Showing 14 results for Leishmaniasis
I Sharifi, F Zamani, Mr Aflatoonian, Ar Fekri,
Volume 4, Issue 1 (4-2008)
Abstract
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.
V Torabi, M Mohebali, Ghh Edrissian, H Keshavarz, M Mohajeri, M Hajjaran, B Akhoundi, Aa Sanati, Z Zarei, A Delshad,
Volume 4, Issue 3 (3-2009)
Abstract
Background & Objectives: This study aimed to determine of the seroprevalence of visceral leishmaniasis to design a prevention and control program in Bojnoord district.
Methods: This was a descriptive and cross sectional study with multistage random sampling method. The study was carried out on children up to 12 years old and 10% of adult’s population in 8 rural areas of Bojnoord district in 2007. In total, 1608 blood samples were collected to detect anti-Leishmania antibodies. All the samples were tested by direct agglutination test (DAT). In order to determine Leishmania species, necropsy was performed on four suspected dogs in the studied areas. The species of Leishmania was determined by RAPD-PCR and PCR-RFLP methods using to amplify the ribosomal internal transcribed spacer 1 (ITS1).
Results: Thirty and eight (2.36%) out of 1608 collected blood samples had anti-Leishmania antibodies at titer 1:800 and nine (0.56%) were just positive at 1:3200 by DAT. There was no statistically significant difference between female and male seroprevalence (p<0/05). The seoprevalence in children <=12 years old compared to individuals greater than 12 years old did not show any statistically significant (p<0/05). Amastigotes were observed in all 4 necropsied dogs. The species of Leishmania isolated from 2 dogs, was determined as L.Infantum. Their ITS1 sequences were registered with Accession numbers EU810776 and EU810777 in NCBI.
Conclusions: These findings showed that visceral leishmaniasis has been circulated with low endemicity in Bojnoord district. Therefore an appropriate monitoring system is needed for health services in this area.
Mr Aflatoonian, I Sharifi, L Ranjbar,
Volume 6, Issue 2 (9-2010)
Abstract
Background & objectives: Cutaneous leishmaniasis (CL) is an endemic disease in district of Bam. It has created considerable concerns by people and health authorities. The objective of this study was to assess the effect of the earthquake and costs of prevention on CL prevalence after earthquake
Methods: This research is based on a natural intervention, in which the information related to the costs and prevalence of CL were collected and analyzed three years after the earthquake (2006-2008) and then compared with similar data three years before the earthquake (2000-2002) as control group.
Results: the earthquake increased the CL prevalence approximately 5.2 fold, although the cost of prevention had no significant effect on control of disease. The average cost of prevention was determined to be two US dollars per capita during the years after the earthquake. It figures up an overall estimation of 600000 US dollars for the three years after the earthquake. Meanwhile the cost of prevention before the earthquake was determined less than 5% comparing to after earthquake.
Conclusions: The findings of this cost-analysis showed that the current and conventional methods of CL prevention seem not useful. It could be concluded that current preventive measures such as spraying and impregnated bed nets particularly in natural disasters would have no effect on control of disease. Further researches are needed to find out the best method of prevention of CL disease. At present, it seems that early case-finding and prompt treatment of cases would be a proper method to control anthropometric CL .
K Azizi, M Kalantari, S Fekri,
Volume 7, Issue 3 (12-2011)
Abstract
Background & Objectives: The city of Jask in south east of Iran has been considered an endemic focus of leishmaniasis. PCR-based techniques can detect lower parasite burdens, reducing the number of false negatives and improving the quantification of Leishmania parasites in the sand fly. The aim of this epidemiological study was to detect vector(s) by PCR techniques in the city of Jask located in Hormozgan province.
Methods: Sand flies were captured using CDC miniature light traps and sticky papers during 2007-2008 and identified by their morphology. DNA extraction performed by Proteinase K and Phenol/Chloroform/Isoamyl Alcohol methods. Leishmania kinetoplast minicircle DNA was amplified by two Nested-PCR techniques using species-specific primers (LINR4-LIN17-LIN19) and (CSB1XR-CSB2XF-LiR-13Z).These primers could differentiate among Leishmania species of Iran.
Results: A total of 8123 sand flies were collected. The fauna was identified as eight species (3 Phlebotomus and 5 Sergentomyia). Phlebotomus papatasi, P. salehi and Sergentomyia theodori were the three most dominant species (59.91%, 17.21% and 7.32% respectively).
60, 50 and 40 parous unfed female specimens of P. papatasi, P. salehi and S. theodori were investigated for Leishmania DNA infection. Leishmania major DNA was detected in 3 (5%) specimens of P. papatasi and 2 (4%) specimens of P. salehi. Anthropophilic index of these two species were 29.6 & 18 percent, respectively.
Conclusion: This study was the first molecular study for detection of cutaneous eishmaniasis vectors in Hormozgan province in Iran. According to the findings of the present study P. papatasi and P. salehi are probable vectors of cutaneous leishmaniasis in this focus.
Mr Aflatoonian, I Sharifi,
Volume 7, Issue 3 (12-2011)
Abstract
Background & Objectives: Cutaneous leishmaniasis (CL) is one the major health problem in tropical and sub– tropical countries. Bam district in Iran is an old focus of anthroponotic CL (ACL). The aim of this survey was to assess the prevalence rate of CL by case– finding, treatment of cases and training of primary school children in the city and suburb of Bam in 2010.
Methods: All school children in three levels (18501 children) were included. Children were physically examined for presence of sores or scars. Suspected cases were referred to the center for cutaneous leishmaniasis control (CCLC) for diagnosis and the CL positive children were treated, accordingly. School children were trained and also educational and informative pamphlets were given to their parents.
Results: After initial physical examination ,117 suspected school children (6.9%) were referred to the CCLC and 48 children (28 per 10000) diagnosed as CL patients, comprising of 19 females (39.5%) and 29 males (60.5%). Fifteen (31.2%) school children were identified as lupoid leishmaniasis, failure to treatment or non – healing cases.
Conclusion: The prevalence rate was decreased about 18– fold as compared to the previous investigation in 2005. Establishment of the CCLC, active case– finding and subsequent treatment, seem to be a successful model for controlling CL in the endemic countries.
E Akbari, E Mayvaneh, A Entezari, M Nazari,
Volume 10, Issue 3 (12-2014)
Abstract
Background & Objectives : Leishmaniasis is a disease of the skin caused by a variety of protozoa. Leishmaniasis can be seen in any geographic region. This study investigated the role of climate on the prevalence of cutaneous leishmaniasis in the city of Sabzevar between 2003 and 2009.
Methods : Daily meteorological data (minimum, maximum and mean temperature, sunshine hours, precipitation, and humidity) and city-level data on the prevalence of cutaneous leishmaniasis between 2003 and 2009 were prepared and analyzed using Pearson correlation, time delay, and time series methods.
Results: The maximum incidence of the disease was observed during the second half of the year, especially in the autumn, in the age group 10 to 20 years. The highest incidence was seen among women and for the wet (rural) type. In addition, the disease showed a weak positive correlation with relative humidity and rainfall, and a weak inverse correlation with sunshine and temperature. It is noteworthy that in the delay analysis, correlations increased with a confidence interval of 95%. In the time delay of three months, the correlation of leishmaniasis incidence and prevalence with relative humidity and rainfall was positive and strong (r=0.82 and P=0.006, r=0.88 and P=0.002, respectively) and the correlation of the disease with temperature and sunshine hours was inverse and strong (r=0.80 and P=0.01, r=0.77 and P=0.01, respectively).
Conclusion : Considering the significant relationship between climatic factors and leishmaniasis in desert regions, we recommend appropriate measures should be taken to identify and control these factors.
Mr Aflatoonian, I Sharifi, Mr Shirzadi, B Aflatoonian,
Volume 12, Issue 1 (6-2016)
Abstract
Background and Objectives: Anthroponotic cutaneous leishmaniasis (ACL) is restricted to humans; thus, prompt diagnosis and early treatment are significant measures to control the disease. This study was conducted to determine the effect of direct active case- detection and early treatment on the control of ACL in Bam District.
Methods: This retrospective cohort study was performed based on intervention and nonintervention. After the 2003 earthquake, an equipped treatment center was established to actively detect CL cases following the CL epidemic. This intervention was carried out in 2007 and the suspected cases were referred to the center for diagnosis and treatment Another comparable CL treatment center was selected as the control in Kerman. The recorded data of the patients were analyzed with statistical tests at p<0.05.
Results: The incidence rate steadily increased to 30% from 2003 to 2007 whereas the incidence gradually decreased to 1% after the intervention. However, by contrast, the incidence rate increased significantly in the control area. The treatment failure and relapse rate of ACL showed no significant difference with the control group before and after the intervention. The effectiveness of the intervention was calculated to be 85%.
Conclusion: Active case-detection and early treatment of ACL could be an effective measure in controlling ACL, particularly during epidemics. Lessons learned from the 2003 Bam earthquake could be used as a suitable model for ACL endemic areas, nationally and globally.
Mr Aflatoonian, I Sharifi, M Zeinali, M Bamorovat, B Aflatoonian,
Volume 12, Issue 2 (8-2016)
Abstract
Background and Objectives: Cutaneous leishmaniasis (CL) is a public health problem in Iran and Kerman Province which is expanding to new foci. This study was conducted to estimate the incidence of CL by a simple and cost – effective method in a major focus of CL in the city of Kerman, southeastern Iran.
Methods: A combination of two longitudinal and cross – sectional studies was performed. First, the frequency of referred patients to the CL treatment clinic in 2009-2014 was assessed. Then, four highly infected zones consisting of 800 households in the city were selected. In addition, the relative proportions of referred and non – referred subjects were assessed. Eventually, the incidence of CL was calculated by dividing the number of CL cases over the total at risk population for the corresponding period (2009-2014).
Results: The mean annual incidence was 175 per 100000 (943 patients) in the city of Kerman, while it was 500 per 100000 people (0.5%) in the new foci. The highest CL infection was observed among the <25-year-old individuals but there was no significant difference between the sexes.
Conclusion:The incidence rate probably increased significantly following the 2003 Bam earthquake because of the migration of CL patients to southern, eastern, and northeastern areas of the city of Kerman. Since only 50% of the cases were passively referred to the CL treatment clinic, health authorities should actively detect CL cases by house – to – house visit for effective treatment strategies.
F Heydarpour, A Akbari Sari, M Mohebali, S Bokaie,
Volume 13, Issue 1 (6-2017)
Abstract
Background and Objectives: Leishmaniasis encompasses a wide range of clinical complaints from skin injury to fatal visceral infections. Detailed information about the economic burden of the disease can help health care decision makers to estimate the magnitude of the problem, economic advantages obtained from the prevention of this disease, resource allocation, and disease management. The study was conducted to determine the economic burden of leishmaniasis in humans and animals in Iran in 2013.
Methods: The cost unit was determined through public service tariffs determined by the Ministry of Health and Medical Education and interviews with experts, and service costs were calculated by multiplying the cost unit for one person by all infected cases. The course of the disease and the services provided to patients were obtained from the review of the literature and records and interview with experts.
Results: The economic burden of leishmaniasis was estimated more than IRR 213 billion ($6,700,000). Moreover, 39%, 27%, 18%, and 16% of the costs were related to indirect costs, direct medical costs, indirect medical costs, and dogs, respectively. The average direct medical cost of cutaneous and visceral leishmaniasis was IRR 3381186 ($106) and IRR 9392832 ($295) per person, respectively.
Conclusion: The economic burden of leishmaniasis compared to some diseases such as hydatid cyst showed a smaller number( 232.3 million$). It is recommended that IIranian health politicians consider the economic burden of other diseases.
G Moradi, A Veysi, K Rahmani, H Erfani, A Doosti Irani , Mr Shirzadi, F Gharachorloo, M Nabav, Mm Gouya,
Volume 15, Issue 1 (5-2019)
Abstract
Background and Objectives: Leishmaniasis control in each country, especially in countries where the disease is endemic, requires designing and implementing an organized national surveillance system. Iran has long been considered as an endemic country for leishmaniasis. The purpose of this study was to review the leishmaniasis surveillance system in Iran.
Methods: In this review study, the data were obtained from the surveillance system, reports and documents, published guidelines, reviews of the existing structures, and the views of the managers and experts of the Center for Communicable Diseases control in Iran in 2018.
Results: The surveillance system for two types of leishmaniasis, cutaneous leishmaniasis and visceral leishmaniasis (Kala-azar), is currently operational in the country, and new cases are reported monthly. For each identified case, in addition to the epidemiologic attributes, treatment and follow-up as well as follow-up of possible contacts are done as per to the guidelines for each of these diseases.
Conclusion: The current surveillance system for leishmaniasis has improved the process of reporting cases in recent years. However, the low rate of reporting of cases, especially for cutaneous leishmaniasis, and epidemiological complexities in the transmission of the infection indicate the need for reviewing and improving the current surveillance system. Data from the surveillance system and the increasing number of leishmaniasis cases in Iran reveal the need for innovations to strengthen the control measures for this disease.
Mr Aflatoonian, A Nadim, I Sharifi, M Bamorevat, S Tajik, M Hashemian, R Abasi Rayeni, R Shabanzadeh, B Aflatoonian,
Volume 15, Issue 3 (11-2019)
Abstract
Background and Objectives: Cutaneous leishmaniasis (CL) is one of the health problems in Iran, especially in Kerman Province. The aim of this study was to determine the morbidity rate of CL in two new foci in the east and southeast of Kerman.
Methods: At the end of 2017, demographic data were obtained from the health centers of Kerman. Using cluster sampling, 800 households (40 clusters of 20 households) were studied in Allahabad (southeast) and Sarasiab (east), Keramn. From each subject, data were collected regarding age, sex, number and location of the ulcer(s), scarring, and time and place of infection. The collected data were analyzed using SPSS software.
Results: The prevalence of CL was 9.6 in Allahabad and 42.8 in Sarasiab and the incidence (new cases) was 3.2 and 3.8, respectively. The highest rate of infection was found in Allahabad in the age group under 6 years old and in the Sarasiab was over 40 years old. There was a significant difference in nationality and local transmission between the rwo regions (P <0.001).
Conclusion: The ratio of the prevalence to incidence in two regions showed that the focus in the east of Kerman was almost 12 years old, whilst a new focus is developing in the southeast. It is suggested that the health centers in the city of Kerman provide a regular program including active case- detection and free-of-charge treatment of patients in the aforementioned areas until complete recovery to achieve disease control.
M Javanbakht, M Argani, K Ezimand, A Saghafipour,
Volume 17, Issue 1 (5-2021)
Abstract
Background and Objectives: Environmental conditions in different geographical areas provide a basis for the spread of some diseases. Cutaneous leishmaniasis is a serious threat to public health and is one of the arthropod-borne diseases. The prevalence and distribution of this disease is affected by environmental and climatic factors. The aim of this study was to model the Spatio-temporal variations in the incidence rate of this disease based on environmental and ecological criteria.
Methods: The northeast of Iran was selected as the study area. The data used in this study included vegetation, surface temperature, precipitation, evapotranspiration, soil moisture, digital elevation model and sunny hours. The artificial neural network method was used to model the spatio-temporal changes of cutaneous leishmaniasis.
Results: Spatial variations in the incidence of the disease had a north-south trend and decreased from north to south. In addition, two foci were identified in the medium altitude areas in North and South Khorasan provinces. Temporal variations in the incidence of disease in the study period showed that the incidence rate decreased in the two identified foci from 2011 to 2016.
Conclusion: The modeling results showed that the estimated regression coefficient was 0.92 for neural network based on all three types of data (training, validation, test) indicating good quality of constructed neural network. In addition, sensitivity analysis results showed that sunny hours and soil moisture were the most important factors in the model function.
N Rajabi, R Fadaei, A Khazeni, J Ramezanpour, S Nasiri Esfahani, Gh Yadegarfar,
Volume 17, Issue 3 (12-2021)
Abstract
Background and Objectives: Due to the importance of cutaneous leishmaniasis, the national leishmaniasis project began in 2007 in Iran. The aim of the present study was to evaluate community interventions in changes in the incidence of cutaneous leishmaniasis in Isfahan Province from 2002 to 2018: an Interrupted time series regression analysis.
Materials and Methods: The present study was a repeated cross-sectional study. The incidence and 95% confidence interval were used to describe the disease trend. Data were entered into the Excel and analyzed using STATA14 software at a significance level of 5%. Intermittent time series regression analysis was used to evaluate community interventions in changes of leishmaniasis incidence.
Results: from 2002 to 2018, the data of 43,904 patients with leishmaniasis was registered in Isfahan Health Centers. The mean (standard deviation) age of the patients was 23.99 (19.03) years. The incidence had a decreasing trend after the interventions in all affiliated cities and the whole province.
Conclusion: The preventive intervention programs of the provincial health center have been rather successful and have reduced the incidence of the disease in the years after the intervention, so that despite the large number of confounding and influential factors regarding this disease, preventive intervention programs have led to disease control according to the reported annual incidence.
Mostafa Talebi, Sareh Shakerian,
Volume 19, Issue 3 (12-2023)
Abstract
Background and Objectives: Cutaneous Leishmaniasis is a significant endemic diseases in Iran, leading to skin lesions, lifelong scars, and social stigma. This study aims to investigate the influence of climatic and ecological factors on the prevalence of cutaneous Leishmaniasis in Iran.
Methods: This study employed a narrative review approach. A comprehensive search was conducted using key terms such as 'skin Leishmaniasis', 'cutaneous Leishmaniasis', 'climatic factors,' and 'environmental factors' in both national and international databases. All relevant research was included without limitations on location, time, or research methodology.
Results: The initial search yielded 823625 articles. After refining the search keywords and conducting initial screening, 184 studies remained following the removal of duplicate articles. Subsequent screening for eligibility further narrowed down the selection to 30. The inclusion of 6 master theses brought the final number of studies for review to 36. A review of the studies showed a significant association between certain climatic factors, including temperature, humidity, hours of sunshine, and rainfall, and the incidence of cutaneous Leishmaniasis, across various geographical regions in the country. The relationship between factors such as vegetation, wind, and the number of disease cases had different results in different parts of the country.
Conclusion: The results of the present study show the effect of climatic and environmental factors on the rate of cutaneous Leishmaniasis in the country. Considering that the effect of these factors is not the same in all parts of the country, it is necessary to implement effective preventive measures to reduce the disease burden according to the needs of each geographical area.
