Genetic Analysis of Cutaneous Leishmania in Ramadi: Species Identification and Report of a Local Genetic Polymorphism.

Cutaneous Leishmaniasis (CL) poses a persistent public health threat in Ramadi, Iraq, where post-conflict environmental degradation and population displacement have altered vector habitats. Accurate species identification remains challenging with traditional diagnostic methods, often hindering effective control in this hyper-endemic setting. This study aimed to characterize the molecular profile of Leishmaniaspecies circulating in Ramadi using Polymerase Chain Reaction (PCR) targeting the Internal Transcribed Spacer 1 (ITS1) region and to assess local epidemiological determinants. Clinical samples were obtained from 60 patients with active ulcerative lesions, from which 38 samples were randomly selected for genomic DNA extraction. The ITS1 region was amplified via PCR, and the resulting products underwent Sanger sequencing and phylogenetic analysis to determine genotypic identities. Statistical analysis revealed a highly significant prevalence of urban infections (66.67%; P ≤ 0.01) compared to rural cases, with peak incidence occurring in February. Clinically, single ulcers were the most common presentation (43.33%). Molecular assays successfully validated diagnoses through specific 300–350 bp amplicons. Significantly, sequencing identified a distinct genetic variant harboring unique local mutations, which was subsequently cataloged in GenBank under accession number PV951494.1. These findings affirm a shift in Ramadi to urban peri-domestic transmission cycles. This study highlights the emergence of a new variant, which increases genetic diversity due to intricate ecological and anthropogenic factors, and molecular surveillance should be integrated as an essential part of intervention strategies in the province of Anbar.