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Öğe Batı Karadeniz Bölgesinde zoonotik visseral leishmaniasis odağı: Karabük(2002) Özbel, Yusuf; Turgay, Nevin; Alkan, M. Ziya; Babaoğlu, Aylin; Töz, Özensoy Seray; Babalıoğlu, NihalZoonotik visseral leishmaniasis (ZVL) ülkemizde genellikle Ege ve Akdeniz başta olmak üzere hemen tüm bölgelerimizde endemik veya sporadik olarak görülmektedir. Karabük'ten 1986 yılından beri VL'in rapor edilmesi, çalışmadan önceki son iki yılda dört Kala-azar olgusu saptaması ve İl Sağlık Müdürlüğü'nün köyde yaptığı aktif sürveyans çalışmasında dört klinik şüpheli çocuğun saptanması üzerine Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğünden bir temsilci ile bu bölgede incelemeler yapılması ve durumun değerlendirilmesi amaçlanmıştır. Son bir olgunun saptandığı köyde 54 çocuk muayene edilmiş ve 47'sinin kan örnekleri alınmıştır. Ayrıca 25 köpek de muayene edilerek kan örnekleri ve lenfadenopati saptanan beşinden de lenf aspirasyon örnekleri alınmıştır. Elde edilen serumlara Indirekt Fluoresan Antikor Testi (IFAT), rK39 ELISA ve Direkt Aglütinasyon Testi (DAT) uygulanmıştır. Daha önce tanı alan ve tedavi edilen olgu dışında hiçbir çocukta seropozitifliğe rastlanmamıştır. IFAT ile 5 köpek seropozitif olarak saptanırken DAT ile bu 5 köpekten 3 tanesinin , rK39 ELISA ile 2 tanesinin seropozitif olduğu görülmüştür. Her üç testte de pozitif bulunan iki köpekte yayma preparatlarda Leishmania amastigotları görülerek parazitolojik olarak onaylanmış ve bölgede köpek leishmaniasis prevalans oranının %8 olduğu saptanmıştır. Ülkemizin diğer bölgelerinde olduğu gibi Karabük'te de visserai leishmaniasisin rezervuarlığını köpeklerin yaptığı ve bu nedenle sporadik şekilde insan olgularının görüldüğü saptanmıştır. Sağlık Bakanlığı ve İl Sağlık Müdürlüğüne sonuçlar bildirilerek koruyucu hekimlik açısından alınması gereken önlemler hakkında bilgi verilmiştir.Öğe Ege Üniversitesi Tıp Fakültesi Hastanesi entegre hastane yönetim bilgi sistemi (HYBS) altyapı yenileme projesi(Ege Üniversitesi, 2009) Alkan, M. Ziya; Özok, GeylaniBilgi-islem agı, üniversite hastanesi, hastane bilgi sistemi.;Günümüzde hastanelerde alt yapı gereksinimlerinin en önemli bilesenlerinden birisi de, bilgi teknolojilerinde yasanan hızlı degisim ve gelisim sonucu olusan beklentilerin karsılanmasıdır. Hastane isletmeleri, günümüz teknoloji kosullarında kaliteli bir saglık hizmeti sunmak, stratejik yönetimsel kararların alınması için gerekli bilgiye hızlı ve etkin bir sekilde ulasmak, hasta verilerini kolay ulasılabilir ve dogru bir biçimde saklamak, çalısanlara etkin bilgi islem destegi sunmak, etkinlik ve karlılıklarını artırarak kalite hedeflerine ulasmak amacıyla, bilgi sistemlerini yenilemek zorunlulugu ile karsılasmaktadırlar. Projenin stratejik hedefleri hastanenin yönetim kapasitesi, planlama, ve düzenleme fonksiyonlarını gelistirmek, çalısan ve hasta memnuniyetini arttırmak amacıyla gerekli altyapı desteginin saglanmasıdır. Bu proje kapsamında Hastane Yönetim Bilgi Sistemleri'nin temel bilesenleri olan Yerel Alan Ag Alt Yapısı (kablo, switch, router vb. elemanlardan olusan Network) ve donanım (is istasyonları, sunucu, istemci bilgisayarlar, yazıcılar vb) gibi, hastanemizde gelistirilmesi düsünülen Hastane Yönetim Bilgi Sistemi uygulamaları için gerekli temel unsurlar temin edilmistir. Projenin stratejik hedefleri hastanenin yönetim kapasitesi, planlama, ve düzenleme fonksiyonlarını gelistirmek, çalısan ve hasta memnuniyetini arttırmak olacaktır.;Network systems, university hospital, hospital management system.Öğe Evaluation of conjunctival swab sampling in the diagnosis of canine leishmaniasis: A two-year follow-up study in Cukurova Plain, Turkey(Elsevier Science Bv, 2015) Karakus, Mehmet; Toz, Seray; Ertabaklar, Hatice; Pasa, Serdar; Atasoy, Abidin; Arserim, Suha K.; Olgen, M. Kirami; Alkan, M. Ziya; Durrant, Caroline; Ozbel, YusufThe diagnosis of canine leishmaniasis (CanL) in symptomatic and asymptomatic dogs is a very important and problematic public health issue in Turkey. A longitudinal study was carried out on dogs in selected villages in the Cukurova Plain in Turkey, from July 2011 to June 2013, where cutaneous (CL) and visceral (VL) leishmaniasis is endemic. The study aimed to determine the prevalence of CanL and to evaluate the early diagnostic performance of the non-invasive conjunctival swab nested PCR (CS n-PCR) test in comparison with the Indirect Fluorescent Antibody Test (IFAT). The consecutive blood and CS samples from a representative number of dogs (80-100 dogs/each survey) were collected in a cohort of 6 villages located in the area. Clinical symptoms, demographic and physical features about each dog were noted and lymph node aspiration samples were obtained from selected dogs with lymphadenopathy. In four surveys during the period, a total of 338 sets (blood and CS) of samples from 206 dogs were obtained, such that 83 dogs were sampled more than once. In the cross-sectional analysis, the CanL prevalence was found to be 27.18% (between 7.14% and 39.13%) by IFAT and 41.74% (between 29.03% and 46.66%) by CS n-PCR. The isolated strains were identified as Leishmania infantum MON-1 (n = 9) and MON-98 (n = 2) by MLEE analysis. Genetic studies targeting the Hsp70 and ITS1 regions performed on 11 dog isolates also showed two clear separate groups. According to IFAT results, 24 of the 83 dogs sampled more than once showed seroconversion (n = 19) or a four-fold increase in Ab titers (n = 5), while 17 were positive in the initial screening. Forty-two dogs stayed negative during the whole period. The natural Leishmania exposure rate was detected as 31.14% in the study area. CS n-PCR only detected Leishmania infection earlier than IFAT in 8 dogs. No statistical difference was found after the analysis of demographical and physical data. The results indicated that (i) circulation of the dog population is very common in settlements in the Cukurova Plain, but the disease prevalence is high and stable, (ii) the performance of CS n-PCR for detecting Leishmania-dog contact is higher than IFAT, (iii) and some of the parasites isolated from dogs have different zymodemes and/or genotypes from previous human and sand fly isolates; suggesting the probability of two different cycles of leishmaniasis in this particular area. This hypothesis should be supported by future studies targeting vectors and-reservoirs. (C) 2015 Elsevier B.V. All rights reserved.Öğe Fascioliasis'in Western Blot yöntemi ile serolojik tanısı(Ege Üniversitesi, 2003) Alkan, M. ZiyaBu çalışmada, parazitolojik ve radyolojik olarak erken ve geç dönem fascioliasis tanısı konmuş hastalara ait serum örnekleri, Western blotting (WB) yöntemi ile incelenmiş ve serum örnekleri tarafından tanınan polipeptid fraksiyonları değerlendirilmiştir. Sonuçlar, hasta serum antikorlarının özellikle düşük moleküler ağırlıklı fraksiyonlardan 25-29, 32, 40-43, 58 kDa'luk antijenlerden en az birine yüksek spesifite gösterdiğini, özellikle 32 kDa'luk antijen bandının erken ve geç dönemin ayırıcı tanısında yol gösterici olabileceğini, Western blot yönteminin çapraz reaksiyonlar sonucu oluşabilecek seropozitifliğin ayırt edilmesinde yararlı olabileceğini, sonuçta diğer serolojik yöntemlerle elde edilecek sonuçların doğrulanmasında, WB yönteminin etkin ve güvenli bir test olduğunu ortaya koymuştur.;Fasciola hepatica, fascioliasis, western blotting.;Fasciola hepatica, fascioliasis, Western blotting.Öğe The infection risk of visceral leishmaniasis among household members of active patients(Elsevier Ireland Ltd, 2006) Sakru, Nermin; Toz, Seray Ozensoy; Korkmaz, Metin; Kavakli, Tulay; Alkan, M. Ziya; Ozbel, YusufHuman visceral leishmaniasis (HVL), caused by Leishmania infantum is mainly observed as sporadic cases in Turkey and dogs are considered as the main reservoir of the disease. The incidence of visceral leishmaniasis among members of households where a HVL infection has already been diagnosed was studied in clusters around the diagnosed cases in different regions in Turkey. A total of 47 serum samples collected from the households of 11 proven visceral leishmaniasis patients were screened for anti-Leishmania antibodies by indirect immunofluorescent antibody test (IFAT). Three and one such household members belonging to the different families were found to be seropositive and borderline, respectively. Diagnosis was confirmed with the presence of amastigotes in bone marrow aspiration samples in all seropositives while the borderline case with slight and indefinitive symptoms of VL was followed only serologically at 3-month intervals and improved spontaneously in I year. Household members of individuals with previously confirmed visceral leishmaniasis were found to have higher frequency of the disease suggesting the household members should be included in the risk group for visceral leishmaniasis and serological screening should be performed for the detection of possible infection. (c) 2005 Elsevier Ireland Ltd. All rights reserved.Öğe Leishmaniasis in Turkey: molecular characterization of Leishmania from human and canine clinical samples(Wiley-Blackwell Publishing, Inc, 2009) Toz, Seray Ozensoy; Nasereddin, Abedelmajeed; Ozbel, Yusuf; Ertabaklar, Hatice; Culha, Gulnaz; Sevil, Naser; Alkan, M. Ziya; Jaffe, Charles L.Human leishmaniasis, both visceral and cutaneous, and canine leishmaniasis have been reported in Turkey for centuries. However, the advent of new diagnostic tools during the last 30 years has led to the recognition that leishmaniasis is an important public health problem throughout the country. In most disease foci both canine and human leishmaniases exist together and identification of parasite species causing these diseases is a pre-requisite for understanding disease epidemiology. A total of 109 samples obtained from human and canine leishmaniasis cases were examined using internal transcribed spacer 1 PCR followed by restriction fragment length polymorphism analysis. Our results indicate that two species, Leishmania tropica and Leishmania infantum, are primarily responsible for cutaneous and visceral leishmaniasis, respectively, in Turkey. However, a new focus of human cutaneous leishmaniasis caused by L. infantum in Hatay region is described. This finding further stresses the importance of Leishmania species molecular characterization in prescribing appropriate therapy and understanding the disease's transmission in different endemic foci.Öğe Leishmaniasis in Turkey: molecular characterization of Leishmania from human and canine clinical samples(Wiley-Blackwell Publishing, Inc, 2009) Toz, Seray Ozensoy; Nasereddin, Abedelmajeed; Ozbel, Yusuf; Ertabaklar, Hatice; Culha, Gulnaz; Sevil, Naser; Alkan, M. Ziya; Jaffe, Charles L.Human leishmaniasis, both visceral and cutaneous, and canine leishmaniasis have been reported in Turkey for centuries. However, the advent of new diagnostic tools during the last 30 years has led to the recognition that leishmaniasis is an important public health problem throughout the country. In most disease foci both canine and human leishmaniases exist together and identification of parasite species causing these diseases is a pre-requisite for understanding disease epidemiology. A total of 109 samples obtained from human and canine leishmaniasis cases were examined using internal transcribed spacer 1 PCR followed by restriction fragment length polymorphism analysis. Our results indicate that two species, Leishmania tropica and Leishmania infantum, are primarily responsible for cutaneous and visceral leishmaniasis, respectively, in Turkey. However, a new focus of human cutaneous leishmaniasis caused by L. infantum in Hatay region is described. This finding further stresses the importance of Leishmania species molecular characterization in prescribing appropriate therapy and understanding the disease's transmission in different endemic foci.Öğe A Real-Time ITS1-PCR Based Method in the Diagnosis and Species Identification of Leishmania Parasite from Human and Dog Clinical Samples in Turkey(Public Library Science, 2013) Toz, Seray Ozensoy; Culha, Gulnaz; Zeyrek, Fadile Yildiz; Ertabaklar, Hatice; Alkan, M. Ziya; Vardarli, Asli Tetik; Gunduz, Cumhur; Ozbel, YusufHuman visceral leishmaniasis (VL) caused by L. infantum and cutaneous leishmaniasis (CL) caused by L. tropica and L. infantum have been reported in Turkey. L. infantum is also responsible for canine leishmaniasis (CanL) and it is widely common in the country. The main aim of the present study was to design a real-time PCR method based on the internal transcribed spacer 1 (ITS1) region in the diagnosis of all clinical forms of leishmaniasis in Mediterranean, and to identify the species directly from clinical samples. Totally, 315 clinical specimens, human/canine visceral (blood, bone marrow, lymph node) and cutaneous (lesion aspiration) samples, and 51 Turkish Leishmania isolates typed by isoenzymatic method were included in the study. For optimization, DNA samples of the 34 strains were amplified by conventional ITS1-PCR and then sequenced for designing the primers and probes, allowing the species identification. Following the validation with the isolates, the test was applied on clinical samples and melting temperatures were used for genotyping. A group of PCR products were further sequenced for confirmation and assigning the inter-and intraspecies heterogeneity. The diagnosis of leishmaniasis is successfully achieved by the new real-time PCR method, and the test identified 80.43% of human and canine VL samples as L. infantum and 6.52% as L. tropica; 52.46% of CL samples as L. infantum and 26.90% as L. tropica. In 13.04% of visceral and 20.62% of cutaneous samples, two peaks were observed. Hovewer, the higher peak was found to be concordant with the sequencing results in 96.96%, in terms of species identification. The real-time ITS1 PCR assay clearly identified the leishmanial species in 81.58% of all clinical samples. Genotypic variations of Leishmania parasites in Turkey within species and intraspecies were observed, and L. tropica is also found as causative agent of human and canine VL in Turkey.Öğe Spatial distribution of phlebotomine sand flies in the Aydin Mountains and surroundings: the main focus of cutaneous leishmaniasis in western Turkey(Soc Vector Ecology, 2011) Ozbel, Yusuf; Balcioglu, I. Cuneyt; Olgen, M. Kirami; Simsek, Fatih M.; Toz, Seray Ozensoy; Ertabaklar, Hatice; Demir, Samiye; Alkan, M. ZiyaAn entomological survey was conducted to determine the spatial distribution of phlebotomine fauna and understand the effect of environmental factors. The entomological survey was carried out during 2006-2007 in a study area in the rural area of Aydin province, near the Kusadasi town where VL, CL, and canine leishmaniasis (CanL) are endemic. In 2006 and 2007, 132 locations were sampled using sticky traps mainly on embankments. Detailed environmental and meteorological information was also collected for each location. The results of entomological studies indicated that the probable vectors are Phlebotomus tobbi and P. neglectus for VL and CanL, and P. similis for CL in this western leishmaniasis focus. The data revealed a correlation between their presence and spatial variables such as altitude, sampling site location, and humidity. The distribution areas of probable vector species in this study area allowed the identification of risk levels, which may provide useful information to guide the leishmaniasis research in endemic regions.
