. METHODOLOGY/PRINCIPAL FINDINGS: This current was executed as a cohort spanning over a period of 5 years which centered in southeastern part of Iran. Altogether, 2,422 participants were evaluated and 1,391 eligible volunteer patients with ACL caused by Leishmania tropica were included. Overall, 1,116 (80.2%) patients received MA intraleisionally (IL), once a week for 12 weeks along with biweekly cryotherapy, while 275 (19.8%) patients received MA alone (20 mg/kg/day for 3 weeks) (intramuscular, IM). The treatment failure rate in ACL patients was 11% using IL combined with cryotherapy plus IM alone, whilst 9% and 18.5% by IL along with cryotherapy or IM alone, respectively. Multivariate logistic regression model predicted 5 major associated-risk determinants including male (odds ratio (OR) = 1.54, confidence interval (CI) = 1.079-2.22, p = 0.018), lesion on face (OR = 1.574, CI = 1.075-2.303, p = 0.02), multiple lesions (OR = 1.446, CI = 1.008-2.075, p = 0.045), poor treatment adherence (OR = 2.041, CI = 1.204-3.46, p = 0.008) and disease duration > 4 months (OR = 2.739, CI = 1.906-3.936, p≤0.001). CONCLUSIONS/SIGNIFICANCE: The present study is the original and largest cohort of ACL patients who treated with MA. A comprehensive intervention and coordinated action by the health authorities and policy-makers are crucial to make sure that patients strictly follow medical instructions. Early detection and effective therapy < 4 months following the onset of the lesion is critical for successful treatment of the patients. Since a significant number of patients are still refractory to MA, reducing man-vector exposure and development of new effective alternative drugs are essential measures against ACL due to L. tropica.

• MeSH
• antiprotozoální látky terapeutické užití   MeSH
• dítě MeSH
• dospělí MeSH
• kohortové studie MeSH
• kojenec MeSH
• kryoterapie metody   MeSH
• Leishmania tropica izolace a purifikace   MeSH
• leishmanióza kožní farmakoterapie   epidemiologie   mikrobiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• meglumin antimoniát terapeutické užití   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• neúspěšná terapie MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Írán epidemiologie   MeSH
• Názvy látek
• antiprotozoální látky MeSH
• meglumin antimoniát MeSH

Cutaneous leishmaniasis (CL) is an important public health problem in Turkey. CL has been most frequently seen in Sanliurfa. There is an expectation of increase in the population of leishmaniasis cases with the influence of Syrian refugees arriving in Turkey. In this study we aimed to diagnosis of CL and identifying of parasite from Leishmania isolates by using ITS 1 PCR RFLP. Samples were collected from 135 CL patients in Sanliurfa. After the specimens were inoculated in medium NNN, the ones which were cultures positive were cultivated in RPMI 1640 followed by PCR-RFLP. Genomic DNA was extracted phenol-chloroform procedure. Samples were examined by using ITS 1 PCR followed by RFLP analysis. Our results indicated that two species, L. tropica (132 samples) and L. major (3 samples), are responsible for cutaneous leishmaniasis in Sanlıurfa. Our study is the first scientific study in which it is reported molecular analyses of cutaneous leishmaniasis cases caused by L. major in Sanliurfa in Southestern Anatolia Region. Because CL cases caused by L.major are detected in our study, it is considered that genotyping is important for diagnosis of Leishmania and following change of epidemiology.

• MeSH
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• kůže mikrobiologie   patologie   MeSH
• Leishmania klasifikace   genetika   MeSH
• leishmanióza kožní diagnóza   epidemiologie   mikrobiologie   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mezerníky ribozomální DNA genetika   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• polymerázová řetězová reakce MeSH
• polymorfismus délky restrikčních fragmentů MeSH
• předškolní dítě MeSH
• protozoální DNA genetika   MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• kojenec MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Geografické názvy
• Turecko epidemiologie   MeSH
• Názvy látek
• mezerníky ribozomální DNA MeSH
• protozoální DNA MeSH

The carbohydrates galactosamine and heparin, previously shown to inhibit phlebotomine lectin activity in vitro, were fed to the sandfly Phlebotomus duboscqi Neveu-Lemaire (Diptera: Psychodidae) with blood, and the effects on mortality, fecundity, protease activity and susceptibility to Leishmania major Yakimoff & Schokhor (Kinetoplastida: Trypanosomatidae) were studied. Previous study revealed that galactosamine considerably enhanced the establishment of L. major infection in P. duboscqi and significantly increased parasite loads in late infections. This work demonstrates a similar but less pronounced effect of heparin. Heparin increased infection rates and parasite loads 3 and 9 days post-feeding but did not affect the location of Leishmania promastigotes and their anterior migration. Galactosamine supplement caused pronounced changes in bloodmeal digestion. It abolished the activity of alkaline proteases and trypsin, caused premature defecation of bloodmeal, increased mortality of female sandflies in days 1-4 post-feeding and decreased their fecundity. Heparin had a less pronounced effect on sandfly physiology. It lowered trypsin activity 12 and 72 h post-bloodmeal but did not alter defecation, mortality and oviposition. The data suggest that the enhancing effect of these carbohydrates on Leishmania infections in sandfly midgut could be explained by their interference with midgut proteases. The study supports the hypothesis that proteolytic activities of midgut proteases strongly influence the vector competence of sandflies.

• MeSH
• endopeptidasy metabolismus   MeSH
• galaktosamin farmakologie   MeSH
• heparin farmakologie   MeSH
• hmyz - vektory metabolismus   mikrobiologie   MeSH
• kur domácí MeSH
• Leishmania major účinky léků   růst a vývoj   MeSH
• leishmanióza kožní mikrobiologie   MeSH
• lektiny antagonisté a inhibitory   metabolismus   MeSH
• lidé MeSH
• Phlebotomus metabolismus   mikrobiologie   MeSH
• trávicí systém enzymologie   metabolismus   MeSH
• trypsin metabolismus   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• endopeptidasy MeSH
• galaktosamin MeSH
• heparin MeSH
• lektiny MeSH
• trypsin MeSH