Epidemiology Of Cutaneous Leishmaniasis Research Articles

Epidemiology of cutaneous leishmaniasis in children of Khyber Pakhtunkhwa, Pakistan.

In Pakistan, cutaneous leishmaniasis is an emerging tropical disease and a very high number (>70%) of children are afflicted by this marring infection. This study aimed to scrutinise the prevalence, spatial distribution and socio-demographic and behavioural risk factors associated with cutaneous leishmaniasis in children aged <5-15 years in Khyber Pakhtunkhwa. A total of 1, 559 clinically confirmed records of children diagnosed with cutaneous leishmaniasis (January-December) from 2020 and 2022 were obtained from selected district hospitals. In addition, a risk factors-related questionnaire was administered to 1, 011 households (400 in 2020 and 611 in 2022) in nine districts during a household survey. The maximum number of cutaneous leishmaniasis cases was recorded in 2022 (n = 877, 56.25%) as compared to 2020 (n = 682, 43.75%). The hospital records showed a greater number of male patients in the 2022 cohort (n = 603, 68.76%). The highest number of cases were observed in children aged 5-9 years in 2022 (n = 282, 32.16%) and 2020 (n = 255, 37.39%). In 2020 and 2022, cutaneous leishmaniasis cases showed peak aggregation in March (n = 118, 17.3%) and January (n = 322, 36.72%). From a spatial analysis, the maximum number of cutaneous leishmaniasis cases was recorded at 59-1700 m elevation in various land-use/land-cover and climatic regions with quaternary alluvium rock formations. A multivariate logistic regression model analysis of risk factors from the households survey suggested that age group, socio-economic status, construction materials of the house, use of insect repellents, Afghan refugee camps in the village/district, knowledge and biting times of sand flies, frequent use of mosquito bed nets, presence of domestic animals in the house, knowledge of the transmission period and peak month of leishmaniasis infection increased the risk of acquiring cutaneous leishmaniasis (p value < 0.05). Our analysis demonstrated that cutaneous leishmaniasis in children is influenced by a variety of environmental, socio-demographic and behavioural risk factors in Khyber Pakhtunkhwa. The increase in recorded cases of cutaneous leishmaniasis in children in 2022 compared to 2020 suggests that the infection likely extended to new foci in the province.

Cutaneous Leishmaniasis: A clinicoepidemiological Study in Al Muthanna Governorate/Iraq

Background: Leishmaniasis is an endemic disease in Iraq. There are three types of leishmaniasis; cutaneous, mucocutaneous, and visceral form. Cutaneous leishmaniasis (CL) is the most common type that causes skin sores. In Iraq, CL has 2 presentations, zoonotic cutaneous leishmaniasis which is caused by L. major, and anthroponotic cutaneous leishmaniasis caused by L. Tropica. Leishmaniasis, is transmitted by the bite of infected female phlebotomine sandflies. Objective: We aimed to verify the clinical and epidemiology of cutaneous leishmaniasis in the Al Muthanna governorate. Materials and methods: A prospective cross-sectional descriptive study was carried out in the outpatient dermatological clinic in Al Hussein Teaching Hospital during the period from the 1st of December 2021 to the 1st of April 2022 in Al Muthanna governorate, Iraq. Patients with CL of any age and both sexes were enrolled in the current investigation. Detailed information regarding the age, gender, residence, duration, site, number, and type (wet or dry) of the lesion was recorded for every participant. Results: Two hundred fifty patients were diagnosed clinically as having CL. Males represented 132 (52.8%) patients. The majority of the cases were found in the age group 0-10 (n = 174, 69.6%) patients. Eighty percent (n = 200) of the participants were from rural areas. Most of the cases were presented in less than two months (n = 164, 65.6 %). Most of the lesions affected the face (n = 89, 35.6%), and the least was seen in the upper and lower limbs (n = 9, 3.6 %). The majority of the cases had a single lesion (n = 164, 65.6%) and of the dry type (n = 178, 71.2%). Conclusion: CL is an endemic dermatological disease in the Al Muthanna governorate. Males were outnumbering females. The highest age group affected was 0-10 years. The majority of patients were from rural areas. The majority of the cases presented within two months, involved the face, had a single lesion, and were of a dry type.

Changes in the microbiological diagnosis and epidemiology of cutaneous leishmaniasis in real-time PCR era: A six-year experience in a referral center in Barcelona.

BackgroundLeishmaniasis is a neglected disease caused by different species of the protozoa Leishmania spp. Cutaneous lesions are the most common clinical manifestation. This disease is prevalent in tropical and subtropical areas, including the Mediterranean basin. In Spain, Leishmania (L.) infantum is the only endemic species, but imported cases are often diagnosed. Different classical parasitological methods can be performed for cutaneous leishmaniasis (CL) diagnosis; but currently molecular techniques serve as a relevant tool for the detection and characterization of Leishmania parasites. We aimed to evaluate clinical and epidemiological characteristics of CL diagnosed patients by real-time PCR in a tertiary hospital over a six-year period.Methodology/Principal findingsClinical, epidemiological and microbiological data were retrospectively collected and analyzed. In our study, CL was confirmed in 59 (31.4%) out of 188 patients by real-time PCR, showing an increase over recent years: 11 cases of CL between 2014 and 2016 and 48 between 2017 and 2019. Real-time PCR was performed on skin swabs and/or biopsies samples, with a positivity of 38.5% and 26.5%, respectively. Results were 100% concordant when biopsy and skin swab were performed simultaneously. L. (L.) infantum was the most frequent species detected (50%), followed by L. (L.) major (45%) and Viannia subgenus (5%), which were detected only in imported cases. L. (L.) major was almost entirely detected in travelers/migrants from Morocco. Multiple and atypical skin lesions were more common in imported cases than in autochthonous cases (44.4% vs. 21.8%).Conclusions/SignificanceAn increase in both autochthonous and imported CL cases has been observed in past years in our hospital. Molecular techniques assist in improving CL diagnosis and characterization of the Leishmania species, mainly in imported cases.

Molecular characterization of Leishmania species from stray dogs and human patients in Saudi Arabia

Leishmania major and Leishmania tropica cause cutaneous leishmaniasis in humans and dogs in several parts of the world, with a large number of cases recorded in the Middle East. However, when they occur in sympatry, the role of each species of Leishmania in the epidemiology of cutaneous leishmaniasis (CL) is not clear. To assess the frequency and to identify the species of Leishmania that infect humans and stray dogs in Riyadh and Al-Qaseem (Saudi Arabia), 311 stray dogs and 27 human patients who were suspected for Leishmania infection were examined for CL by a nested polymerase chain reaction (nPCR). Seven (25.9%) out of 27 human patients scored positive for Leishmania spp. (i.e., L. major in five patients from Riyadh and L. tropica in two patients from Al-Qaseem). Out of 311 dogs, five (1.6%) were infected by L. tropica. Data herein presented demonstrate the occurrence of L. tropica in dogs and humans in Saudi Arabia, as well as the occurrence of L. major in humans.

Epidemiology of Cutaneous Leishmaniasis due to Leishmania tropica through molecular approach in a residential area, Central Iran

Epidemiology of Cutaneous Leishmaniasis due to Leishmania tropica through molecular approach in a residential area, Central Iran

Changes in the Epidemiology of Cutaneous Leishmaniasis in Northeastern Iran

The province of Khorasan-Razavi in the North East of Iran is an endemic area for anthroponotic cutaneous leishmaniasis (ACL caused mainly by Leishmania tropica) and zoonotic cutaneous leishmaniasis (ZCL caused mainly by Leishmania major). Based on clinical signs, some cities were considered as ACL foci while others were considered to be endemic for ZCL. This paper reviews studies performed on patients diagnosed with cutaneous leishmaniasis (CL) via the use of direct slide examination, ELISA, electrophoresis isoenzyme, RAPD PCR and PCR in Mashhad; the study also includes cases of CL in other cities of the Khorasan-Razavi province where only PCR used as a diagnostic tool. The data show that both Leishmania tropica and Leishmania major caused CL in most of the cities investigated. Our review shows that Leishmania major was found in areas where ACL is prevalent and Leishmania tropica was observed in areas with high incidence of ZCL. This distribution represents a major change in the epidemiological pattern of Leishmania in the Khorasan-Razavi province.

The epidemiology of cutaneous leishmaniasis in Golestan Province, Iran: A cross-sectional study of 8-years

BackgroundLeishmaniasis occurs with an incidence of 0.5–1.5 million new cases annually, and is also endemic in 88 countries across the world. AimPresently, we aimed to investigate the status of Cutaneous Leishmaniasis (CL) in Golestan Province in North of Iran. MethodsA retrospective survey was conducted on existed data of 6873 patients with CL who attended to Health Centers in Golestan Province during 2010 to 2017 years. Data were collected using patient sheets and online registry form of CL. Descriptive statistical methods such as mean and standard deviation, and Chi-square test were employed to report and analyze results. p-Value <0.05 was considered significant. ResultsCL cases were more common in men 3885 (56.7%) than women 2965 (43.3%) (p = 0.001). The most and least cases was reported in 2017 and 2104 as 18 and 3 CL cases, accordingly. CL was mainly happen in the November (3816 cases), December (2832 cases) months. Presently, CL gradually increases in the last three years from 2014 to 2017 years. ConclusionDecrease of exposurement, improve the nutrition and child's immunity can be more beneficial.

Epidemiology ofCutaneous Leishmaniasis inAlgeria through Molecular Characterization

Three distinct noso-epidemiological cutaneous leishmaniasis (LC) entities coexist in Algeria: the so-called sporadic form of the North (LCN), the zoonotic form (LCZ) and the chronic form (LCC). The precise identification of the parasitic species involved in each of the forms makes it possible to specify the geographical distribution of each of the forms raised, to distinguish their clinical aspects, to guide the therapeutic behaviors and to adapt the control programs. Ninety-seven (97) human strains from 97cases of LC were subjected to molecular characterization by PCR-ITS1 followed by sequencing of this inter-gene space. Our results confirm the endemicity of the three forms. The LCN, caused by L.infantum (17isolates/97 i.e. 17.52%) is limited to the North of the country mainly (16isolates/17). Its geographical distribution is superimposable to that of visceral leishmaniasis with an extension more and more reported in previously unaffected areas, such as the regions of Tlemcen and Oran in the West, Setif, Annaba and Collo in the East. The LCZ, due to L.major (70strains/97 i.e. 72.16%), remains the dominant form in the arid and semi-arid zones (47strains/70) with a progression towards the North (20/70strains). Indeed, long confined to the Sahara, it shows a geographical extension outside its historic homes of Biskra and Abadla. This form is progressing dangerously towards the highlands and the steppe regions of the country. The most interesting fact was the identification of L.tropica for the first time in North-Central and North-West Algeria in Algerian patients who had never left the national territory. Out of the 10strains of L.tropica identified, 8belonged to patients of Syrian origin and 2to Algerian patients. L.tropica was reported for the first time in 2008 in 6patients living in Constantine (North-East Algeria) and in 2017, still in the North-East of the country, in Annaba. The observation of L.tropica in the North and Northeast center of the country, where L.infantum and L.major coexist, suggests changes in the epidemiology of cutaneous leishmaniasis in Algeria, which highlights the interest of more investigations to better understand the transmission cycle of the different entities.

Epidemiology of Cutaneous Leishmaniasis, Crimean Congo Hemorrhagic Fever, West Nile Virus and Malaria in Adana Province

Amac: Calismamizin amaci Adana ilinde Sark Cibani, Kirim‐Kongo Kanamali Atesi (KKKA), Bati Nil Virusu (BNV) ve Sitma’nin dahil oldugu bazi vektorel hastaliklarin biyolojik ve guncel epidemiyolojik ozelliklerini tanimlayarak birinci basamak ve halk sagligi alaninda calisanlara yol gostermesini saglamaktir. Materyal ve Metot: Bu calisma Cukurova Universitesi Halk Sagligi Anabilim Dali ve Adana Il Saglik Mudurlugu Halk Sagligi Hizmetleri Baskanligi ile ortaklasa yapilmistir. Gerekli izinler alindiktan sonra Adana Il Saglik Mudurlugu Halk Sagligi Hizmetleri Baskanligi Vektorel ve Zoonotik Hastaliklar Birimi’nin elde ettigi Sark Cibani, KKKA, BNV ve Sitma iceren ve 01.01.2016 ile 15.11.2018 zaman araligini kapsayan yaklasik 3 yillik kayitlar incelenmistir. Veriler STATISTICA 8.0 yazilimi kullanilarak analiz edilmistir. Verilerin niteligine gore uygun χ2 ikili veya coklu karsilastirma testlerinden yararlanilmistir. Tum istatistik analizlerde p<0,05 degeri anlamli kabul edilmistir. Bulgular: Yaklasik uc yillik donemde sik gorulen bu dort vektorel hastaliktaki toplam 638 vakanin %86,20’si (n: 550) etkenle temasin Adana’da oldugu yerel vaka, %13,80’i (n: 88) importe vakadir. Vakalarin %89,34’u (n: 570) Sark Cibani, %5,32’si (n: 34) Sitma, %2,83’u (n: 18) BNV, %2,51 (n: 16) KKKA’dir. Sark cibaninda vakalarin %50,35’i (n: 287) erkek ve yas ortalamasi 23,97 yildir. Sark cibaninin %54,1’i (n: 317) Suriyeli gocmenlerde gorulmustur. Sark cibaninin Suriyeli gocmenlerde Turk vatandaslarina gore daha fazla (p=0,023) ve Ocak ile Mayis araliginda, diger aylara gore daha yuksek siklikta gorulmesi istatistiksel olarak anlamli bulunmustur (p<0,001). Kirim Kongo Kanamali Atesi’nde vakalarin yas ortalamasi 35,68 yil, %75,00’i (n: 12) erkek ve %6,25’sinin (n: 1) olum ile sonuclandigi gorulmektedir. Haziran ile agustos araliginda, diger aylara gore daha fazla gorulmesi istatistiksel olarak anlamli bulunmustur (p<0,01). BNV’de yas ortalamasi 36,52 yil, %88,9’u (n: 16) erkek, %22,22’sinde (n: 4) BNV kaynakli norolojik hastalik gorulmus ve %5,55’si da (n: 1) olumle sonuclanmistir. BNV’nin temmuz ile eylul araliginda diger aylara gore daha fazla goruldugu istatistiksel olarak anlamli bulunmustur (p<0,001). Sitma vakalarinin yas ortalamasi 38,54 yil, %2,94’u (n: 1) yabanci uyruklu ve tamami (n: 34) erkek ve importe vakadir. Sonuc: Sark Cibani, KKKA, BNV ve Sitma tum dunyada oldugu gibi ulkemizde de ciddi saglik etkileri olmasi bakimindan gunumuzde hala onemini korumaktadir. Hastaliklarin farkli ozelliklerini tanimlayan guncel epidemiyolojik calismalarin, koruyucu saglik hizmetlerinin uygulanmasina rehberlik ettigi bilinen bir gercektir. Calismamizda yer alan bu vektorel hastaliklarla ilgili guncel verilerin, alanda calisan tum saglik sunucularina yol gosterecegini umuyoruz.

Epidemiology of Cutaneous Leishmaniasis in a Colombian Municipality.

This study describes the epidemiological and clinical characteristics of leishmaniasis and the pharmacological treatment of this disease in the municipality of Pueblo Rico, Risaralda, between January 2010 and December 2014. An observational study was conducted using information from the clinical records and epidemiological reports of patients diagnosed and confirmed with leishmaniasis of any age and sex, including sociodemographic, clinical, and pharmacological variables of the therapy received. Univariate and bivariate analyses were performed. A total of 539 cases of leishmaniasis were confirmed, with 29.5% occurring in children under 5 years of age. The median age was 10 years, with predominance in males (55.5%). The indigenous Emberá (aboriginal Americans) were the most affected (50.8%), and 93.3% of cases occurred in people living in scattered rural areas. All lesions corresponded to cutaneous leishmaniasis, of which 251 patients had compromise of the upper limbs (46.6%), 221 of the face (41.0%), and 139 of the lower limbs (25.8%). Pentavalent antimony salts (n-methyl glucamine and sodium stibogluconate) were prescribed in 77.6% (N = 418) of the cases; miltefosine was the second most frequently prescribed medication (21.5%, N = 116). The inhabitants of rural areas and the indigenous communities are at a higher risk of acquiring the infection, particularly among infants, which highlights the importance of the biological, social, and demographic factors involved in the disease. There is a need to seek effective public health actions and further research this disease.

Epidemiology of Cutaneous Leishmaniasis in an Endemic Pacific Coastal Rainforest Area of Ecuador

Epidemiology of Cutaneous Leishmaniasis in an Endemic Pacific Coastal Rainforest Area of Ecuador

Epidemiology of cutaneous leishmaniasis in Neyshabur, Iran from 2010 to 2014

Epidemiology of cutaneous leishmaniasis in Neyshabur, Iran from 2010 to 2014

Epidemiology of cutaneous leishmaniasis in Sidi Kacem Province, Northwestern Morocco (2006–2014)

ObjectiveTo describe the epidemiological profile of cutaneous leishmaniasis (CL) in Sidi Kacem Province, North-Western Morocco between 2006 and 2014. MethodsThe Leishmania parasite (amastigotes) was identified by direct microscopic identification after staining. May-Grünwald Giemsa was the method used to diagnose CL in Sidi Kacem Province between 2006 and 2014. The collected data were exploited by using Microsoft Office Excel 2010 and the geographical distribution was prepared by the Geographical Information System ArcGIS Version 10.2. ResultsFrom 2006 to 2014, 415 cases of CL were reported in Sidi Kacem area. The incidence of this skin disease that had affected all age groups was 49.1 cases per year and the sex ratio (M/F) was 0.85. Children aged 15 to 19 represented the most affected class with more than 28.2% of the study population. Also, CL affected virtually the rural and urban areas but with an uneven incidence. It is more important in rural areas where they were registered 56.85% of cases against 43.15% in urban areas. ConclusionsThe retrospective analysis has showed that cutaneous leishmaniasis is still major public health problem in Sidi Kacem Province. Indeed, this disease which presented an evolution according hyperendemic fashion can become endemic to the future in this province which borders the endemic area of Ouazzane. We highlight the cutaneous leishmaniasis incidence through the Sidi Kasem area during the last 8 years (2006–2014).

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

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.

P244 Potential impacts of climate change and variability on cutaneous leishmaniasis epidemiology in Risaralda and Magdalena, Colombia, 1985–2002

dengue incidence rate, after adjusting by year and week (p< 0.001, pseudo r2 =0.6913). Conclusion: 2010 season of El Nino affected significantly the number of cases and incidence rates of dengue in Risaralda. Case notification was not different across the period time, then this association with climate change and variability should be considered in the elements influencing disease epidemiology, as well to develop further predictive models with more available data from disease surveillance.

Clinical features and epidemiology of cutaneous leishmaniasis and Leishmania major/HIV co-infection in Cameroon: results of a large cross-sectional study

Cutaneous leishmaniasis (CL) is endemic in Central Africa, including Cameroon. However, data on its prevalence and co-infection with HIV are scarce. Here we present the results of a large cross-sectional study reporting the prevalence, clinical features and species identification of CL and HIV co-infection in northern Cameroon. A total of 32 466 subjects were clinically screened for CL during a door-to-door survey, followed by parasitological diagnosis in the field laboratory. Amongst the subjects surveyed, 146 (0.4%) were diagnosed with active CL. Seven (4.8%) of these 146 CL patients tested positive for HIV-1 and/or HIV-2. The number of lesions per CL patient ranged from 1 to 20. Three of the five subjects with >10 active lesions were co-infected with HIV. In both CL and HIV co-infected subjects, three successful parasite isolates were identified as Leishmania major by PCR. This first report of L. major/HIV co-infection in Cameroon and Central Africa confirms the endemicity of CL in the region and highlights a worsened CL pathology in HIV co-infected individuals. These findings provide important data necessary for the development and implementation of successful control programmes against CL and HIV in this geographical area.

Trends in the epidemiology of cutaneous leishmaniasis in a young adult population in Israel: a long-term survey

The Israel Defense Forces (IDF) medical records offer a unique and valid 28-year view of the striking differences in cutaneous leishmaniasis (CL) seasonality patterns and incidence rates between the military and civilian sectors in Israel. To determine the annual epidemiology and seasonality trends of CL over the long term in the IDF. The database of the Epidemiology Section of the IDF Medical Corps was reviewed for all reported cases of CL (passive surveillance) from 1 January 1978 to 31 December 2006. The diagnosis of reported CL was based on the clinical presentation, relevant epidemiologic data, and, in most cases, microscopic visualization of the parasite. Polymerase chain reaction (PCR) confirmation of the parasite has been more routinely performed since 2003. Rates of CL were generally characterized by peaks every 10 years, until the last 10 years when a second peak occurred in the same decade. The average monthly rates varied from a low of 0.8 cases per 100,000 population in June to a high of 9.83 cases per 100,000 soldiers in December. The results of this study imply that we are currently in the midst of a re-emergence of CL in Israel, in particular among IDF soldiers. This increase warrants a change in the public health approach.

Epidemiology of Cutaneous Leishmaniasis in Suriname: A Study Performed in 2006

Cutaneous leishmaniasis (CL) is a widespread disease in Suriname caused by Leishmania Viannia guyanensis. It is argued that other Leishmania species are also responsible for CL and that the incidence is increasing. This study aimed to identify the species causing the disease and to estimate the annual detection rate of CL in Suriname in 2006. In Paramaribo, 152 patients were registered, of whom 33 were tested in two polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) methods. Twenty-seven patients were infected with L. (V.) guyanensis (complex), one with L. (V.) lainsoni, and one with L. (Leishmania) amazonensis. In the hinterland, 162 CL suspected patients were registered by questionnaires; of these, 24 of 27 tested positive by PCR-RFLP (88.9%; 95% CI, 77.1-100%). With extrapolation of collected data, a detection rate was calculated of 5.32 to 6.13 CL patients per 1,000 inhabitants for the hinterland and 0.64 to 0.74 patients per 1,000 inhabitants for the whole country.

Epidemiology of cutaneous leishmaniasis in the endemic area of Jericho, Palestine

This study of cutaneous leishmaniasis in Jericho city and the adjacent Aqbat-Jaber refugee camp investigated the seroprevalance of Leishmania major and the risk factors associated with acquiring the disease. Clinical and parasitology identification of cases showed children and young men were more affected, with the head most affected in children. Enzyme-linked immunosorbent assay (ELISA) was used to test sera from 190 individuals. The overall seroprevalence of cutaneous leishmaniasis was 26.3%. A case-control study of 247 individual in 37 households showed that a higher level of education of the head of the household and having children sleep under bed nets were significantly related to a lower incidence of cutaneous leishmaniasis.

Characterization of Leishmania parasites isolated from provinces of the Islamic Republic of Iran

Leishmania parasites isolated in the Islamic of Iran were studied by a random amplified polymorphic DNA polymerase chain reaction (RAPD-PCR). Of 82 isolates, 80 were from cutaneous lesions, 1 from a human throat lesion and 1 from a dog. Of these, 42 isolates were L. tropica, 36 were L. major and 2 were L. infantum. There were 2 unidentified isolates (from the throat lesion and a cutaneous lesion) and these demonstrated 52% and 48% similarity with L. tropica and L. infantum. Both L. tropica and L. major were isolated from four provinces indicating a recent change in the epidemiology of cutaneous leishmaniasis. L. tropica was isolated from three provinces; L. major from one province. L. infantum was isolated from a human cutaneous lesion and from a dog in Bushehr province.