Table 5.
Serial qPCR studies recommended for detection and species discrimination of Leishmania spp. in clinical or environmental specimens based on geographic region
| Region | Clinical syndromea | Expected Leishmania species | 1st step: detection | 2nd step: species discrimination |
|---|---|---|---|---|
| North, Central, and South America | LCL | L. (L.) amazonensis | kDNA 1 | kDNA 1 melt curve |
| L. (L.) mexicana | L. braziliensis kDNA 3 | MAG 1 melt curve | ||
| L. (V.)b braziliensis, L. (V.) panamensis, L. (V.) guyanensis | L. braziliensis kDNA 3 | |||
| L. (L.) infantum chagasi (rare) | SLACS | |||
| North, Central, and South America | MCL, DL, DCL | L. (V.) braziliensis, L. (V.) panamensis, L. (V.) guyanensis | L. amazonensis kDNA 3 | L. amazonensis kDNA 3 melt curve |
| L. (L.) amazonensis | L. braziliensis kDNA 3 | L. braziliensis kDNA 3 | ||
| L. (L.) mexicana | SLACS | |||
| North, Central, and South America | VL | L. (L.) infantum | kDNA 2 | kDNA 2c |
| L. (L.) amazonensis (rare) | L. amazonensis kDNA 4 | L. amazonensis kDNA 4c | ||
| Europe | VL | L. (L.) infantum | kDNA 1 | MAG 1 melt curve |
| L. (L.) donovani | ||||
| Middle East and Northern and sub-Saharan Africa | CL, DCL, LR | L. (L.) major | kDNA 1 | kDNA 1 melt curve |
| L. (L.) tropica | L. tropica cytochrome B 1c | |||
| L. (L.) infantum (rare) | MAG 1 melt curve | |||
| L. (L.) donovani (rare) | ||||
| Middle East and Northern and sub-Saharan Africa | VL, PKDL | L. (L.) infantum | kDNA 1 | kDNA 1 melt curve |
| L. (L.) donovani | L. tropica cytochrome B 1c | |||
| L. (L.) tropica (rare) | MAG 1 melt curve | |||
| India/Bangladesh/Pakistan/Nepal | VL, PKDL | L. (L.) donovani | kDNA 1 to 7 (any) | |
| Asia | VL | L. (L.) donovani | kDNA 1 to 7 (any) |
a
Clinical syndromes are as follows: DCL, diffuse cutaneous leishmaniasis; DL, disseminated leishmaniasis; LCL, localized cutaneous leishmaniasis; LR, leishmaniasis recidivans; MCL, mucocutaneous leishmaniasis; VL, visceral leishmaniasis; CL, cutaneous leishmaniasis; and PKDL, post-kala-azar dermal leishmaniasis.
b
V. refers to parasites belonging to the subgenus Leishmania Viannia. All other species listed belong to the Leishmania Leishmania subgenus.
c
This marker amplifies only one species listed in the 3rd column of this row.