EVALUATION OF THE POLYMERASE CHAIN-REACTION IN THE DIAGNOSIS OF CUTANEOUS LEISHMANIASIS DUE TO LEISHMANIA-MAJOR - A COMPARISON WITH DIRECT MICROSCOPY OF SMEARS AND SECTIONS FROM LESIONS

We have compared the sensitivity of the polymerase chain reaction (PCR ) as a diagnostic tool against conventional microscopical diagnostic t echniques in patients with cutaneous leishmaniasis from the Sudan. Twe nty-eight patients were diagnosed according to clinical criteria follo wed by microscopical examination of histological sections and slit or impression smears. The PCR had a sensitivity of 86% when used alone, a nd 93% when combined with Southern blotting. In contrast, microscopy o f histological sections had a sensitivity of 76% and slit and impressi on smears of only 55% and 48%, respectively. The PCR should be conside red as a valuable and sensitive diagnostic tool in the diagnosis of cu taneous leishmaniasis; it has the added advantage of identification of the species of Leishmania causing the lesion.