Detection of Leishmania infantum minicircle kinetoplast DNA in bone marrow and peripheral blood samples of paediatric patients from children's hospital of Tabriz Medical University

Abstract

Visceral leishmaniasis is a life-threatening disease caused by the multiplication of the protozoan parasite Leishmania infantum in the phagocytes of the reticuloendothelial (RE) system. In Northeast Azerbaijan Province of Iran, childhood Visceral Leishmaniasis (VL) is endemic particularly in Kalaibar and Meshkin Shahr region, the areas which lack adequate diagnostic facilities. The disease manifests as the Mediterranean type of Kala-azar, which mainly affect children. Early diagnosis and prompt treatment could prevent its high mortality. In order to study the frequency of this disease in the region and also to examine the applicability and sensitivity of various diagnostic methods in identifying the childhood Visceral Leishmaniasis, a total of 30 blood and bone marrow samples were collected from patients admitted to Children's Hospital of Tabriz Medical University over a 12 months period. These patients showed predominant signs of the disease such as fever and splenomegaly. They were screened for visceral leishmaniasis using various methods such as direct examination, culture isolation, Direct Agglutination Test (DAT) and PCR. Median age of the patients was 32.13 months and the prevalence of the infection was 46.7%. According to these results, PCR which was used to detect L. infantum kinetoplast DNA (kDNA) had the highest sensitivity and specificity using bone marrow aspirate. Other diagnostic protocols were also useful in identifying the disease even though they had a lower sensitivity. é 2008 Asian Network for Scientific Information.