Isoenzyme characterization of Leishmania isolates from Lebanon and Syria

Leishmania parasites were isolated from 22 Lebanese and 5 Syrian patients with active skin lesions for whom the diagnosis was confirmed by histopathological examination. The isolates were characterized by starch gel electrophoresis and analysis of 13 enzyme systems. Eight Old-World reference strains were used for comparison. One Syrian isolate belonged to Leishmania major, and four Syrian and two Lebanese to Leishmania tropica. Contrary to expectations, the majority of Lebanese isolates were related to the Leishmania donovani complex, and more particularly Leishmania infantum.

The epidemiology of leishmaniases in Lebanon

The prevalence of leishmaniasis in Lebanon was studied in 1993-97 for a Lebanese population sample of about 81,000 subjects (60% rural and 40% urban) constituting roughly 3.4% of the total population. The prevalence of cutaneous leishmaniasis was found to be 0.18% in the rural versus 0.41% in the urban areas. Visceral leishmaniasis was practically non-existent in both environments. In addition, skin tests were done and anti-Leishmania antibodies were sought in a sample of the population at risk in the rural area. Skin tests were positive in 2.5% of the tested subjects, and 1% of the normal population had elevated levels of anti-Leishmania antibodies. The difference between the prevalence of clinical disease and positive skin testing and/or antibodies may be due to the existence of past or present subclinical disease. An unexpected finding was that the prevalent dermotropic parasite in Lebanon belongs to the L. donovani complex. Further characterization of the isolates by molecular techniques and definition of the transmission cycle of this parasite may explain our epidemiological findings.

Identification of Leishmania isolates from a Lebanese population

We report the results of enzymatic patterns of isolates of Leishmania cultured from patients referred to Department of Dermatology of the American University of Beirut Medical Center in Lebanon. The results reveal that these Lebanese isolates are all very similar despite variable clinical presentations of the patients and differences in geographic origin. Leishmania donovani sensu lato is the dominant species present in the skin lesions observed; thus, clinical manifestations and/or geographic distribution cannot be used as reliable criteria for identifying Leishmania parasites from this geographic area. Enzyme data should be combined with these parameters before definitive identification can be made.