Iranian Journal of

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Background & Objectives: Drug abuse and addiction is one of the four major crises in the world. The first step in combating any disease or social problem is proper organization. The aim of this case-control study was comparing the distribution of blood groups between healthy blood donors and clients of drug rehabilitation clinics in the city of Bam.
 Methods: In this case-control study, cases were 249 drug users attending the city's rehabilitation clinic. Controls included 360 healthy blood donors at the headquarters of the Blood Transfusion Organization in Bam. We extracted and analyzed data on demographic characteristics, blood group and RH, using the software package SPSS.
Results: This study showed that the AB blood type is more common in drug addicts than in healthy blood donors.
Conclusions: Many studies have reported that an association between ABO blood groups/ RH and various health outcomes such as infections and non-infectious diseases as well as mental and social problems. Our study showed that there is a significant relationship between drug addiction, AB blood type, and negative RH. It therefore seems that genes play a role in the tendency towards addiction. This investigation may be valuable in the sense that it may prompt further research in fields such as genetic, immunology and other related disciplines.

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Background and Objectives: There are conflicting data on the effects of different types of fat on aortic atherosclerosis. This study used Wister rats to compare the atherogenic effects of a standard diet with a diet containing fish oil and another diet containing mixed oils (typical of the current consumption pattern in Iran).
Methods: Thirty female Wistar rats were randomly assigned to three diet groups: a standard diet (containing soy bean-oil as the only dietary fat), a diet containing fish oil and another diet which contained mixed oils and was designed on the basis of the current fat consumption pattern in Iran (butter, hydrogenated vegetable oil and sunflower oil). Mothers in each group were fed the same diet during pregnancy and lactation the litters were also weaned onto the same diet. Aortic samples were taken from the offspring at the time of weaning and puberty. Data were analyzed using SPSS software Kruskal-Wallis test was applied for comparison among groups.
Results: Rats that were fed soy bean oil showed less extensive fatty streaks and intimal thickening of aorta on weaning and at puberty. Rats fed fish oil and mixed oils showed more atherosclerosis lesions compared to those receiving soy bean oil.
Conclusions: It seems that diets with an omega-3 to omega-6 ratio of 0.6 can enhance aortic atherosclerosis. Diets with an Iranian fat consumption pattern also increase aortic atherosclerotic lesions because they contain substantial amounts of saturated fat.

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Background and Objectives: A pregnancy can be considered high-risk if there are conditions that put the mother or the baby at higher-than-average risk of morbidity or mortality. Neonatal mortality rate is one of the most important indices of children's health status. The present study was conducted to evaluate the effects of high-risk states on neonatal mortality.
Methods: We performed a nested case-control study in the rural areas of Kohgiluyeh and Boyerahmad province. Within the study cohort, 97 cases and 97 controls were selected by a risk-set sampling method. Data were analyzed with univariate and multivariate conditional logistic regression models.
Results: Neonatal mortality was shown to increase significantly in high-risk pregnancies. There were no substantial differences between crude odds ratios and those adjusted for the presence of other risk factors (crude odds ratio decreased from 5.5 to an adjusted figure of 3.25 for pregnancies with one risk factor and from 5.21 to adjusted level of 4.80 for pregnancies with more than one risk factor).
Conclusions: High-risk pregnancies need great attention in family health and prenatal care programs, especially in remote rural areas. Within our rural health network there are potential cohorts for use in nested case-control studies, especially in the evaluation of neonatal mortality risk factors.

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Background & Objectives: The aim of present study is to compare Afghan refugees and Iranian residents in terms of their knowledge, attitude and practice concerning malaria transmission and protection in an endemic area in Southeast Iran.
Methods: This cross sectional study was conducted over a period of 10 months (2004-2005) and involved a total of 775 people, including Iranian and Afghan subjects. The age range of participants was 15 to 55 years. Data collection was done through a structured questionnaire consisting of open and close questions and comprising several, namely personal characteristics details, history of malaria infection and treatments, type of residence, mobility, self protection, facilities, and access to health services.
Results: Both Iranians and Afghans were familiar with the three typical symptoms of the disease (fever, chills and muscle aches): 67.1% of Iranians and 78% of Afghans were able to name least one of the three typical symptoms. In both groups the majority of subjects were aware that malaria transmission occurs through mosquito bite but there was a significant difference regarding knowledge of malaria transmission (χ2 =142.2, P<0.001). Chi-square test for goodness of fit showed that the distribution of symptom indicators is significantly different between the two groups. For Iranians, the most important source of information about malaria was the health facilities (44.5% of the total) while most Afghans (65.3%) had obtained the information through friends and relatives. In both groups, the mass media had acted as the source of information in only 3.4%. Altogether, 24% of the participants reported the use of mosquito bed nets almost 90% of Afghans and 62% of Iranians said that they did not used bed nets at all. However, the number of Iranians who used bed nets was four times greater than the Afghans who did so.
Conclusions: Although the majority of subjects were familiar with malaria transmission and protection methods, they largely neglected safety precautions. Moreover, it seems that the high prevalence of malaria among Afghans is due to their life style rather than cross-border travel. The study also revealed that Afghan people have poor communication with the local health facilities, a point that must receive special attention in future malaria control programs.

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Background & Objectives: Over the last few years, the province of Golestan has ranked second among all Iranian provinces in terms of TB prevalence after Sistan and Balochestan. The present study was done with the aim of evaluating the incidence of TB among different ethnic groups residing in Golestan.
Methods: In a descriptive study, all TB patients including sputum smear-positive and negative, extra-pulmonary, and milliary cases were evaluated from 1999 to 2003. The incidence of all types of TB was compared among different ethnicities in the province.
Results: Forty-seven percent of the 2773 cases registered for Golestan Province in the Communicable Disease Control Center from1999 to 2003 were male. As regards the type of disease, 62.7% of the cases were sputum smear-positive, 16.4% were smear-negative, 20.7% had extra-pulmonary disease, and 0.1% were milliary TB cases. The incidence rate of all types of TB was 36 per 100000 population and the rate did not show any significant changes over the study period. As for the ethnic distribution of the cases, more than 50% of all TB cases were observed among Sistanis and Baluches, who together account for only 20% of all Golestan residents. The incidence in Sistanis was ten times that in Turks and Kurds, six times that in Persians, 4 times the rate in Torkamans, and 2.5 times that in Afghans living in the same region.
Conclusions: The incidence rate of tuberculosis was significantly different among various ethnicities of Golestan province, being highest in Sistanis.

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Background & Objectives: Arsenicosis is a serious environmental disease caused by chronic exposure to arsenic- usually from drinking water. Signs and symptoms of chronic arsenic poisoning include hyperkeratosis, hyper- or hypopigmentation, and ulcers. Also, the incidence of cancer is increased in the exposed population. There is some evidence of high arsenic levels in drinking water in the village of Ghopuz, located in Hashtrud District, East Azerbaijan province. We evaluated the genetic and health effects of chronic arsenic exposure in the residents of Ghopuz.
Methods: In this cross-sectional study we determined the prevalence of hyperkeratosis, hyperpigmentation and hypertension in Ghopuz village. The study involved 101 individuals in Ghopuz and 107 in the adjacent village of Mayan, who were all visited by a trained physician. A total of 46 blood samples were collected for kariotyping. The level of heavy metals in water was determined by the Inductively Coupled Plasma (ICP) method.
Results: We detected high arsenic levels in the drinking water at Ghopuz (mean concentration in water = 1.03 mg/L). There were chromosomal defects in the exposed group. Mean systolic blood pressure at Ghopuz (137mmHg, 95% CI: 132-142) was significantly higher than in Mayan (107, 95% CI: 99.9-114). Also, mean diastolic blood pressure at Ghopuz (82, 95% CI: 79-85) was significantly higher than in Mayan (71, 95% CI: 66-75). Hyperkeratosis was 34 times more frequent in the exposed population (OR = 34, P< 0.001). Also, hyperpigmentation was significantly more frequent in the exposed population (OR = 2.4, P < 0.007).
Conclusions: Water arsenic and nitrate levels at Ghopuz were higher than the maximum permissible levels. The prevalence of skin lesions and hypertension is increased at Ghopuz village due to arsenic exposure. There is also some evidence of chromosomal defects in the exposed group. Affected people need appropriate medical care, and safe drinking water should be provided to reduce arsenic exposure.

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Background & Objectives: Malocclusion is not a disease but rather a set of dental deviations, which in some cases can influence quality of life. The aim of this study was to assess the frequency of various dento–facial anomalies.
Methods: In this cross-sectional study in 2006 we assessed a sample of 600 randomly selected schoolchildren, with a mean age of 11.97 years, who were attending secondary school in various districts of Karaj. We used questionnaires to obtain information on extracted teeth, crowding, spacing, diastem, the severest disorders in anteriors (maxilla and mandible), overjet, negative overjet, open space between two jaws and antero-posterior molar relationship.
Results: Ninety-nine percent of children had no extracted teeth in maxillary anteriors, while 98.3% had no extracted teeth in mandibular anteriors. In 41.2% of the subjects there was no crowding, and 57.7% of the sample had no spacing. The mean diastem was 0.36 mm and the mean of the most severe disorders in anteriors was 1.08 mm in the maxilla and 0.78 mm in the mandible. Mean overjet was 1.98 mm, mean negative overjet 0.03 mm, and mean open space between two jaws was 0.28 mm. In 58.5% of the subjects the antero–posterior molar relationship was normal. The DIA ranged form 13 to 63, with a mean of 24.12.
Conclusions: This study indicates that over than one-third of the population needs different degrees of orthodontic treatment.

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Background & Objectives: Malnutrition is widely regarded as one of the factors affecting quality of life. The adverse effects of malnutrition have been documented in various age groups. School problems, learning difficulties, humiliation and teasing from peers are some of the most common complications of obesity and excessive thinness. The goal of this study was to determine the BMI and some of the factors affecting it in the students of Dezfool.
Methods: In a cross-sectional study and using random cluster sampling, 5726 students from 39 clusters were selected and anthropometric measurements were performed in the schools and under standard conditions. Cases of obesity and thinness were identified using BMI percentiles for age and sex (NCHS). A Body Mass Index above the 95th and below the 5th percentile was defined as obesity and thinness respectively.
Results: This study involved the participation of 5508 students (96.2%). The prevalence of thinness was 33% (1716) with a 95% confidence interval of 27.3%-38.8%. The prevalence of obesity was 2.6% (157) with a 95% confidence interval of 1.7%-3.4%. There was no significant difference between the prevalence of obesity or thinness between the two sexes (P>0.05). The prevalence of obesity and thinness significantly increased and decreased respectively with aging (P<0.05).
Conclusions: Malnutrition among the students in Dezfool predominantly takes the form of thinness, while obesity is not a serious problem in this population overall, these findings indicate poor nutritional status. High-risk groups have been identified and they must become the target of interventions by the Health and Education Ministries.

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Background & Objectives: Exclusive breast-feeding during the first 6 months of life is the best type of nutrition for the infants in terms of fulfilling their its physical and emotional needs. The incidence of many kinds of infection decreases with breast-feeding. The aim of this study was to determine the prevalence of exclusive breast-feeding infants aged less than 6 months in Mash'had and to look at some factors that affect breastfeeding.
Methods: This population-based survey used a stratified cluster sampling method to draw 30 clusters containing a total of 1450 infants aged 7-12 months. Data collection was performed using both questionnaires and interviews with mothers. Exclusive breast-feeding was defined as nursing through the first 6 months of life without any other food intake except drugs and vitamin supplements.
Results: The study achieved a response rate of 87.4% in mothers 51.2% of the infants were male and the remaining 48.8% (618) were female. The overall prevalence of exclusive breast-feeding during the first 6 months was 56.4% with (95% CI: 49.7%-63.2%). The figure was 57.2% (95% CI: 49.9%-64.4%) for boys and 55.7% (95% CI: 48.7%-62.6%) for girls. In this survey, 91.7% of the infants (95% CI: 88.7%–94.7%) had received breast-feeding immediately after birth. In multiple logistic regression analysis, the mother's age, her awareness of the adequacy of her milk, and advice from others to use formulas were the factors that had a significant relationship with breast-feeding in the first 6 months.
Conclusions: Almost 43% of infants had received alternative nutrition such as family food or formula. Considering the important effect of breast-feeding, provision of educational programs by the Health Ministry to raise the mothers' awareness of breast feeding can be a priority in children's health.

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Background & Objectives: Men (husbands) play a very important role in family planning programs, especially in developing countries. The objective of this study was to determine the prevalence of different methods of contraception in women of reproductive age in Iranshahr in 2004-2005 and the extent of their husbands' participation in family planning.
Methods: This was a cross-sectional study focused on women who were married but not pregnant at the time of the research. We used multi-stage cluster sampling and a pre-tested questionnaire to record the method of contraception and to see if the husband was actually participating in family planning. We used the SPSS (13th version) software to calculated measures of location and dispersion.
Results: The total sample of 700 married women in the (10-49y) age group included 400 subjects in rural areas and 300 in cities. Of these, 696 agreed to take part in the research. Overall, 65.5% of these women were using at least one form of contraception the remaining 34.5% did not use any contraceptive methods. The percentage of unwanted pregnancies was estimated at 16%. The mean number of pregnancies was 7, with a median of 4.5. Sixty-three percent of the subjects reported good cooperation by their husbands. Logistic regression analysis showed that the probability of using contraception was significantly related to the husband's cooperation.
Conclusions: Our results underline the importance of men's support and cooperation in the success of family planning efforts.

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Background & Objectives: Today, the quality of life study has an important role in health care especially in chronic diseases, in clinical judgment and in medical resources supplying. Malignancies have a clinical and health importance in the world and Iran. Breast cancer has first order among women’s malignancies. Now, survival rate for this cancer is long. However Breast cancer has several complications that affected patient’s life. It is necessary that we studying the quality of life and related factors among this patients.
Methods: We conducted a cross-sectional study on 119 breast cancer patients that admitted and treated in chemotherapy ward of Namazi hospital in Shiraz.We used QLQ-C30 & QLQ-BR23 to assessment quality of life in these patients. We used univariate nonparametric tests and multiple linear regression model to identify associations between dependent variables and the quality of life and it’s different scales.All calculation performed by using SPSS.V.13.
Results: Mean age of patients was 48.27±11.42 with quality of life total score 64.92±24.28. Univariate analysis showed that occupation,duration of disease,grade of tumor,physical,emotional and cognitive functioning, also, symptoms such as fatigue,pain, nausea and vomiting , insomnia , constipation and financial difficulties, perspective were associated to quality of life. (P< 0.05). But in multivariate analysis, only occupation, menopause status, dyspnea , grade of tumor and financial difficulties perspective were related to quality of life (p<0.05).
Conclusions: With this finding, It is recommended that financial supports, also early detection are necessary for improvement of quality of life in these patients

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Background & Objectives: This research focused on estimating the mean of Neurological Soft Signs scores in children with Attention Deficit and Hyperactivity Disorder and comparing them with normal children.
Methods: We evaluated 25 children with Attention Deficit- Hyperactivity Disorder in the age group of 7-12 years (mean age: 10.16 ± 1.5y) using the DSM-VI Attention Deficit – Hyperactivity Disorder Questionnaire, Conner’s Parents’ Rating Scale, and the 28-item NES Questionnaire. There was no significant age difference between cases and controls. The mean total NES score was 11.4±4.14 in cases and 5.6± 2.79 in controls (P< 0.0001). Compared to the control group, the cases had significantly more problems with the glabellar reflex, rapid alternative movements and right-left discrimination.
Results: Soft Neurological signs are observed with greater frequency among children with ADHD compared to normal subjects and the difference is more significant in certain domains such as rapid alternative movements, right- left confusion, and glabellar reflex.
Conclusions: Considering the relatively high frequency of soft neurological signs in children with Attention deficit- Hyperactivity Disorder, earlier diagnosis and treatment of the disease might be possible through careful neurological examination.

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Background & Objectives: Cardiovascular disease is the leading cause of death worldwide and is predicted to retain this position until 2020. The aim of the present study was to map cardiovascular mortality rates in Kerman Province counties during 2004-2005.
Methods: In this descriptive study we collected all mortality data registered in various counties of Kerman Province. We calculated mortality rates and drew maps showing the geographical distribution of the dead cases.
Results: Total cardiovascular mortality was higher in the northern counties. The pattern is the same in males and females
Conclusions: The reasons for higher mortality in the northern regions of the province may include a greater prevalence of major cardiovascular risk factors such as physical inactivity, unhealthy diets, and smoking.

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The case-crossover design was developed in the early 1990s to study the effects of transient, short-term exposures on the risk of acute events such as myocardial infarction. To estimate relative risk, the exposure frequency during a period just before outcome onset (hazard period) is compared with exposure frequency during control time(s) in that person rather than in a control. One or more "control times" are supplied by each of the cases themselves to control for confounding by constant characteristics and self-confounding between the trigger's acute and chronic effects. In the analysis of case-crossover studies, exposure frequency in the hazard period is compared with the control period or the individual's usual frequency of exposure. The design has been used frequently for heart diseases, injuries and air pollution epidemiology. This review article looks at published case-crossover studies and is intended to help the reader gain a better understanding of the strengths and limitations of the case-crossover design in studying the epidemiology of injuries and air pollution.

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Background & Objective: Disability-Adjusted Life Years (DALY) summarizes the fatal and nonfatal outcomes of diseases and injuries in one number and gives a quantitative assessment of the health of a population. Estimating the burden of diseases and injuries in Iran in terms of DALY both nationwide and in 6 provinces.
Methods: We used slightly modified versions of the methods developed by the World Health Organization for estimating the burden of premature mortality, disability, and the DALY.
Results: The DALY rate per 100,000 was 21572 and 62% of this was life lost due to premature mortality the remaining 38% was due to disability from diseases and injuries. Fifty-eight percent of the total DALYs had been lost due to non-communicable diseases, 28% due to external causes (injuries), and 14% due to communicable, maternal/ perinatal and nutritional illnesses. The group of diseases and injuries with the highest burden in males waz intentional and unintentional injuries (2.789 million DALYs), while in the female population this position was held by mental disorders with 1.191 million DALYs. The single most important cause of burden was traffic accidents in males and ischemic heart disease in females. Disease burden showed considerable variability between different provinces.
Conclusion: The profile of health and disease in Iran has generally shifted from the predominance of communicable, maternal/perinatal, and nutritional illnesses towards predominance of non-communicable diseases and injuries at the national level. These figures on disease burden at population level are the most objective evidence that can be used in policy making and management of health programs, health research, and resource development within the health sector.

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Background & Objective: Malnutrition is one of the main nutritional problems among children under 5 years especially in developing countries. The effects of malnutrition in this range of age group includes disorder of mental and physical growth and development, increase in the morbidity and mortality, decrease of the learning capacity. A detailed epidemiological picture of the prevalent malnutrition status among children under 5 years in different regions of Iran enables health policy makers to identify priorities, establish political commitment and design appropriate interventional programs to prevent and control malnutrition and improve nutritional status of children. To determine the prevalence rate of malnutrition among children under 5 years.
Methods: Demographic data, weight and height of 34200 Iranian children between 0-72 months old in 28 provinces of the country in 2005 year based on a cluster sampling were gathered. The subjects' weight and height were measured by trained staff. Prevalence of underweight, stunting, and wasting indicators was determined by measuring the weight and height of subjects in urban and rural areas. EPI6 statistical software, version b6/04, was used for all statistical analyses.
Results: 4.7% of the children aged less than five years suffered from stunting (95% CI: 4.5- 4.9%) The prevalence of this type of malnutrition among urban children is significantly less than rural children (95% CI: 3.1- 3.5% and 6.5-7.1% respectively). Meanwhile the prevalence of underweight was 5.2% in the country (95% CI: 5.1-5.4% while the prevalence of this type of malnutrition was significantly less among urban children than those in rural ones. Moreover, the prevalence of wasting was 3.7% (95%CI: 3.5-3.9%) and there was a significant difference in this regard between the urban and rural children. Thus this indicator was significantly higher among urban children than those in rural areas (95%CI: 3.8-4.3% and 3.0-3.5% respectively).
Conclusion: The results of the study show that the prevalence of protein-energy malnutrition was low among Iranian children under five years old. In comparison with previous studies, it is felt that there has been a prudent decrease in all malnutrition in all levels. However, there were significant differences in the prevalence of malnutrition in different provinces, which has resulted in the differences in their developmental stages as well. It appears that subjective strategies are required to improve the nutritional and health status among children under five in all provinces.

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Background & Objectives: Children are highly vulnerable to TB and childhood tuberculosis is a sign of TB transmission in community. This study aimed to determine the epidemiologic trend of this disease in Iranian children.
Method: A Trend Study was conducted to evaluate all Iranian patients aged below 14 who had been diagnosed with pulmonary or extrapulmonary TB from 1992 to 2005. Statistical relationships were tested using chi square tests (c²) and the software package SPSS (version 11.5).
Results: Out of the 6168 cases studied, 2528 (40.1%) were boys. Patients were assigned to three groups based on disease type: there were 1812 (29.4%) sputum- positive, 1920 (31.1%) sputum-negative, and 2449(39.7%) extrapulmonary cases.The incidence of sputum-positive TB declined from 0.8 per 100000 in 1992 to 0.2 per 100000 in 2005. A similar declining trend was observed for the overall TB incidence and in the incidence of sputum-negative and extrapulmonary cases. There was significant difference in TB incidence between girls and boys in the 10-14 year age group (P<0.001), but no sex difference was observed in 0-4y and 5-9y age groups.
Discussion: The incidence of sputum-positive TB decreased by 75 percent over the study period. This could be partly due to improvements in health status, better disease knowledge and the effects of Iran's National TB Control Program.
Conclusions: In children aged below 10 years, there was no significant difference in the incidence of tuberculosis between girls and boys. At puberty, the incidence of all types of TB was higher in girls. Based on these findings, further studies are needed to elucidate the gender distribution of childhood tuberculosis in Iran.

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Background & Objectives: Anemia is one of the most common disorders affecting all age groups. This cross-sectional study aimed to determine the prevalence of anemia and microcytic anemia in the population served by Asadabadi Health Center in Tabriz.
Methods: We used a systematic sampling method to select 1623 subjects out of a total of 233000 persons aged above 12 years. Measurements of hemoglobin, MCV (Mean Cell Volume) and in the case of anemia, serum iron, ferritin, TIBC (Total Iron Binding Capacity), together with hemoglobin electrophoresis and reticulocyte count were performed in reference laboratories. Data were analyzed using T tests and the Epi6 software package.
Results: The prevalence rate of anemia was 9.7% more than 75% of the cases were due to iron deficiency, while 11.4% were caused by minor thalassemia. Prevalence rates for iron deficiency anemia and minor thalassemia in studied population were 7.3% and 1.1% respectively.
Conclusion: Findings show that the degree of anemia- as defined in the WHO classification- is mild in this region. The most common cause of anemia is iron deficiency.

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Background & Objectives: Rabies is one of the oldest and most lethal zoonoses in the world. Cases have been reported from most provinces of Iran, involving both domestic and wild animals. This study aimed to define the epidemiology of rabies in human and animal populations in the western province of Ilam and was conducted in all of the 7 cities of the province.
Methods: In this descriptive study we recorded data on the number of the persons bitten by animals, geographical location, age category, occupation and professional relationships, pre-exposure prophylaxis, treatment for rabies, conditions of the injured organs, and the mortality rate. Data were analyzed using the SPSS software package.
Results: There were 4 human deaths from rabies in this province (2 men and 2 women) three of these cases had been bitten by dogs and the remaining one by a cat. The mean age of these people was 25.2 years (SD=15.3y). A total of 2431 people had been bitten by animals over the preceding 10 years. Most such injuries happened in the 10-29y age group and the frequency was greater for males (P<0.01). About 64% of all cases had been reported from rural areas, and the greatest number of injuries occurred in winter and spring. The most common sites of injury were hands and feet (88.5%), trunk and the cervical region (9.3%) and head/ face (2.2%).
Conclusion: The increasing number of stray dogs and the movement of dogs and wild animals into cities and villages are important factors in the transmission of rabies. More research needs to be done on the eco-epidemiology of the disease in different cities of Ilam.

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Background & objective: In Iran, cutaneous leishmaniasis (CL) as a health problem is increasing and presenting two epidemiological forms Zoonotic CL (ZCL) and anthroponotic CL (ACL). The objective of the present study was to introduce the CL epidemic in Baft district, Kerman province.
Methods: This study was conducted in 3 villages Soltanabad, Vakilabad and Shahmaran as a census between spring and autumn of 1998 in Orzoeihe region, Baft district. Various epidemiological aspects of this epidemic including prevalence and related demographic factors, diagnosis by direct smears, identification of the causative species by immunological and biological methods were determined.
Results: Population of the 3 villages was 13721 mean 21.8±13.9 years, 50.7% males and 49.3% females.. The prevalence rate of 12.3% with mean age of 16.3±12.1 years were infected. Most of the cases were in 10-20 years of age and in Soltanabad (30.6%). The mean number of lesions was 2.58, majority with ≥2 lesions, frequently located on the legs and hands. No previous history of CL scar were observed. All 100 IFAT, 30 ELISA tests and 18 inoculated mice showed L.major as the overall causative agent.
Conclusions: This is the first epidemic of CL occurred in the southern villages of Baft district with high severity in all age and sex groups in a new agricultural region. Probably the source of infection was the new comers who arrived the region from endemic areas for agricultural purposes and infecting the gerbils. Thus, this new agricultural development has created an extraordinary suitable condition for propagation of rodents and sand fly populations, then the occurrence of the new epidemic in rural residence, consequently.