Cutaneous Leishmaniasis in Isfahan Province, Iran, During 2001-2011

Abstract

Background: Isfahan province is one of the common foci of the cutaneous leishmaniasis in Iran, particularly the wet or rural zoonotic cutaneous leishmaniasis (ZCL). Several factors other than the location of the disease are implicated in the epidemiology of cutaneous leishmaniasis, such as the presence of sandflies as vectors and the role of rodents as reservoirs. These factors that contribute to the transmission of the disease include agricultural projects, migration of the non-immune individuals to the endemic areas, rapid and unplanned urbanization, environmental changes (such as irrigation, dam construction, and desertification). Objectives: Due to the lack of information about the epidemiology and prevalence of cutaneous leishmaniasis in Isfahan province, Iran, this study was designed to investigate the aforementioned factors. Patients and Methods: Data were collected from the recorded data of patients with leishmaniasis referred to Isfahan Province Health Care Center, Isfahan, Iran. The patients were diagnosed by direct microscopic examination of the samples in Leishmaniasis and Skin Diseases Research Center and other health care centers. Data concerning demographic features, the number and location of lesions, duration of disease, area of residence, work location, the history of travel within the past two months, address, and telephone number of the patients was collected. The epidemiological status of leishmaniasis was determined from the recorded data. Results: In total, data of 28315 patients with leishmaniasis during 2001 to 2011 were studied .Among them, 10809 (38.2%) patients were female and 17491 (61.8%) patients were male. The mean age of the patients was 22.40 ± 16.52 years (range, 1-100 years). The incidence of lesions in different body parts was as follows: face, 12.1%; hands and legs, 12.3%; face and hands, 4.5%; legs, 24.1%; hands prevalence, 32.3%; and the other parts of body, 11.5%. The number of the lesions on the trunk ranged from one to three. In this study, 12163 (43%) patients had one, 6330 (22.4%) had two, 503 (8.1%) had three, and 8008 (28.3%) had more than three lesions. Overall, 17883 (63.2%) patients lived in urban areas and 8241 (29.1%) in rural areas and most of the cases were seen among those who lived in cities and urban areas. Conclusions: Considering the high prevalence of cutaneous leishmaniasis in the Isfahan province, eliminating the leishmaniasis vector and its reservoirs in this endemic area seems to be necessary. During the years, it has been showed that leishmaniasis is endemic in Isfahan province hence, a more extensive epidemiologic study is recommended.