Comparative investigation of Leishmania parasites with new micro culture method and other methods in donor blood samples which are obtained from blood centers in Istanbul

Leishmaniasis is a zoonotic disease which occurs by a compulsory intracellular protozoon Leishmania species. According to the World Health Organization (WHO) leishmaniasis is threatening 350 million people in 98 countries in which 72 of these countries is developing countries. There are approximately 12 million cases worldwide. It is estimated that every year 500 thousand people are being added to this number and 75 thousand people going to die according to this disease. Recently, the basic reason of the disease?s expanding is emerging resistance to the insecticides in vectors and to drugs in parasites. Furthermore vaccines are inefficient improving against leishmaniasis up to now. In addition global warming is indicating this disease?s effect area in the world including Europe countries, so this situation is being increase the importance of the problem. Leishmania parasites are being transmitted by Phlebotomus bites, blood transfusion, organ transplantation and etc. Additionally it?s known that the disease can be transmitted by donor bloods and this subject is producing a current problem. Transmitting the disease by donor bloods not only has a vital importance as epidemiologically but also important for the health of blood receivers. It?s difficult to determinate the transmitting with blood transfusion but in endemic areas there are evidences about transmitting the Leishmania parasite between blood donors and blood receivers. Furthermore according to WHO, the number of symptomatic patient is just 5-20 % of total patients.There are different studies on donor bloods in the endemic countries of the world but in our country there is no study about this subject. Accordingly in this thesis study for the first time, different Leishmania diagnostic methods and micro culture method (MCM) investigated by comparing to identify Leishmania parasites in the donor blood samples. Because MCM is highly specific and sensitive for symptomatic visceral leishmaniasis but the sensitivity of the MCM is not known in asymptomatic healthy individuals or donors. Obtained 343 donor blood samples from the Çapa Red Crescent Blood Center were analyzed by microscopic (smear), culture (NNN agar and MCM), serological (IFAT, ELISA and ICT) and molecular (PCR) methods. Twenty-six of (7.58 %) the investigated 343 donor blood samples were identified as positive for Leishmania parasites with the applied methods. The sensitivity was calculated as considered that these 26 donors were probably infected when was one of the techniques gave a positive result. The sensitivity assessment was 58 % for MCM, 15 % for smear, 4 % for NNN agar, 11 % for PCR and 4 % for ICT. Furthermore the sensitivity calculated 38 % for IFAT-L. infantum, 23 % for IFAT-L. tropica and 35 % for ELISA-L. infantum, 19 % for ELISA-L. tropica. Thus, for the first time, in donor bloods as a result of investigation in comparison MCM with other methods used in the diagnosis of leishmaniasis, in samples which are obtained from the blood bank for the detection of Leishmania parasites have emerged as the most sensitive method MCM. In addition, for the first time in Turkey such as Istanbul, which is a non-endemic region, the presence of Leishmania parasites in the blood donors has been identified. Serological methods, IFAT and ELISA, also showed a high sensitivity according to the other used methods. However, as a parasitological definitive diagnosis based on the parasite itself or its molecular characteristics. MCM can be suggested for diagnosis of asymptomatic healthy individuals, because the serological methods could be given cross-reaction.As a result, obtained blood from blood banks, must be checked before giving people according to leishmaniasis with MCM which easy to apply, non-invasive and economical. Arrangements such as physicians informing about the diagnosis of Leishmania and screening of blood banks according to leishmaniasis should be made. For this purpose, studies must be started for considering this issue by the Turkish Ministry of Health.