Abstract:
Cutaneous leishmaniasis (CL) caused by Leishmania donovani MON-37 is becoming a major
public health problem in Sri Lanka, with 100 new cases per month being reported in endemic
regions. Diagnosis of CL is challenging for several reasons. Due to relative specificity and
rapidity we propose Fluorescence in Situ Hybridization as a diagnostic tool for CL.
The objective was to evaluate the potential of Fluorescence in Situ Hybridization as
a diagnostic method for Cutaneous leishmaniasis in Sri Lanka.
Literature on current laboratory tests used to diagnose Cutaneous leishmaniasis in Sri
Lanka and globally was reviewed. Sri Lankan data were reviewed systematically following the
PRISMA guidelines. A narrative of the results is presented.
There is currently no gold standard diagnostic method for Cutaneous leishmaniasis. Fluorescence
in Situ Hybridization has been previously applied to detect dermal pathologies including those
involving infectious agents, and its use to detect the Leishmania parasite in human cutaneous
lesions reported in small number of studies, generally with limited numbers of subjects. Advantages
of FISH has been specificity, cost and ease-of-use compared to the alternatives.
Based on the available literature and our current work, FISH has potential for diagnosing CL
and should now be evaluated in larger cohorts in endemic regions. FISH for CL diagnosis
could find application in countries such as Sri Lanka, where laboratory facilities may be
limited in rural areas where the disease burden is highest.
