[Leish-l] Status of PCR for CL diagnosis

[Maxy De los Santos]

Dear leishmaniac colleagues

As you know, tegumentary leishmaniasis has an spectrum of clinical manifestation described by physicians and the molecular detection of parasite by PCR depends enormously of parasite load, time of disease, immune respond of patient, co-infections and treatment received in some cases, in other words: quantity and quality of DNA target.

Although the PCR is a good alternative to detect gDNA or kDNA from parasite, we do not have a consensus and we have multiple DNA targets, protocols and variants with multiple results. Microscopy has been consider a gold standard for leish, even when the sensitivity is less than molecular tools, other strategies as isolation of parasite by culture or genotyping by MLEE spend a lot of time if you need a rapid test for the disease. Molecular tools in general are better alternatives, but need experienced personnel and expensive equipments and reagents, many times impossible to develop in the point of care.

But in resume, I think that the physicians in cooperation with laboratory personnel  from remarkable institutions with broad expertise, both of them should to compare different results to give a diagnostic and appropriate treatment, not only clinical discrimination as a first filter, not only microscopy detection, not only identification by PCR and variants. We need to develop clear guidelines, may be establish a flowchart standardizated to our region, and constant international trainings and updates to share experiences an to be prepared to take the best decision for benefit of each patient.

Regards

Dr. Maxy De los Santos
Parasitology Department
U.S.Naval Medical Research No 6
NAMRU-6
Lima-Peru




________________________________
De: leish-l-bounces at lineu.icb.usp.br <leish-l-bounces at lineu.icb.usp.br> en nombre de Hugo Valdivia <hvalrod at hotmail.com>
Enviado: miércoles, 5 de abril de 2017 15:40
Para: Leish-L
Asunto: Re: [Leish-l] Status of PCR for CL diagnosis

Thank you all for your thoughts and insights, it is fantastic to see all the interaction in the Leish community,


I am fully aware of the advantages of PCR and the clear need of standardization in the region for CL diagnosis. I hope that this issue will be discussed on WorldLeish and could result in better diagnostics for the people who are most affected by this disease.


Thank you,

Hugo Valdivia,




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