Parasites belonging to
Leishmania braziliensis
,
Leishmania donovani
,
Leishmania mexicana
complexes and
Trypanosoma cruzi
(clones 20 and 39) were searched in blood, lesions and strains collected from
28 patients with active cutaneous leishmaniasis and one patient with visceral
leishmaniasis. PCR-hybridization with specific probes of
Leishmania
complexes (
L. braziliensis
,
L. donovani
and
L. mexicana
) and
T. cruzi
clones was applied to the different DNA samples. Over 29 patients, 8 (27.6%)
presented a mixed infection
Leishmania
complex species, 17 (58.6%) a mixed infection
Leishmania-T. cruzi
, and 4 (13.8%) a multi
Leishmania-T. cruzi
infection. Several patients were infected by the two Bolivian major clones
20 and 39 of T. cruzi (44.8%). The
L. braziliensis
complex was more frequently detected in lesions than in blood and a reverse
result was observed for
L. mexicana
complex. The polymerase chain reaction-hybridization design offers new arguments
supporting the idea of an underestimated rate of visceral leishmanisis in Bolivia.
Parasites were isolated by culture from the blood of two patients and lesions
of 10 patients. The UPGMA (unweighted pair-group method with arithmetic averages)
dendrogram computed from Jaccard's distances obtained from 11 isoenzyme loci
data confirmed the presence of the three Leishmania complexes and undoubtedly
identified human infections by
L. (V.) braziliensis
,
L. (L.) chagasi
and
L. (L.) mexicana
species. Additional evidence of parasite mixtures was visualized through mixed
isoenzyme profiles,
L. (V.) braziliensis-L. (L.) mexicana
and
Leishmania
spp.-
T. cruzi
. The epidemiological profile in the studied area appeared more complex than
currently known. This is the first report of parasitological evidence of Bolivian
patients with trypanosomatidae multi infections and consequences on the diseases'
control and patient treatments are discussed.
