Background: Leishmaniasis is one of the most important parasitic diseases in the Golestan Province, northeastern Iran. In this study, we summarize the results of studies on the disease and its causative agent Leishmania in humans, vectors and reservoirs in the Golestan Province, Iran. Methods: We retrieved all articles related to leishmaniasis in the Golestan Province, northern Iran from 1994 to 2018 in various databases including PubMed, Scopus and Web of Science. Articles in Persian were retrieved from the IranMedex, SID and Magiran. Reference lists of relevant articles were also hand-searched. Local active researchers in the field of leishmaniasis were contacted to avoid missing any relevant articles. Overall, 54 papers were extracted, later evaluated by two research team members based on inclusion criteria. All analyses were performed using the Stata 14 software. Pooled prevalence was calculated using the metaprop command and a random-effect model. The I² statistic was used for measuring heterogeneity of studies. Results: Ten articles in the province were related to detection of Leishmania species in patients with suspected cutaneous or visceral leishmaniasis. Fifteen articles were dedicated to identification of Leishmania species in disease reservoirs and five articles were about detection of the parasite in sand flies. The pooled prevalence of L. major in patients with acute ulcer, wild rodents and sandflies was 83%, 29% and 11%, respectively. Conclusion: Our findings highlight the need for implementation of control measures among the reservoirs of both cutaneous and visceral leishmaniasis in the Golestan Province, Iran.

Background and objective: zoonotic cutaneous leishmaniasis (ZCL) is one of the most important health problems in Golestan Province, northeastern Iran. Several studies have investigated various aspects of the disease in this province. Herein, we provide a detailed review of the results of all studies related to leishmaniasis to give a reliable insight into the state of the disease in this province. Methods: The search for articles was performed in PubMed, Scopus, and Web of Science without language restriction until the beginning of 2019. Articles in Persian were retrieved from the Magiran, Scientific Information Database, and IranMedex. Overall, 41 articles were subjected to content analysis under the different themes. Results: Counties of Gonbad-e-Kavus and Maraveh Tappeh are endemic areas of ZCL with an incidence rate 99.4-379.1 in 100000 population and has mesoendemic situation in these counties. Leishmania major is the dominant (99.1%) agent of leishmaniasis. Among 18 sandflies species detected in the province, Phlebotomus papatasi was the main vector of the disease with a mean infection rate of 9.2%. Peak of sandflies activity was recorded in the mid-July and mid-September. Rhombomys opimus and Meriones libycus were the main reservoirs of this disease with a mean infection rate of 25.3 and 31.8%. The density of sandflies and wild rodents were highest in the endemic areas for ZCL. Conclusion: In Golestan Province, ZCL has been in a hypoendemic situation and in some areas in a mesoendemic situation and has increased significantly in recent years, so it is recommended to investigate the reasons for this increase.