[Not Available].

INTRODUCTION

Biological confirmation of cutaneous leishmaniosis (CL) and identification of species involved are not always available. Zoonotic CL (ZCL) in the center-south and sporadic CL (SCL) in the north are the main forms of the disease in Tunisia. They have recently spread and are now coexisting in several regions.

AIM: To establish simple epidemiological and clinical criteria to improve CL diagnosis and to assess the CL form.

METHODS

Dermal smears of 227 patients suspected of CL were examined by microscopy and then scrapped, the DNAs were extracted and tested by PCR. Epidemiological and clinical data were anonymously collected.

RESULTS

The diagnosis of CL was confirmed by at least one biological test in 76 patients infected in the center-south (ZCL) and 24 patients infected in the north (SCL). CL cases consulted mainly between october and january (66.3% versus 46%; p=0.003). Their lesions were more multiple (48.5% versus 32.5%; p=0.002). Compared to SCL cases, a higher proportion of ZCL cases consulted between october and january (73.7% versus 45.8%; p0.01). Their number of lesions was higher (3.3±0.4 versus 1.2±0.1; p0.0001), with a preferential limb location (80.3% versus 25%; p0.001). Lesions of SCL cases were older (6±1.2 versus 2.2±0.2 months; p0.001) with less ulcerative-crusted presentation (41.6% versus 77.6%; p=0.009).

CONCLUSION

Some easy to collect epidemiological and clinical data would be suggestive of the diagnosis and the form of CL. Collecting these data could improve surveillance of the disease and case management especially in rural areas with few diagnostic facilities.