Epidemiological Survey of Cutaneous Leishmaniasis in Mazandaran Province, Northern Iran

Abstract

Background & Aims of the Study: Cutaneous leishmaniasis (CL) is considered one of the most important human vector-borne diseases in Iran. The current study aimed to determine some epidemiological aspects of cutaneous leishmaniasis in Mazandaran, Northern Iran. Materials and Methods: This descriptive study was conducted using the epidemiological data, including demographic and clinical features collected from 379 patients diagnosed with leishmaniasis in health centers affiliated to the Deputy for Health Center of Mazandaran University of Medical Sciences within 2009-2017. The disease was diagnosed based on clinical information and direct microscopic examination of the samples. Data were analyzed in SPSS software using nonparametric Kruskal-Wallis and Mann-Whitney U tests. Results: A total number of 379 individuals were diagnosed with CL during a 9-year period. Considering the population in Mazandaran, the incidence rate was reported as 1.27 per 100,000 population. It was also revealed that most of the cases of CL (n=279; 73.6%) were males and the majority of patients (n=137; 36.1%) were in the 20-29 age group. In addition, the majority of the ulcers were observed in hand (n=152; 26.7%) and foot (n=129; 22.6%), respectively. Moreover, just one ulcer was spotted in most of the patients (n=143; 37.7%). As the final note, the incidence was at the highest level during autumn in November (n=61; 16.1%). Conclusion: As evidenced by the obtained results, cutaneous leishmaniasis poses a daunting challenge to the public health in Mazandaran. This disease can be attributed to several factors, including agricultural activities, animal husbandry, and frequent national and international holidaymakers' visits to the province. With this background in mind, the results of the currents study could contribute greatly to the effective control of this disease.

Reemergence of zoonotic cutaneous leishmaniasis in an endemic focus, northeastern Iran

“…In the present study, most of the patients were male, which is in accord with the results of other studies in Golestan ( Jorjani et al, 2019 ), Mazandaran ( Ghavibazou et al, 2019 ), Northkhorasan ( Alavinia et al, 2009 ) and Qom ( Rostami et al, 2013 ) provinces, and also the study carried out over four decades in Iran ( Piroozi et al, 2019 ). The higher leishmaniasis cases in men seems to be due to more outdoor activity and less coverage compared with women wearing Hijab in Muslim countries, leading to being bitten more by sand flies.…”

“…This finding is in accordance with studies conducted in Golestan ( Jorjani et al, 2019 ) and Kerman ( Khosravi et al, 2017 ) provinces, in northern and southeastern Iran, respectively. However, contradict with studies conducted in the areas with low endemicity of CL such as Mazandaran ( Ghavibazou et al, 2019 ), in northern and Kashan ( Moein et al, 2018 ), in central Iran, which reported the highest incidence in the age group of 20–29 years. It is worth noting that when the endemicity of a certain disease is high (as in the current study), the disease is more common in younger age groups.…”

“…This monthly distribution is due to the duration of disease and reflects the rural type of disease in the present study. In other studies, for example in Golestan ( Jorjani et al, 2019 ) and Mazandaran ( Ghavibazou et al, 2019 ), the peak of disease distribution was in November, in North Khorasan Province ( Alavinia et al, 2009 ) in September and in Kashan ( Moein et al, 2018 ) and Qom ( Rostami et al, 2013 ) in central Iran, in Autumn.…”

“…This result agrees with the study carried out in North Khorasan Province, which the lesions were observed more frequently on the face. In the studies in Kashan ( Moein et al, 2018 ), Kerman ( Khosravi et al, 2017 ) and Mazandaran ( Ghavibazou et al, 2019 ) provinces most of the lesion were reported on the hands. In CL, dermal lesions are commonly seen on bare areas of the body.…”

Bioecological Study on the Sand Flies (Diptera: Psychodidae, Phlebotominae) in Sari County, North of Iran

“…Mazandaran Province is considered as one of the sporadic foci of leishmaniasis. In previous studies, sporadic cases of cutaneous and visceral leishmaniasis have been documented in some parts of the Province ( 18 – 20 ), some of which have a history of travel to endemic areas of leishmaniasis. Since Mazandaran Province borders with the provinces that are endemic foci of the disease, disregarding the characteristics of the vectors can lead to an increase in the incidence of this disease.…”