{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:11:13Z","timestamp":1790295073720,"version":"4.1.0"},"reference-count":92,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T00:00:00Z","timestamp":1630454400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["Elisa Cupolillo - Finance Code 001"],"award-info":[{"award-number":["Elisa Cupolillo - Finance Code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["Elisa Cupolillo - Researcher Fellow - 302622\/2017-9"],"award-info":[{"award-number":["Elisa Cupolillo - Researcher Fellow - 302622\/2017-9"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003593","name":"Conselho Nacional de Desenvolvimento Cient\u00edfico e Tecnol\u00f3gico","doi-asserted-by":"publisher","award":["Instituto Nacional de Ci\u00eancia e Tecnologia da Amaz\u00f4nia Ocidental - INCT EpiAmO (465657\/2014-1)"],"award-info":[{"award-number":["Instituto Nacional de Ci\u00eancia e Tecnologia da Amaz\u00f4nia Ocidental - INCT EpiAmO (465657\/2014-1)"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004586","name":"Funda\u00e7\u00e3o Carlos Chagas Filho de Amparo \u00e0 Pesquisa do Estado do Rio de Janeiro","doi-asserted-by":"publisher","award":["Elisa Cupolillo - CNE, E26-202.569\/2019"],"award-info":[{"award-number":["Elisa Cupolillo - CNE, E26-202.569\/2019"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Funda\u00e7\u00e3o de Amparo ao Desenvolvimento das A\u00e7\u00f5es Cient\u00edficas e Tecnol\u00f3gicas e \u00e0 Pesquisa \u2013 FAPERO","award":["Universal Fapero 003\/2015 (01.1331.00032.029\/2015), PAP-PRO-RO (01133100038-0000.75\/2016); PPSUS 003\/2016 (01133100051-0000.83\/2015), Chamada 009\/2016 (33621.506.20448.26082016)"],"award-info":[{"award-number":["Universal Fapero 003\/2015 (01.1331.00032.029\/2015), PAP-PRO-RO (01133100038-0000.75\/2016); PPSUS 003\/2016 (01133100051-0000.83\/2015), Chamada 009\/2016 (33621.506.20448.26082016)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>The northern region of Brazil, which has the largest number of cases of tegumentary leishmaniasis (TL) in the country, is also the region that has the highest diversity of species of vectors and Leishmania parasites. In this region, cases of mucosal leishmaniasis (ML), a clinical form of TL, exceed the national average of cases, reaching up to 12% of the total annual TL notifications. ML is associated with multiple factors, such as the parasite species and the viral endosymbiont Leishmania RNA virus 1 (LRV1). Being a chronic parasitological disease, laboratory diagnosis of ML poses a challenge for health services. Here, we evaluated more than 700 clinical samples from patients with clinical suspicion of TL, including patients with cutaneous leishmaniasis (CL) and mucosal leishmaniasis, comparing the results of parasitological tests\u2014direct parasitological examination by microscopy (DP) and conventional PCR (cPCR) targeting of both kDNA and hsp70. The DP was performed by collecting material from lesions through biopsies (mucosal lesions) or scarification (cutaneous lesions); for PCR, a cervical brush was used for sample collection. Blood samples were tested employing standardized real-time PCR (qPCR) protocol targeting the HSP70 gene. PCR tests showed higher sensitivity than DP for both CL and ML samples. Considering ML samples only (N = 89), DP showed a sensitivity of 49.4% (N = 44) against 98.8% (N = 88) for kDNA PCR. The qPCR hsp70 for blood samples from patients with ML (N = 14) resulted in superior sensitivity (50%; N = 7) compared to DP (21.4%; N = 3) for samples from the same patients. Our results reinforced the need to implement a molecular test for the diagnosis of ML, in addition to proposing methods less invasive for collecting material from TL patients. Sample collection using a cervical brush in lesions observed in CL and ML patients is easy to perform and less invasive, compared to scarification and biopsies. Blood samples could be a good source for qPCR diagnosis for ML patients. Thus, we propose here a standardized method for collection and for performing of molecular diagnosis of clinical samples from suspicious ML patients that can be applied in reference services for improving ML diagnosis.<\/jats:p>","DOI":"10.3390\/pathogens10091116","type":"journal-article","created":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T11:39:03Z","timestamp":1630496343000},"page":"1116","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Overcoming the Negligence in Laboratory Diagnosis of Mucosal Leishmaniasis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2376-4236","authenticated-orcid":false,"given":"Lilian Motta","family":"Cantanh\u00eade","sequence":"first","affiliation":[{"name":"Laboratory of Genetic Epidemiology, FIOCRUZ, Porto Velho 76812245, Rondonia, Brazil"},{"name":"Leishmaniasis Research Laboratory, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro 21040360, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2169-0990","authenticated-orcid":false,"given":"Cristiane Batista","family":"Mattos","sequence":"additional","affiliation":[{"name":"Laboratory of Genetic Epidemiology, FIOCRUZ, Porto Velho 76812245, Rondonia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Karoline","family":"Cruz","sequence":"additional","affiliation":[{"name":"Laboratory of Genetic Epidemiology, FIOCRUZ, Porto Velho 76812245, Rondonia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoda Janaina","family":"Ikenohuchi","sequence":"additional","affiliation":[{"name":"Laboratory of Genetic Epidemiology, FIOCRUZ, Porto Velho 76812245, Rondonia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2852-467X","authenticated-orcid":false,"given":"Flavia Gon\u00e7alves","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Laboratory of Genetic Epidemiology, FIOCRUZ, Porto Velho 76812245, Rondonia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enmanuella Helga Ratier Terceiro","family":"Medeiros","sequence":"additional","affiliation":[{"name":"Laboratory of Genetic Epidemiology, FIOCRUZ, Porto Velho 76812245, Rondonia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cipriano Ferreira","family":"da Silva-J\u00fanior","sequence":"additional","affiliation":[{"name":"Laboratory of Genetic Epidemiology, FIOCRUZ, Porto Velho 76812245, Rondonia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0620-3250","authenticated-orcid":false,"given":"Elisa","family":"Cupolillo","sequence":"additional","affiliation":[{"name":"Leishmaniasis Research Laboratory, Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro 21040360, Rio de Janeiro, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel Eduardo Melim","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Laboratory of Genetic Epidemiology, FIOCRUZ, Porto Velho 76812245, Rondonia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2363-1289","authenticated-orcid":false,"given":"Ricardo de Godoi Mattos","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Laboratory of Genetic Epidemiology, FIOCRUZ, Porto Velho 76812245, Rondonia, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Alvar, J., V\u00e9lez, I.D., Bern, C., Herrero, M., Desjeux, P., Cano, J., Jannin, J., and den Boer, M. 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