Forms Of Leishmaniasis Research Articles

Bioassay-guided isolation of dehydrocostus lactone from Echinops kebericho as a leishmanicidal drug

Several strains of Leishmania parasite are involved in the occurrence of leishmaniasis infections, which makes its prevention and treatment very challenging. Currently, all forms of leishmaniasis are being treated with chemical drugs, which have limitations and adverse effects. Discovering antileishmanial agents from natural sources can lead to novel drugs against this dreadful disease. The essential oils and nonpolar solvent extracts of the roots of E. kebericho exhibit antileishmanial activity. Thus, the isolation of the leishmanicidal compounds from the roots of E. kebericho through a bioassay-guided technique was carried out in this study. The present finding showed that the essential oil and hexane fraction of crude extract from the roots of E. kebericho possessed significant leishmanicidal activity against L. major and L. tropica. Dehydrocostus lactone (1), one of the major constituents of the essential oil and hexane fraction, was more active than the standard drug miltefosine against L. major and L. tropica promastigotes. The presence of α-methylene, γ-lactone is the responsible moiety of dehydrocostus lactone towards the leishmanicidal activity against the tested Leishmania species. The MTT assay of dehydrocostus lactone showed inactive toxicity against the human cervical carcinoma HeLa cells. In addition, dehydrocostus lactone exhibits a broad spectrum of antibiotic activities. Based on this interesting finding, dehydrocostus lactone was identified as a potential lead for treating infections caused by Leishmania.

Targeting Trypanothione Metabolism in Trypanosomatids.

Infectious diseases caused by trypanosomatids, including African trypanosomiasis (sleeping sickness), Chagas disease, and different forms of leishmaniasis, are Neglected Tropical Diseases affecting millions of people worldwide, mainly in vulnerable territories of tropical and subtropical areas. In general, current treatments against these diseases are old-fashioned, showing adverse effects and loss of efficacy due to misuse or overuse, thus leading to the emergence of resistance. For these reasons, searching for new antitrypanosomatid drugs has become an urgent necessity, and different metabolic pathways have been studied as potential drug targets against these parasites. Considering that trypanosomatids possess a unique redox pathway based on the trypanothione molecule absent in the mammalian host, the key enzymes involved in trypanothione metabolism, trypanothione reductase and trypanothione synthetase, have been studied in detail as druggable targets. In this review, we summarize some of the recent findings on the molecules inhibiting these two essential enzymes for Trypanosoma and Leishmania viability.

Phenotypic and functional characteristics of monocyte subsets in the blood and bone marrow of Indian subjects with Visceral Leishmaniasis.

Visceral leishmaniasis (VL) is a potentially fatal parasitic infection caused by Leishmania donovani in India. L. donovani is an obligate intracellular protozoan residing mostly in macrophages of the reticuloendothelial system throughout chronic infection. Monocytic phagocytes are critical in the pathogenesis of different forms of leishmaniasis. Subsets of monocytes are distinguished by their surface markers into CD14+CD16- classical monocytes, CD14+CD16+ intermediate monocytes, and CD16++CD14low non-classical monocyte subsets. During cutaneous leishmaniasis (CL), intermediate monocyte are reported to be a source of inflammatory cytokines IL-1β and TNF, and they express CCR2 attracting them to sites of inflammatory pathology. We examined monocyte subsets in the blood and bone marrow of patients with VL from an endemic site in Bihar, India, and found these contrasted with the roles of monocytes in CL. During VL, intermediate and non-classical CD16+ monocyte subsets expressed instead a non-inflammatory phenotype with low CCR2, high CX3CR1 and low microbicidal oxidant generation, making them more similar to patrolling monocytes than inflammatory cells. Bone marrow CD16+ monocyte subsets expressed a phenotype that might be more similar to the inflammatory subsets of CL, although our inability to obtain bone marrow from healthy donors in the endemic region hampered this interpretation Overall the data suggest that CD16+ intermediate monocyte subsets in VL patients express a phenotypes that contributes to an immunosuppressed pathologic immune state, but in contrast to CL, these do not mediate localized inflammatory responses.

Streptococcus pyogenes Cas9 ribonucleoprotein delivery for efficient, rapid and marker-free gene editing in Trypanosoma and Leishmania.

Kinetoplastids are unicellular eukaryotic flagellated parasites found in a wide range of hosts within the animal and plant kingdoms. They are known to be responsible in humans for African sleeping sickness (Trypanosoma brucei), Chagas disease (Trypanosoma cruzi), and various forms of leishmaniasis (Leishmania spp.), as well as several animal diseases with important economic impact (African trypanosomes, including Trypanosoma congolense). Understanding the biology of these parasites necessarily implies the ability to manipulate their genomes. In this study, we demonstrate that transfection of a ribonucleoprotein complex, composed of recombinant Streptococcus pyogenes Cas9 (SpCas9) and an invitro-synthesized guide RNA, results in rapid and efficient genetic modifications of trypanosomatids, in marker-free conditions. This approach was successfully developed to inactivate, delete, and mutate candidate genes in various stages of the life cycle of T. brucei and T. congolense, and Leishmania promastigotes. The functionality of SpCas9 in these parasites now provides, to the research community working on these parasites, a rapid and efficient method of genome editing, without requiring plasmid construction and selection by antibiotics but requires only cloning and PCR screening of the clones. Importantly, this approach is adaptable to any wild-type parasite.

Effect of environmental variables on the incidence of Visceral Leishmaniasis in Brazil and Colombia

Visceral Leishmaniasis (VL) is the most severe of the three forms of Leishmaniasis. In the Americas, Brazil and Colombia present more than 90 % of the cases in the region. Our aim in this research was to estimate the association of the incidence rate of Visceral Leishmaniasis with the following environmental variables: the percentage of area suitable for the vector Lutzomyia longipalpis, the episodes of La Niña and El Niño, the Brazilian and Colombian biomes. Epidemiological data were obtained from the Brazilian Notifiable Diseases Information System and the Colombian National Public Health Surveillance System. Environmental data were downloaded from the NASA Giovanni web app, the Modis Sensor database, and the meteorological agencies of Australia, Japan, and the United States of America. Records of the presence of Lu. longipalpis were obtained from public databases and previous studies. As a result, the incidence per 10,000 inhabitants with LEBS for each El Niño-Southern Oscillation (ENSO) episode showed the largest values during El Niño 2015–2016, mainly in Brazil's Northeast and Central regions and the Northeast region of Colombia. Compared with the Neutral 2012–2014 episode, the episodes of El Niño 2015–2016 and La Niña 2010–2011 showed an average increase in the monthly incidence rate of VL, and the average increase was higher during El Niño 2015–2016 (aIRR = 2.304 vs.1.453) We found a positive association between the incidence rate of VL and the El Niño 2015–2016 episode and an impressive% of area suitable for the vector Lu. longipalpis in the Amazon region.An increase of 1 % in the area suitable for the vector Lu. longipalpis leads to an average rise of 0.8 % in the monthly incidence rate of VL. Our study shows a possible association between VL incidence and ENSO, with the most considerable incidence rates observed during El Niño 2015–2016 in Brazil's Northeast and Central regions and the Northeast region of Colombia. The present study is very important to better understand the Visceral Leishmaniasis transmission dynamics.

Natural Therapy of Cutaneous Leishmaniasis

Leishmaniasis is a parasitic disease that is spread by the bite of phlebotomine sand flies, there are several different forms of leishmaniasis in people, the most common forms is cutaneous leishmaniasis, and visceral leishmaniasis, Cutaneous leishmaniasis is characterized by one or more cutaneous lesions, the sores can change in size and appearance over time, the skin sores of Cutaneous leishmaniasis usually heal on their own, even without treatment, but this can take months or even years. A recent study has lead to new natural treatment to accelerate the healing time of lesions caused by leishmania parasite, which based on using a bandage of banana peels at the lesions site during night for seven to ten days. There were eight cases out of ten had responded positively for using banana peels and completely cured, and two did not respond. Patients who have the injection treatment is healed in short time in compare to one who did not take injection.

Adjuvantation of whole-killed Leishmania vaccine with anti-CD200 and anti-CD300a antibodies potentiates its efficacy and provides protection against wild-type parasites

One of the major reasons behind the limited success of vaccine candidates against all forms of leishmaniasis is the inability of parasitic antigens to induce robust cell-mediated immunity and immunological memory. Here we find, for the first time, that the adjuvantation of whole-killed Leishmania vaccine (Leishvacc) with anti-CD200 and anti-CD300a antibodies enhances CD4+ T cells mediated immunity in vaccinated mice and provides protection against wild-type parasites. The antibody adjuvantation, either alone or with a TLR4 agonist monophosphoryl A (MPL-A), induced the production of pro-inflammatory cytokines viz., IFN-γ, TNF-α, and IL-2 by antigen experienced CD4+ T cells, and also enhanced their rate of conversion into their memory phenotypes against Leishvacc antigens. The antibody adjuvanted vaccine also promoted the generation of IgG2a-mediated protective humoral immunity in vaccinated mice. Further, the mice vaccinated with antibodies adjuvanted vaccine showed strong resilience against metacyclic forms of L. donovani parasites as we observed reduced clinical features such as splenomegaly, hepatomegaly, granulomatous tissues in the liver, and parasitic load in their spleen. The findings of this study demonstrate that the anti-CD200 and anti-CD300a antibodies have potential to increase the protective efficacy of the whole-killed Leishmania vaccine, and opens up a new gateway to diversify the roles of immune checkpoints in vaccine development against leishmaniasis.

Molecular Detection of Leishmania Infection in Phlebotomine Sand Flies from an Endemic Focus of Zoonotic Cutaneous Leishmaniasis in Iran.

Due to the outbreak of zoonotic cutaneous leishmaniasis (ZCL), a disease caused by Leishmania major and mainly transmitted by Phlebotomus papatasi, in Damghan City, Semnan Province, the probable vectors of the disease were investigated in the city from 20 March 2016 to 20 January 2018. Sand flies were collected from indoors and outdoors biweekly by sticky traps in different parts of the city. The trapped sand flies were stored in 70% ethanol. They were identified and checked for Leishmania infections using nested-PCR method and specific primers; CSB1XR, CSB2XF, LiR, and 13Z. Overall, 1862 phlebotomine sand flies of Ph. papatasi (48.8%), Ph. andrejevi (8.3%), Ph. caucasicus (7.7), Ph. mongolensis (2%), Ph. sergenti (1.2%), Ph. alexandri (0.7%), Sergentomyia murgabiensis sintoni (29.3%), and Se. sumbarica (2%) were collected indoors (31.1%) and outdoors (68.9%). The highest and lowest numbers of collected sand flies were belonging to Ph. papatasi (48.8%) and Ph. alexandri (0.7%) respectively. 2.2% of the examined sand flies were shown to be infected with L. major and all were belonging to Ph. papatasi. This study confirms the report of Ph. papatasi infection with L. major and also the existence of Ph. sergenti and Ph. alexandri, the potential vectors of L. tropica and L. infantum respectively, in Damghan City. According to the findings, it is necessary for health officials to plan and take action to prevent the occurrence of ZCL epidemic in the city as well as the occurrence of other forms of leishmaniasis.

Bestatin analogs-4-quinolinone hybrids as antileishmanial hits: Design, repurposing rational, synthesis, in vitro and in silico studies

Amongst different forms of leishmaniasis, visceral leishmaniasis caused by L. donovani is highly mortal. Identification of new hit compounds might afford new starting points to develop novel therapeutics. In this lieu, a rationally designed small library of bestatin analogs-4-quinolone hybrids were prepared and evaluated. Analysis of SAR unveiled distinct profiles for hybrids type 1 and type 2, which might arise from their different molecular targets. Amongst type 1 bestatin analog-4-quinolone hybrids, hybrid 1e was identified as potential hit inhibiting growth of L. donovani promastigotes by 91 and 53% at 50 and 25 μM concentrations, respectively. Meanwhile, hybrid 2j was identified amongst type 2 bestatin analog-4-quinolone hybrids as potential hit compound inhibiting growth of L. donovani promastigotes by 50 and 38% at 50 and 25 μM concentrations, respectively. Preliminary safety evaluation of the promising hit compounds showed that they are 50–100 folds safer against human derived monocytic THP-1 cells relative to the drug erufosine. In silico study was conducted to predict the possible binding of hybrid 1e with methionine aminopeptidases 1 and 2 of L. donovani. Molecular dynamic simulations verified the predicted binding modes and provide more in depth understanding of the impact of hybrid 1e on LdMetAP-1 and LdMetAP-2.

The Checklist and Distribution of Sand Flies (Diptera: Psychodidae) of Guilan Province and Their Medical Importance With a Taxonomic Note on the Name Sergentomyia murgabiensis sintoni

Background: Different forms of leishmaniasis are important infectious diseases in Iran. While Rudbar County of Guilan Province has been introduced as a cutaneous leishmaniasis focus, there are few published data about the phlebotomine sand flies (Diptera: Psychodidae, Phlebotominae) of the province and their medical importance. Objectives: The present study is going to provide a review of sand fly-borne infections in Guilan Province and a checklist of sand flies of the province. Also, a note is presented on the name Sergentomyia murgabiensis sintoni. Materials & Methods: Using the main databases such as Web of Science, PubMed, Scopus, Google Scholar, Scientific Information Database (SID), IranMedex and Magiran which were searched up to September 2022 and reviewing the literature, the available data about the sand fly-borne diseases of Iran and Guilan Province were extracted and analyzed. Results: In total, 11 species representing two genera of sand flies, Phlebotomus and Sergentomyia, are found in Guilan Province. The checklist and distribution of sand flies of the province have been provided. All species of the genus Phlebotomus in the province are proven or suspected vectors of leishmaniasis. Sand fly-borne leishmaniasis (cutaneous and visceral), sand fly fever and lizard leishmaniasis, which are among the endemic infections of the province, are discussed. Also, a taxonomic note is presented on the name Sergentomyia murgabiensis sintoni. Conclusion: The prevalence of suspected or proven vectors of sand fly-borne diseases in Guilan Province is noteworthy. The study of the ecology of sand flies and detecting the exact vectors and reservoirs of leishmaniasis and phlebotomine fever by serological or molecular- specific tests in the province are recommended. Moreover, additional samplings of sand flies from localities, where have not been studied, are necessary.

Cutaneous/Mucocutaneous Leishmaniasis Treatment for Wound Healing: Classical versus New Treatment Approaches

Cutaneous leishmaniasis (CL) and mucocutaneous leishmaniasis (ML) show clinical spectra that can range from a localized lesion (with a spontaneous healing process) to cases that progress to a generalized systemic disease with a risk of death. The treatment of leishmaniasis is complex since most of the available drugs show high toxicity. The development of an effective topical drug formulation for CL and ML treatment offers advantages as it will improve patient’s compliance to the therapy given the possibility for self-administration, as well as overcoming the first pass metabolism and the high costs of currently available alternatives. The most common dosage forms include solid formulations, such as membranes and semi-solid formulations (e.g., ointments, creams, gels, and pastes). Topical treatment has been used as a new route of administration for conventional drugs against leishmaniasis and its combinations, as well as to exploit new substances. In this review, we discuss the advantages and limitations of using topical drug delivery for the treatment of these two forms of leishmaniasis and the relevance of combining this approach with other pharmaceutical dosage forms. Emphasis will also be given to the use of nanomaterials for site-specific delivery.

LEISH2b - A phase 2b study to assess the safety, efficacy, and immunogenicity of the Leishmania vaccine ChAd63-KH in post-kala azar dermal leishmaniasis.

Background: The leishmaniases are neglected tropical diseases caused by various Leishmania parasite species transmitted by sand flies. They comprise a number of systemic and cutaneous syndromes including kala-azar (visceral leishmaniasis, VL), cutaneous leishmaniasis (CL), and post-kala-azar dermal leishmaniasis (PKDL). The leishmaniases cause significant mortality (estimated 20 - 50,000 deaths annually), morbidity, psychological sequelae, and healthcare and societal costs. Treatment modalities remain difficult. E.g., East African PKDL requires 20 days of intravenous therapy, andfrequently relapsing VL is seen in the setting of HIV and immunodeficiency. We developed a new therapeutic vaccine, ChAd63-KH for VL / CL / PKDL and showed it to be safe and immunogenic in a phase 1 trial in the UK, and in a phase 2a trial in PKDL patients in Sudan. Methods: This is a randomised double-blind placebo-controlled phase 2b trial to assess the therapeutic efficacy and safety of ChAd63-KH in patients with persistent PKDL in Sudan. 100 participants will be randomly assigned 1:1 to receive placebo or ChAd63-KH (7.5 x10 10vp i.m.) at a single time point. Follow up is for 120 days after dosing and we will compare the clinical evolution of PKDL, as well as the humoral and cellular immune responses between the two arms. Discussion: Successful development of a therapeutic vaccine for leishmaniasis would have wide-ranging direct and indirect healthcare benefits that could be realized rapidly. For PKDL patients, an effective therapeutic vaccination used alone would have very significant clinical value, reducing the need for extensive hospitalization and chemotherapy. Combining vaccine with drug (immuno-chemotherapy) might significantly increase the effective life of new drugs, with lower dose / abbreviated regimens helping to limit the emergence of drug resistance. If therapeutic benefit of ChAd63-KH can be shown in PKDL further evaluation of the vaccine in other forms of leishmaniasis should be considered. Clinicaltrials.gov registration: NCT03969134.

Replacement of Leishmania (Leishmania) infantum Populations in an Endemic Focus of Visceral Leishmaniasis in Brazil.

Visceral leishmaniasis is an important global health problem with an estimated of 50,000 to 90,000 new cases per year. VL is the most serious form of leishmaniasis as it can be fatal in 95% of the cases if it remains untreated. VL is a particularly acute problem in Brazil which contributed with 97% of all cases reported in 2020 in the Americas. In this country, VL affects mainly the poorest people in both urban and rural areas and continues to have a high mortality rate estimated around 8.15%. Here, we performed a temporal parasite population study using whole genome sequence data from a set of 34 canine isolates sampled in 2008, 2012 and 2015 from a re-emergent focus in Southeastern Brazil. Our study found the presence of two distinct sexual subpopulations that corresponded to two isolation periods. These subpopulations diverged hundreds of years ago with no apparent gene flow between them suggesting a process of rapid replacement during a two-year period. Sequence comparisons and analysis of nucleotide diversity also showed evidence of balancing selection acting on transport-related genes and antigenic families. To our knowledge this is the first population genomic study showing a turn-over of parasite populations in an endemic region for leishmaniasis. The complexity and rapid adaptability of these parasites pose new challenges to control activities and demand more integrated approaches to understand this disease in New World foci.

Atypical manifestations of cutaneous leishmaniasis in a boy from Afghanistan

Cutaneous leishmaniasis is one of the most common forms of leishmaniasis in Afghanistan, which is caused by different Leishmania species that are transmitted to humans by sandflies. Its clinical manifestations are very diverse and depend on a variety of parasite and host factors.

Immune Responses in Leishmaniasis: An Overview.

Leishmaniasis is a parasitic, widespread, and neglected disease that affects more than 90 countries in the world. More than 20 Leishmania species cause different forms of leishmaniasis that range in severity from cutaneous lesions to systemic infection. The diversity of leishmaniasis forms is due to the species of parasite, vector, environmental and social factors, genetic background, nutritional status, as well as immunocompetence of the host. Here, we discuss the role of the immune system, its molecules, and responses in the establishment, development, and outcome of Leishmaniasis, focusing on innate immune cells and Leishmania major interactions.

Retinoic acid restores the levels of cellular cholesterol in Leishmania donovani infected macrophages by increasing npc1 and npc2 expressions

Visceral leishmaniasis (VL) is a fatal form among all forms of leishmaniasis and is caused by visceralization of the Leishmania donovani (Ld) parasite to the critical organs. Mild to severe malnutrition is common in VL patients and the deficiency of retinoic acid (RA), an important micronutrient, results in a compromised state of immune response in macrophages (mφ) leading to the increased parasite load. In the continuation of our earlier work, we observed loss of cellular cholesterol in infected mφ in the absence of RA i.e., upon inhibition of RALDH pathway. Moreover, the Leishmania utilizes host cholesterol for the establishment of infection and causes a decrease in the expressions of Niemann-Pick C2 (npc2) and Niemann-Pick C1 (npc1) genes involved in the uptake of extracellular cholesterol. This results in reduced levels of cellular cholesterol in infected mφ. Intrigued by this, as the first sign of our hypothesis, we investigated the presence of RA Response Element (RARE) sequences in the upstream of npc1 and npc2 genes. To functionally confirm this, we measured their expressions and the levels of cellular cholesterol in Ld infected mφ in the absence (i.e., using an inhibitor of RALDH pathway) and presence of RA. We found restoration of the levels of cellular cholesterol in infected mφ under the supplementation of RA resulting in the decreased parasite load. Hence, the supplementation of RA with the standard therapy and/or preventive use of RA could be potentially an advancement in the treatment and cure of VL patients.

Functionalized 1,2,3-triazolium salts as potential agents against visceral leishmaniasis.

Visceral leishmaniasis (VL) is the most severe clinical form of leishmaniasis, being fatal if untreated. In search of a more effective treatment for VL, one of the main strategies is the development and screening of new antileishmanial compounds. Here, we reported the synthesis of seven new acetyl functionalized 1,2,3-triazolium salts, together with four 1,2,3-triazole precursors, and investigated their effect against different strains of L. infantum from dogs and humans. The 1,2,3-triazolium salts exhibited better activity than the 1,2,3-triazole derivatives with IC50 range from 0.12 to 8.66μM and, among them, compound 5 showed significant activity against promastigotes (IC50 from 4.55 to 5.28μM) and intracellular amastigotes (IC50 from 5.36 to 7.92μM), with the best selective index (SI ~ 6-9) and reduced toxicity. Our findings, using biochemical and ultrastructural approaches, demonstrated that compound 5 targets the mitochondrion of L. infantum promastigotes, leading to the formation of reactive oxygen species (ROS), increase of the mitochondrial membrane potential, and mitochondrial alteration. Moreover, quantitative transmission electron microscopy (TEM) revealed that compound 5 induces the reduction of promastigote size and cytoplasmic vacuolization. Interestingly, the effect of compound 5 was not associated with apoptosis or necrosis of the parasites but, instead, seems to be mediated through a pathway involving autophagy, with a clear detection of autophagic vacuoles in the cytoplasm by using both a fluorescent marker and TEM. As for the in vivo studies, compound 5 showed activity in a mouse model of VL at 20mg/kg, reducing the parasite load in both spleen and liver (59.80% and 26.88%, respectively). Finally, this compound did not induce hepatoxicity or nephrotoxicity and was able to normalize the altered biochemical parameters in the infected mice. Thus, our findings support the use of 1,2,3-triazolium salts as potential agents against visceral leishmaniasis.

New developments in the treatment of cutaneous leishmaniasis

Leishmaniasis, including the cutaneous form, poses an important public health threat around the world, while no vaccine is currently available against any form of leishmaniasis. The drugs used in the first line treatment of cutaneous leishmaniasis (CL) are commonly pentavalent antimonials despite their toxicities, long-term treatment duration and increasing resistance rates. Other alternatives are amphotericin B, pentamidine, miltefosine and paromomycine. Movement of the population, especially in endemic regions, increases the spread of the parasite and affectes the distribution of causative species, which requires re-evaluation the treatment regimen. Extensive researches are carried out on the treatment of leishmaniasis. The immunotherapeutic and targeted therapeutic approaches, formulations of carrier-loaded active drugs, local thermotherapeutic applications, the combination of antileishmanial drugs/compounds, the use of new synthetic and natural products are promising therapeutic options in the future. Herein, the author reviews the potential treatment modalities of CL with a brief overview of current treatments in the light of ongoing studies around the world.

Epidemiological Characteristics of Visceral Leishmaniasis - Shanxi Province, China, 1950-2019.

What is already known about this topic?Visceral leishmaniasis (VL) is the most serious form of leishmaniasis. In recent years, reported cases of VL have been gradually increasing in Shanxi Province, China.What is added by this report?The report describes the epidemiology of VL from 1950 to 2019 in Shanxi Province and the recent trend of VL reemergence.What are the implications for public health practice?Measures to prevent and control VL, such as health education, improving clinical diagnostics, strengthening epidemiological investigation capacity for VL cases, monitoring surveillance, and use of other evidence-based preventive measures, should be undertaken in Shanxi Province.

Trend Analysis of Cutaneous Leishmaniasis Incidence in Izeh County During 2014-2019

Background: A cutaneous form of leishmaniasis (cutaneous leishmaniasis, CL) is becoming increasingly common, and this study was conducted to investigate the epidemiological features of CL in the county of Izeh in Khuzestan province. Materials and Methods: This retrospective cross-sectional research was performed during 2014- 2019. Basic demographic and clinical information was gathered from patients with CL referring to Izeh health centre and then processed using SPSS software, version 25.0. Results: Overall, data related to 131 patients were recorded from 2014 to 2019. The incidence of CL showed a decrease from 16.207 to 5.028 per 100000 individuals in Izeh. Based on the analysis of CL incidence in Izeh county, a statistically significant difference was observed through the mentioned six-year study (P<0.05). Male patients with a frequency rate of 65.6% demonstrated a statistically significant association in the CL and the type of gender compared to 34.4% of females (P<0.05). The age group of 20-29 years old (32.1%) had a higher frequency of CL in the age groups. Finally, there was a statistically considerable discrepancy in the frequencies of infected people with CL related to age groups (P<0.05). Conclusion: Based on the findings and other epidemiological characteristics, Izeh does not seem to be an endemic focus of CL. Nonetheless, it is a concerning situation, and proper preparation is strongly advised for disease control and prevention.