Prevalence of human visceral leishmaniasis in Iran: A systematic review and meta-analysis

Rostamian, Mosayeb; Bashiri, Homayoon; Yousefinejad, Vahid; Bozorgomid, Arezoo; Sohrabi, Nasrin; Raeghi, Saber; Khodayari, Mohammad Taghi; Ghadiri, Keyghobad; Rezaeian, Shahab

doi:10.1016/j.cimid.2020.101604

Cited by 24 publications

(19 citation statements)

References 34 publications

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“…These findings are in agreement with Haftom et al [ 45 ] (2021) in Ethiopia, Belo et al [ 53 ] (2013) in the Americas, and Kone et al [ 50 ] (2016) in Mali. However, two Iranian studies[ 47 , 49 ] disagreed with the current findings, with both studies reporting that the pooled prevalence of human leishmaniasis (CL & VL) was higher in females than in males. The sex-related difference in the pooled prevalence of human leishmaniasis between the current study and the Iranian studies may be due to differences in the cultural and work patterns between Sudan and Iran, Whereby, Iranian women were more involved in agricultural and livestock activities than men which would increase their risk of being bitten by sand flies[ 49 , 54 ].…”

Section: Discussioncontrasting

confidence: 91%

“…This makes sense because people who work in the agriculture and/or livestock sectors are at a higher risk of being bitten by sand flies. Similar results were found in Iran[ 47 , 49 ], Mali[ 50 ], and the Americas[ 53 ].…”

Section: Discussionsupporting

confidence: 83%

“…In contrast, Haftom and his colleagues (2021)[ 45 ] found a higher pooled prevalence of VL compared with CL in Ethiopia. Furthermore, the pooled prevalence of VL in Sudan was significantly higher than in Iran (2%)[ 46 , 47 ] and lower than it is in Latin America at 38.8%[ 48 ]. However, the current results seem to have one the highest reported pooled prevalence of CL worldwide, with only Sabzevari and his colleagues (2021)[ 49 ] in Iran reporting a higher pooled prevalence (45%); all other studies reported a lower pooled prevalence of CL compared with the current findings, including 22.1% in Mali[ 50 ], and 6.03%[ 45 ], and 19%[ 44 ] in Ethiopia.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of human leishmaniasis in Sudan: A systematic review and meta-analysis

Ahmed¹,

Abdullah²,

Bello³

et al. 2022

WJM

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BACKGROUND There are three main forms of leishmaniasis in humans: cutaneous leishmaniasis (CL), visceral leishmaniasis (VL), and mucocutaneous leishmaniasis. The prevalence of human leishmaniasis varies widely in different countries and different regions of the same country. To date, there is no overall estimation of the prevalence of human leishmaniasis in Sudan. AIM To determine the pooled prevalence of human leishmaniasis and the disease risk factors among Sudanese citizens. METHODS From all articles written in English or Arabic languages conducted before the 4th of August 2021 from [Scopus, Web of Science, PubMed, and MEDLINE, African Journals Online (AJOL), ResearchGate, direct Google search, Google Scholar, and universities websites], just 20 articles with a total of 230960 participants were eligible for this study. Data synthesis and analysis were done using STATA software, version 16. EndNote citation manager version X9.3.3 and Reference Citation Analysis ( RCA ) were used to remove the duplicated studies and manage the citation respectively. RESULTS The overall pooled prevalence of human leishmaniasis in Sudan was 21% (with confidence interval 12%-30%). CL was the most common type of leishmaniasis in Sudan, with a pooled prevalence of 26% followed by VL (18%). Nevertheless, the pooled prevalence of human leishmaniasis in Sudan was higher in males compared with females (60% vs 40%). The current results revealed that the people in the age group between 15 and 44 were the most affected group (60%), and central Sudan has the highest pooled prevalence of human leishmaniasis (27%) compared with other regions of Sudan. Finally, the prevalence of human leishmaniasis seems to decrease with time. CONCLUSION This study showed that human leishmaniasis infection is still endemic in many regions in Sudan and highly prevalent in central and eastern Sudan, and CL is the most prevalent in the country. Males and adults were more susceptible to infection compared with females and children. However, the human leishmaniasis prevalence decreased relatively over time.

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Section: Discussioncontrasting

confidence: 91%

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

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Prevalence of human leishmaniasis in Sudan: A systematic review and meta-analysis

Ahmed¹,

Abdullah²,

Bello³

et al. 2022

WJM

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“…According to the results of a recent systematic review, the prevalence of HVL infection has been decreased in Iran throughout the last two decades. The maximum (3%, 95% CI: 1-5%) and minimum (0.5%, 95% CI, 0.2-0.7%) pooled prevalence of HVL was estimated in the northern and western Iranian provinces, respectively (173). It should be noted that the reason for reporting the relatively high number of cases of VL in Tehran, central Iran, as shown in Figure 3, is that these patients were referred to Tehran University Hospitals from other regions for diagnosis and treatment follow-up.…”

Section: Discussionmentioning

confidence: 95%

The Geographical Distribution of Human Cutaneous and Visceral Leishmania Species Identified by Molecular Methods in Iran: A Systematic Review With Meta-Analysis

Hajjaran

Saberi

Borjian

et al. 2021

Front. Public Health

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Leishmaniasis is one of the most common vector-borne parasitic diseases in Iran. Leishmania species identification is necessary for epidemiological aspects, precise prognosis, control and treatment of the disease. We systematically searched all the studies, reports, and documentation related to species identification and geographical distribution of causative agents of cutaneous (CL), mucosal (ML), and visceral leishmaniasis (VL) using DNA-based molecular diagnostic techniques in Iran. International databases including PubMed, ScienceDirect, Embase, Google Scholar, Scopus, and Web of Science were systemically searched for English articles and Iran's databases including SID, IranMedex and Magiran were searched for Persian reports and articles. Searches were performed from 1999 to 2019 (20 years). The current review was conducted using the keywords: cutaneous leishmaniasis, visceral leishmaniasis, Leishmania species, Human, Molecular, PCR, and Iran. The study quality was evaluated using the NOS checklist. This meta-analysis procedure was accomplished using STATA, version 2.7.9. Of the 3,426 records identified in the initial search, 154 articles met inclusion criteria and qualified for the systematic review and meta-analysis. In subgroup analysis, the pooled frequency of causative agents of CL isolates was 67.3% (95% CI: 59.51–74.67%) for L. major and 32.1% (95% CI: 24.72–39.87%) for L. tropica. In addition, the pooled frequency of causative agents of VL isolates was 97.1% (95% CI: 94.6–98.8%) for L. infantum and 2.9% (95% CI: 1.12–5.37%) for L. tropica. The findings of this study showed that the main causative agents of CL and VL in Iran are L. major and L. infantum, respectively. Moreover, kinetoplast DNA (kDNA) and internal transcriber spacer (ITS) were the most used markers for identifying Leishmania species. The current study provides valuable data to encourage and direct researchers as well as public health managers in the comprehensive leishmaniasis control and prevention planning in Iran.

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“…It is good to know that Fars province is one of the central endemic regions of visceral leishmaniasis in southern Iran, with an estimated incidence rate of 0.01/10,000 in 2015 [ 11 ]. A recent meta-analysis reported a pooled prevalence of 2.1% (95% CI 1.4–2.8%) of VL in Southern Iran [ 17 ]. The first report of a benign hemophagocytic syndrome associated with VL in our region was published by Kumar et al in 1994 [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of the clinical features and outcome of children with hemophagocytic lymphohistiocytosis (HLH) secondary to visceral leishmaniasis and primary HLH: a single-center study

et al. 2021

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Background Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of excessive inflammation. We aimed to describe the clinical and laboratory findings of HLH patients secondary to Visceral leishmaniasis (VL) and their treatment outcome during a 4-year follow-up period compared to primary HLH. Method Forty children with primary HLH confirmed by genetic study and 20 children with HLH secondary to VL confirmed by a blood or bone marrow polymerase chain reaction from 2014 to 2018 in Shiraz, Fars province, Southern Iran, were enrolled. Results The median age at diagnosis was 11.5 months (range 1–170), and 56.7% were male. Fever and splenomegaly were the most frequent clinical presentations. 93.3% of the subjects had an HScore > 169, which had a good correlation with HLH-2004 criteria (r = 0.371, P = 0.004). Patients with primary HLH experienced more thrombocytopenia (P = 0.012) and higher alanine transaminase (P = 0.016), while patients with VL-associated HLH had higher ferritin (P = 0.034) and erythrocyte sedimentation rate (P = 0.011). Central nervous system (CNS) involvement occurred in 38.3% of patients. The mortality rate was higher in patients with CNS disease (61% vs. 35%, P = 0.051). The 3-yr overall survival rate was 35.9%. (24% in primary HLH and 100% in VL-associated HLH, P < 0.001). In Cox regression analysis, platelet count < 100,000/ μ l (hazard ratio 4.472, 95% confidence interval 1.324–15.107, P = 0.016) correlated with increased mortality in patients with primary HLH. Conclusion VL is a potential source of secondary HLH in regions with high endemicity. Treatment of the underlying disease in VL-associated HLH is sufficient in most cases, with no need to start etoposide-based chemotherapy.

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Prevalence of human visceral leishmaniasis in Iran: A systematic review and meta-analysis

Cited by 24 publications

References 34 publications

Prevalence of human leishmaniasis in Sudan: A systematic review and meta-analysis

Prevalence of human leishmaniasis in Sudan: A systematic review and meta-analysis

The Geographical Distribution of Human Cutaneous and Visceral Leishmania Species Identified by Molecular Methods in Iran: A Systematic Review With Meta-Analysis

Comparison of the clinical features and outcome of children with hemophagocytic lymphohistiocytosis (HLH) secondary to visceral leishmaniasis and primary HLH: a single-center study

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