Molecular epidemiology, clinical molecular diagnosis and genetic diversity of cutaneous Leishmaniasis in Jericho, Palestine

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1. Verfasser: Jawabreh, Amer al- 1969- (VerfasserIn)
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Sprache:English
Veröffentlicht: 2005
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adam_text Table of contents ABBREVIATIONS ABSTRACT 1 CHAPTER 1: INTRODUCTION 2 Forward: Molecular epidemiology 2 1.1 Historical background 2 1.2 Clinical symptoms of leishmaniasis 3 1.3 Epidemiology of leishmaniasis 4 1.3.1 Global view 4 1.3.2 Local view 4 1. 4 Leishmaniasis: Public Health Surveillance 5 1.5 Clinical diagnosis and identification 6 1.6 Multilocus enzyme electrophoresis (MLEE) 7 1. 7 Microsatellites 8 1. 7. 1 Mutation mechanism 9 1.7.2 Functions of microsatellites 10 1.7.3 Application of microsatellites for Leishmania strain typing 11 1. 8 Two models for microsatellite evolution 11 1. 9 Genetic distance measures used in microsatellite analyses 12 1. 10 L. major snAL. tropica 13 1. 10. 1. Distribution 13 1. 10.2 Clinical features 16 1. 10.3 Clinical diagnosis and characterization 17 1.10.4 Vector 18 1.10.5 Reservoir 19 1.10.6 Control 20 1.10.7 Treatment 21 1.11 Population genetics of Leishmania parasites 21 1.12 Genetic diversity and bottleneck theory 23 1. 18 Objectives 24 CHAPTER 2: MATERIALS AND METHODS 26 2.1 Clinical molecular diagnosis and local molecular epidemiology 26 2.1.1 Patients and study area 34 2.2 Sample collection 27 2.2.1. Patient data sheets 27 2.2.2. Collection and Giemsa staining of skin scrapings 28 2.2.3. Sampling using filter papers and unstained smears 28 2.2.4. Cultivation of parasites from dermal tissue aspirate 28 2.3. DNA extraction 29 2.3.1 DNA extraction of cultured parasites 29 2.3.2 DNA extraction of Clinical samples 30 2.4 PCR amplification: Internal transcribed spacer (ITS1) 30 2.5 Panel of controls used in diagnostic PCR 32 2.5.1 DNA extraction control 32 2.5.2 Positive and negative controls 33 2.5.3 Inhibition control 33 2.6 RFLP analysis of ITS 1 amplicon 33 : 2.7 Evaluation studies 34 2.7.1 Graded microscopy vs ITS 1 PCR 34 2.7.1.1 Patients and study area 34 2.7.1.2 Sample collection and preparation 34 2.7.1.3 Standardized graded microscopy 35 2.7.2 Filter Paper vs Unstained smears and conventional methods vs PCR 36 2.8 Genetic microsatelite variation and global molecular epidemiology 36 2.8.1 Study area 36 2.9 Microsatellite markers 37 2.9.1 Amplification of microsatellite markers by PCR 38 2.9.2 Polyacrylamide gel electrophoresis (PAGE) 39 2.9.3 Silver staining 39 2.9.4 Capillary electrophoresis (CE) using CEQTM 8000 Beckman coulter 40 2.10 Data analysis: clustering methods and presentation of genetic data 40 2.10.1 Calculating a distance matrix using M1CROSAT. 40 2.10.2 Drawing ofNJ and UPGMA consensus trees using PHYLIP/PAUP 41 v 2.10.3 Structuring populations with Structure 2.0 41 2.10.4 F Statistic by F STAT and GENEPOP 41 2.10.5 Descriptive statistics for for markers by GDA 42 2.11 Epidemiological data banking and analysis: Epi Info™ 42 2.12 Geographical clustering and public health surveillance 42 2. 12. 1 Spatial scan statistics 43 2. 12. 2 Space time scan statistics 43 2. 12.3 Adjustment for season relative risk 44 2. 12. 4 Adjusting for covariates 44 2. 13 Shewhart s Chart 44 CHAPTER 3. RESULTS 46 3. 1. Method comparison 46 3.1.1 Graded microscopy and ITS 1 PCR 46 3.1.1.1 Positivity rates and sensitivities of ITS 1 PCR and graded microscopy 46 3.1.1.2 Statistical comparison of sensitivities 46 3.1.1.3 Diagnostic relevance of ITS 1 PCR 47 3.1.2 Clinical diagnosis of cutaneous leishmaniasis: filter paper and unstained smears as potential sampling methods for ITS1 PCR 50 3.2 Molecular epidemiology 54 3.2.1 L. major vs. L. tropica in Jericho 54 3.2.2 Sex age group distribution 57 3.2.3 Annual rain fall (ARF) and CL 59 3.2.4 SeasonalityofCL 60 3.3 Public health surveillance and cluster analysis 62 3.3.1 Descriptive data of CL cases 62 3.3.2 Purely spatial analysis, adjusted for season 63 3.3.3 Space time analysis, adjusted for season 64 3.4 Shewhart s Plot: Early warning system 66 3.5 Genetic variability within L. major as revealed by Multilocus Microsatellite Analysis (MLMT) 67 3.5.1 Description of the microsatellite markers used in this study 67 3.5.2 Assignment of multilocus microsatellite profiles to the strains of L. major under study 70 vi 3.5.3 Population structure ofL. major using structure 76 3.5.3.1 Estimation of population structure using non predefined populations 76 3.5.3.2 Estimation of population structure using predefined population 79 3.5.4 Analysis of L. major population structure using distance based methods 80 3.5.5 Genetic isolation of the L. major populations identified in this study 85 3.5.6 Estimation of allele numbers in geographical groups of strains 86 CHAPTER 4: DISCUSSION 88 4. 1. Method comparison 46 4.1.1 Graded microscopy and ITS 1 PCR 88 4.1.2 Clinical diagnosis of cutaneous leishmaniasis 91 4.2 Molecular epidemiology 96 4.2.2 Seasonally of CL 98 4.3 Public health surveillance and cluster analysis 99 4.4 Multilocus microsatellite analysis and population structure 103 4.4.1 Optimal number of markers and isolates 103 4.4.2 Distance and model based methods: congruence and contradiction 105 4.4.3 Origin of L. major and bottleneck theory 106 4.5 Recommendations 107 REFERENCES 110 ACKNOWLEDGEMENTS 146 CV 147 ERKLARUNG 152 vii
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spellingShingle Jawabreh, Amer al- 1969-
Molecular epidemiology, clinical molecular diagnosis and genetic diversity of cutaneous Leishmaniasis in Jericho, Palestine
subject_GND (DE-588)4113937-9
title Molecular epidemiology, clinical molecular diagnosis and genetic diversity of cutaneous Leishmaniasis in Jericho, Palestine
title_auth Molecular epidemiology, clinical molecular diagnosis and genetic diversity of cutaneous Leishmaniasis in Jericho, Palestine
title_exact_search Molecular epidemiology, clinical molecular diagnosis and genetic diversity of cutaneous Leishmaniasis in Jericho, Palestine
title_full Molecular epidemiology, clinical molecular diagnosis and genetic diversity of cutaneous Leishmaniasis in Jericho, Palestine von Amer al-Jawabreh
title_fullStr Molecular epidemiology, clinical molecular diagnosis and genetic diversity of cutaneous Leishmaniasis in Jericho, Palestine von Amer al-Jawabreh
title_full_unstemmed Molecular epidemiology, clinical molecular diagnosis and genetic diversity of cutaneous Leishmaniasis in Jericho, Palestine von Amer al-Jawabreh
title_short Molecular epidemiology, clinical molecular diagnosis and genetic diversity of cutaneous Leishmaniasis in Jericho, Palestine
title_sort molecular epidemiology clinical molecular diagnosis and genetic diversity of cutaneous leishmaniasis in jericho palestine
topic_facet Hochschulschrift
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