Identification of Leishmania strains from Jordan.

The enzymatic profiles of 22 Jordanian Leishmania isolates obtained from humans, Psammomys obesus and Phlebotomus papatasi were determined using starch-gel electrophoresis and a 15-enzyme system. Thirteen of the isolates were typed as L. major and the other nine, all from Mediterranean or sub-Mediterranean regions, as L. tropica. The two zymodemes of L. major encountered, MON-26 and MON-103, differed in terms of purine nucleoside phosphorylase 2. The MON-26 isolates came from the Jordanian plateau whereas those of MON-103 were only collected from the Jordan valley. The four zymodemes of L. tropica observed (MON-7, MON-137, MON-200 and MON-265) were identical for only two of the 15 enzymes studied (i.e. isocitrate dehydrogenase and glucose phosphate isomerase), confirming the high level of enzymatic polymorphism of L. tropica. So far, MON-200 and MON-265 have only been found in Jordan.

Humoral response of Meriones libycus to experimental infection with Leishmania major.

The humoral responses of laboratory-reared jirds (Meriones libycus) to inoculation with various doses of Leishmania major were determined. The animals were inoculated intradermally with 10(2), 10(3), 10(5) or 10(7) promastigotes of a strain of L. major originally isolated from a Jordanian patient. The jirds were then bled at various intervals throughout the 26 weeks of the study, and the sera checked, by IFAT, for antibodies to homologous parasites. There were no detectable humoral responses in the animals inoculated with 10(2) promastigotes each or in parasite-free controls but a positive response was apparent in each of the other jirds. The animals given 10(3) promastigotes each required 3 months to become IFAT-positive whereas those given 10(5) and 10(7) parasites only needed 4 and 2 weeks, respectively. More than 50% of the animals inoculated with 10(3) parasites each developed strongly positive sera 2 months post-infection, whereas > 50% of the animals inoculated with 10(5) or 10(7) parasites each had strongly or very strongly positive sera 4 and 2 weeks post-inoculation, respectively. The data indicate that, in M. libycus inoculated with L. major, the time required for the humoral response to develop and its intensity are both dose-related.

The philosophical, cultural, and historical aspects of complementary, alternative, unconventional, and integrative medicine in the Old World.

BACKGROUND: Complementary, alternative, unconventional, and integrative medicine are types of natural medicine that have been known and practiced ever since the recording of history, and in particular in the Old World. This has been rediscovered in many countries, including the New World and especially in the United States. In this review, the philosophical, cultural, and historical aspects are discussed, and the many types of alternative medical practices are mentioned. OBSERVATIONS: The study of complementary medicine shows that evidence required the medical establishment to take unconventional therapies more seriously, and realize that their use alongside traditional medicine, is rapidly increasing. CONCLUSIONS: Complementary medicine is a formal method of health care in most countries of the Old World and is expected to become integrated in the modern medical system and to be part of the medical curriculum and the teaching programs of medical institutions as well. Issues of efficacy and safety of complementary medicine have become increasingly important and supervision of the techniques and procedures used is required. More research studies are needed to understand and use this type of medicine.

The endemicity of Leishmania tropica (zymodeme MON-137) in the Eira-Yarqa area of Salt District, Jordan.

The endemicity of cutaneous leishmaniasis (CL) caused by Leishmania tropica was ascertained in a focus of the disease around Eira and Yarqa in Salt District, Jordan. This focus is about 10 km to the east of another focus of CL, where L. major is the causative agent. As CL occurs sporadically in the study area, with nine cases diagnosed between 1993 and 1995, it is probably zoonotic. Each case had one or two lesions and most lesions were on the face. Isoenzymatic electrophoresis showed that all the parasites isolated in the Eira-Yarqa focus and identified to zymodeme level belonged to zymodeme MON-137 and therefore differed from all the L. tropica isolates identified in other regions of Jordan. Eight species of Phlebotomus (P. alexandri, P. major, P. sergenti, P. papatasi, P. perfiliewi, P. jacusieli, P. canaaniticus and P. arabicus), two members of the Sergentomyia dentata group and S. tiberiadis and S. taizi were collected in the focus, using castor-oil traps. The epidemiological significance of the sandflies collected is discussed.

Epidemiology of primary cutaneous malignant melanoma in Jordan.

BACKGROUND: Primary cutaneous malignant melanoma is an uncommon tumor in Jordan compared with other countries. There are no previous comprehensive Jordanian studies on this tumor and proper statistical data on morbidity and incidence are nonexistent. The purpose of this paper was to study the epidemiologic aspects of cutaneous malignant melanoma among Jordanians. METHODS: Both the clinical and the histopathologic feature of 138 melanoma patients (86 men, median age 56; 52 women, median age 53) seen during the period November 1969-May 1994 were studied. The analysed data included age, sex, skin type, race, socioeconomic status, exposure to sunlight, trauma, and family history. RESULTS: Malignant melanoma was found to be more common in men than women, in the ratio of approximately 2:1, due to the higher exposure of men to sunlight, and occurred more in people with skin types I, II, and III, and less in people with skin types IV and V. The majority of cases were of the superficial spreading variety, followed by the nodular, lentigo maligna, and acrolentiginous melanomas, respectively. CONCLUSION: The incidence of cutaneous malignant melanoma, formerly considered a rare tumor in Jordan, is now recognized to be on the increase. Exposure to sunlight seems to be the most prominent risk factor in the development of this tumor among Jordanians.

Epidemiology of cutaneous leishmaniasis in Jordan: 1983-1992.

BACKGROUND: The extent of the problem of cutaneous leishmaniasis in Jordan during the decade 1983 to 1992 was investigated. METHODS: Data were collected from the dermatology departments and the laboratories of the Royal Medical Services and the Ministry of Health as well as from private dermatologists. Two thousand two hundred and ninety-five cases were verified of whom men represented 80%. The majority (80%) were < 25 years with the highest percentage (31%) occurring in the 16 to 20-year age group. RESULTS: The lowest number of cases was reported in June compared to the maximum in October, and the highest number recorded per year was 463 in 1992. For the decade, the Jordan Valley was the most important locality where 43% of the cases occurred. The incidence rate per 100,000 ranged from 1.89 in 1989 to 14.39 in 1984 and the period prevalence for the decade was 5.36 per 100,000. The time-lag between the appearance of a lesion and the first diagnosis extended from 0 to 23 months with the average being 2 months. The number of lesions per patient ranged from one to 45; 24% were located on the face, 28% on the upper extremity, 36% on the lower extremity, and 12% on other sites. CONCLUSIONS: The factors that contributed to the findings include infected rodent, nonexposed army recruits and farm workers, land reclamatory and relaxation of preventative measures.