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Molecular Epidemiology of American Tegumentary Leishmaniasis in Panama

American tegumentary leishmaniasis is an increasing public health problem in Panama. This study describes the clinical characteristics and the molecular epidemiology of leishmaniasis in Panama over a 5-year period (2004–2008). Additionally, we applied a polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP)–based assay to identify Leishmania species in clinical isolates, skin scrapings, and sandflies specimens. Whereas 60.3% of cases were detected with conventional parasitologic techniques (smear or in vitro culture), the PCR detected 72% positive patients. Our clinical-epidemiologic data corroborate the high incidence of L. (Viannia) panamensis and provide evidence of peridomestic and/or domestic transmission. Mucosal involvement was observed in 4.2% of the patients. The overall natural infection rate with Leishmania in 103 pools of sandflies was 0.46%. Lutzomyia gomezi and Lutzomya panamensis were the prevalent species incriminated as vectors at the capture sites in central Panama. This study contributes to a better knowledge of the current epidemiology of tegumentary leishmaniasis in Panama.

Received May 27, 2008. Accepted for publication July 6, 2009.

Acknowledgments: The authors acknowledge with appreciation the field and technical assistance of Salomon Puga, Roberto Rojas, and Jose Montenegro. Leishmania reference strains were kindly donated by Dr. Octavio E. Sousa, Center for Research and Diagnosis of Parasitic Diseases, Faculty of Medicine, University of Panama.

Financial support: This study received financial support from Grant RLA 6050, International Atomic Energy Agency and from the Research Fund of Instituto Conmemorativo Gorgas de Estudios de la Salud.

^* Address correspondence to Jose E. Calzada, Instituto Conmemo-rativo Gorgas de Estudios de la Salud, ICGES, Apartado Postal No. 0816-02593, Panamá Rep. De Panamá. E-mail: jcalzada{at}gorgas.gob.pa

Authors’ addresses: Aracelis Miranda, Ricardo Carrasco, Hector Paz, Juan M. Pascale, Franklyn Samudio, Azael Saldaña, Giovanna Santamaría, Yaxelis Mendoza, and Jose E. Calzada, Instituto Conmemorativo Gorgas de Estudios de la Salud, ICGES, Apartado Postal No. 0816-02593, Panamá Rep. De Panamá, Tel: 507-527-4811, Fax: 527-527-4366, E-mail: jcalzada{at}gorgas.gob.pa.