Eco-Epidemiology of Cutaneous Leishmaniasis in Golestan Province, Northeastern Iran: A Systematic Review

Abstract

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.

Geographical and climatic risk factors of cutaneous leishmaniasis in the hyper-endemic focus of Bam County in southeast Iran

“…Shirzadi et al in a study that included provinces in the east and northeast of Iran showed a significantly positive relationship between CL incidence and land surface temperature (47). Mozafari et al (48) reported that the maximum temperature of the warmest month and mean temperature of the warmest and driest quarters have the highest contribution to the distribution of the disease in the Golestan province. Various studies have confirmed that higher maximum temperature, lower rainfall, and lower relative humidity are effective factors in the geographic distribution of leishmaniasis, especially in semi-arid areas of central Iran (47, 49, 50).…”

Epidemiological Aspects of Zoonotic Cutaneous Leishmaniasis (ZCL) in Iran, the Middle East, and Worldwide: A Comprehensive Systematic Review

“…The only area where the Indian desert jird is found is Sistan and Baluchistan. The female sandfly Phlebotomus papatasi spreads the virus, and it has been reported in different provinces of Iran, including Fars, Isfahan, Khuzestan, Yazd, Semnan, Ilam, Golestan, and North Khorasan (51)(52)(67)(68)(79)(80)(81)(82)(83)(84)(85)(107)(108)(109)(110)(111)(112)(113)(114)(115)(116)(117)(118)(119)14,31,48,62,65,71,75).…”

The Effect of Geographical and Climatic Factors on the Distribution of Phlebotomus papatasi (Diptera: Psychodidae) in Golestan Province, an Endemic Focus of Zoonotic Cutaneous Leishmaniasis in Iran, 2014

“…Further, various studies conducted in the province showed the CL incidence equal to 31.7 per 100,000 people. among them, the two counties of Gonbad-e Kavus and Maraveh Tappeh located in the northeast of the province had the highest incidence rates of 153 and 117 per 100,000 people ( 13 ). During 2010 – 2017, 360 – 1766 people from all age and gender groups in the province were infected with CL annually ( 14 ).…”

“…Compared to the other regions of the province, the vectors and reservoirs of the disease are more abundant in the northeastern region of the province and the disease has higher incidence. These differences could be reasons for the geographical and climatic susceptibility of the region to a higher prevalence of the disease ( 13 , 15 ).…”