Prevalence Of Cutaneous Leishmaniasis Research Articles

Cutaneous leishmaniasis prevalence and morbidity based on environmental factors in Ilam, Iran: Spatial analysis and land use regression models

The aim of this study was to investigate the impact of the environmental factors on cutaneous leishmaniasis (CL) prevalence and morbidity in Ilam province, western Iran, as a known endemic area for this disease. Accurate locations of 3237 CL patients diagnosed from 2013 to 2015, their demographic information, and data of 17 potentially predictive environmental variables (PPEVs) were prepared to be used in Geographic Information System (GIS) and Land-Use Regression (LUR) analysis. The prevalence, risk, and predictive risk maps were provided using Inverse Distance Weighting (IDW) model in GIS software. Regression analysis was used to determine how environmental variables affect on CL prevalence. All maps and regression models were developed based on the annual and three-year average of the CL prevalence. The results showed that there was statistically significant relationship (P value≤0.05) between CL prevalence and 11 (64%) PPEVs which were elevation, population, rainfall, temperature, urban land use, poorland, dry farming, inceptisol and aridisol soils, and forest and irrigated lands. The highest probability of the CL prevalence was predicted in the west of the study area and frontier with Iraq. An inverse relationship was found between CL prevalence and environmental factors, including elevation, covering soil, rainfall, agricultural irrigation, and elevation while this relation was positive for temperature, urban land use, and population density. Environmental factors were found to be an important predictive variables for CL prevalence and should be considered in management strategies for CL control.

Evaluation of the photodynamic therapy as a potential technique for blood decontamination

Evaluation of the photodynamic therapy as a potential technique for blood decontamination

Prevalence and epidemiologic profile of acute cutaneous leishmaniasis in an endemic focus, Southwestern Iran

ObjectiveTo evaluate the cutaneous leishmaniasis prevalence in Shadegan County, Iran, during 2007–2009. MethodsThis is a descriptive research which concentrates on the 100 patients who we referred to the Shadegan Health Center. The disease was diagnosed based on clinical exam and microscopic observation of the parasites in the lesion site. The patients' data were recorded. The statistics have examined the various epidemiological aspects of the disease by considering descriptive indices such as gender, age, occupation, month and seasonal distribution, number and site of the lesions. Information analysis was performed using SPSS software. ResultsOverall, 100 cases consisting of 32 females (32%) and 68 males (68%) were examined for the presence of active ulcers. Most of the infection was in age group 11–20 years (31%) and the lowest in 31–40 years group (7%). Most of the active ulcers were on the feet (42%). The majority (47%) had one lesion. Most of the cases (42%) had occurred during 2007. All cases were observed in the rural areas. ConclusionsThis study showed that the male sex and people under 20 years of age are mostly at risk. Therefore, education for groups at risk is very important.

Epidemiological Aspects of Cutaneous Leishmaniasis in Iran

Background: The prevalence of Cutaneous Leishmaniasis (CL) has been reported as 1.8% to 37.9% in different provinces of Iran. However, enough knowledge about epidemiological aspects of CL disease is needed to launch a proper program to plan control and preventive strategies about the disease. Objectives: The present study aimed to determine the epidemiological aspect of CL in Iran during the first 6 months of 2014. Patients and Methods: In this cross-sectional study, all cases of CL reported to centers for disease control and prevention (CDC) by state health departments from March 2014 to September 2014 were included. Descriptive statistics including frequency tables, measures of central value, and measures of dispersion to describe the study variables were used to analyze data. Area maps were created using ArcView GIS v. 3.3. Results: Most of the CL cases were observed in eastern, central, and southern provinces. Two thousand thirty-one cases (55.13%) were male and 2,306 (62.6%) were living in urban areas. The mean age of the patients was 27 ± 18 years old. More than 31% of them were under 14 years of age. Also, 3570 individuals (96.91%) were new cases. more wounds were seen so that 62.75% of the wounds were on the hands, 24.8% in the head and neck, and 2.7% in the body. Conclusions: According to the epidemiological features of CL in Iran, Providing a uniform mechanism for control and prevention of this disease is not possible. Thus, initial actions such as staff training, screening in endemic areas, and treatment of patients with urban leishmaniasis as a reservoir for the disease can be useful, according to the geographical position and carrier.

Effect of the Syrian Civil War on Prevalence of Cutaneous Leishmaniasis in Southeastern Anatolia, Turkey.

BackgroundCutaneous leishmaniasis (CL) is a vector-mediated skin disease, characterized by chronic wounds on the skin and caused by macrophages in protozoan parasites. It is an endemic disease in the southern and southeastern Anatolia region and is still an important public health problem in Turkey. Because of the civil war in Syria, immigrants to this region in the last 3 years have begun to more frequently present with this disease. The aim of this study was to draw attention to the dramatic increase in new cases with CL after the beginning of the civil war in Syria.Material/MethodsIn this retrospective study, we evaluated demographic, epidemiological, and clinical features of 110 patients diagnosed with cutaneous leishmaniasis who were admitted to the Department of Dermatology at Kahramanmaras Sutcu Imam University Faculty of Medicine between January 2011 and June 2014.ResultsA total of 110 patients included in the study; 50 (45%) were males, and 60 (55%) were females. The age range of the study group was 1–78 years, and the infection was more prevalent in the 0–20 year age group. Of these patients, 76 (69%) were Syrian refugees living in tent camps and 34 (31%) were Turkish citizens. The majority of the cases were diagnosed between October and December.ConclusionsImmigrations to endemic regions of Turkey from neighbouring countries where CL incidence is higher may lead to large increases in case numbers. In order to decrease the risk of exposure, housing conditions of the refugees must be improved, routine health controls must be performed, effective measures must be set in place for vector control, and infected individuals must be diagnosed and treated to prevent spread of the infection.

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.

The Current Status of Cutaneous Leishmaniasis and the Pattern of Lesions in Ochollo Primary School Students, Ochollo, Southwestern Ethiopia

Background: Leishmaniasis is a vector borne disease caused by the obligate intracellular protozoan leishmania. Objective:To assess the prevalence of cutaneous leishmaniasis and pattern of lesions in Dega Ochollo primary school students, Ochollo, Southwestern Ethiopia. Methods: A cross-sectional study was carried out among 523 school children aging between 6 to 25 years. The students were physically examined for the presence of scar and active lesions. Skin slit and blood were collected from students with suspected active lesions of cutaneous leishmaniasis. Scraps were cultured in Nicolle-Novy-MacNeal(NNN) medium and serological tests were performed using direct agglutination test (DAT). Results: The overall prevalence of tegumentary leishmaniasis including both scar and active lesions among the 523 students which underwent physical examination was 65.8 %. Besides, the study revealed that 64.8% of the participants had current and/or past lesion of cutaneous leishmaniasis. The prevalence of Mucocutaneous leishmaniasis and recidivan was 0.2% and 0.8%, respectively. Three hundred and thirteen (59.8%) students were with scar and 21(4.01%) were with active lesions whereas 8(1.5%) of the cases had both scar and active lesions. Majority (49.71%) of the participants belonging to the age group 11-15 years old were the most affected group (p-value<0.05). The average number of scars and lesions per patient was calculated to be 1.5 and 1.7, respectively. Majority (64.17%) of the cases had single scars while 22.74%, 7.48%, and 5.61% of them had double, triple, and four and above, respectively. The scars were more localized above the neck (82.16%) where the highest (54.56%) proportion of the scars was distributed on check. Of the 29 participants who had active lesions, 4(13.8%) of them were found to be culture positive and one patient was also positive for DAT out of these culture positive patients. One smear positive sample was also found among the samples which were positive for NNN medium. Conclusions: cutaneous leishmaniasis is prevalent in the area causing disfigurement and resulting social stigmatization. This calls for the implementation of prevention and control measures including treatment of infected individuals.

Progressive increasing of cutaneous leishmaniasis in Kashan district, central of Iran

ObjectiveTo investigate the prevalence of cutaneous leishmaniasis in important endemic focus of Kashan district, central of Iran during 2007-2008. MethodsThis was a cross-sectional study and 5 098 individuals were selected from thirteen rural and urban districts of Kashan city. Information of positive cases including age, sex, job, number and sites of ulcers or scars, date and place of the ulcer, and results of clinical examination and laboratory tests were recorded. Diagnoses of affected cases were based on clinical examination and microscopic observation of the ulcer parasite. The results were analyzed with statistical Chi-square test. ResultsAn infection prevalence rate of 6.4% was obtained among 5 098 individuals. Regarding to 326 affected cases, 103 (2.0%) and 223 (4.4%) persons were observed with active lesion and scars, respectively. The highest frequency of active ulcer rate (23.3%) was associated with age group of 20-29 years old, while the lowest rate was related to age group of 0-9 years old with 7.8% infection. About 49.5% of the infected cases were under 30 years old. This study showed 64.1% of cases with one and the rest of them with two or more ulcers. Hands (46.6%) were the most affected parts of body. ConclusionsThere is a progressive increasing of cutaneous leishmaniasis in Kashan district and this is a warning to local health workers to provide prevention as well as control program of the disease.

Epidemiological aspects of cutaneous leishmaniasis in Ilam province, west of Iran (2000–2007)

ObjectiveTo investigate the epidemiology of cutaneous leishmaniasis in Ilam province between 2000 and 2007. MethodsThe data of this descriptive cross-sectional study included the existing data regarding the prevalence of cutaneous leishmaniasis in different seasons, years and districts which were reported to Ilam Provincial Health center between 2000 and 2007. ResultsThe analysis of the collected data revealed that Ilam province was one of the endemic foci of zoonotic cutaneous leishmaniasis caused by Leishmania major. The study also showed the rate of cutaneous leishmaniasis incidence with the general rate of 1.2 per one thousand populations. It was also evident that the highest rate of incidence of cutaneous leishmaniasis was in fall and winter, which is one of the most important characteristics of zoonotic cutaneous leishmaniasis. Ulcers were present in 5 161 Patients. Of these, 28.9% were female and 71.1% were male. 3 447 cases (66.8%) had ulcers on hand and foot, 1 213 cases (23.5%) on face and 501 cases (9.7%) on trunk. A total of 1 907 patients (36.9%) had only one ulcer. But 3 254 cases (63.1%) had more than one ulcer. The highest incidence was found among patients with two age groups of 20–29 years old (46.8%) and 10–19 years old (17.3%). ConclusionsWith respect to the increased prevalence of cutaneous leishmaniasis in Ilam province, health care observers should pay further attention on preventing the disease spread.

Prevalence of cutaneous leishmaniasis during 2010 in Mazandaran Province, Iran

Leishmaniasis includes a wide variety of diseases which are classified into three main categories: cutaneous leishmaniasis, muco-cutaneous leishmaniasis, and visceral leishmaniasis. Cutaneous leishmaniasis is one of the health problems in tropical regions and a priority of world health. The vector of this disease is female sand fly fromPhlebotomus specie. This descriptive-inferential retrograde study was conducted on all 62 individuals that were diagnosed with cutaneous leishmaniasis using clinical and lab finding and underwent treatment for this disease in seven health centers of Mazandaran province from January to December 2010. It was carried out during one year in all the health centers of Mazandaran province. During the study of the 62 cases, it was recognized that 37 (59.67%) were male and 25 (40.33%) were female and the most common type of cutaneous leishmaniasis seen in this province was the rural or wet type (61.3%). Considering the high prevalence rate and distribution of leishmaniasis in Iran, it is crystal clear that accumulating data about vectors and reservoirs of each region for prevention and control programs play prominent role in this case. Key words: Cutaneous leishmaniasis, Mazandaran province, Iran.

The prevalence of cutaneous leishmaniasis in school children in southwestern Iran, 2009

This study was designed to assess the epidemiological characteristics and molecular characterization of the disease in school children in the city of Dehloran, southwestern Iran. A total of 7,555 school children from the city of Dehloran were surveyed as a descriptive cross-sectional study during autumn 2009. A questionnaire was completed, recording demographic and disease characteristics. Microscopic examination and kinetoplast DNA-PCR assay were carried out for leishmaniasis detection and species identification. The overall prevalence of scars and active lesions were 9.7% and 0.4%, respectively. The prevalence rate of cutaneous leishmaniasis (CL) was significantly different between males and females (P < 0.05). The highest rate of CL was detected in the age group of 10–14 years with significant differences (P < 0.05). Most of the lesions were on face (42%). Clinically, 76.5% of the patients had single lesion. Also the prevalence rate in non-native residents was significantly higher than natives (P < 0.05). PCR technique revealed all examined cases as Leishmania major. CL in Dehloran is mainly caused by L. major and measures should be planned for future control programs. In addition, further investigations are required to clarify the possible reservoirs and vectors in the area.

Leishmaniose cutanée au cours d'une polymyosite

Introduction The prevalence of cutaneous leishmaniasis is increasing, especially in immunocompromized subjects. Case record We report a case of particular interest, where a patient with steroid refractory polymyositis developed cutaneous leishmaniasis. Clinical outcome was favorable after institution of intralesional antimony therapy. Discussion Cutaneous leishmaniasis is still recognized to be an opportunistic infection. Its frequency is indeed higher in immunocompromized subjects, mainly HIV-infected patients. In our patient, both polymyositis and steroid therapy were predisposing factors of cutaneous leishmaniasis onset; prednisone therapy has been postulated to be associated with immune dysfunction leading to: reduced blood T cells' levels (CD4 et CD8) as well as decreased cytokine synthesis (e.g. interferon gamma).

Clinical Finding Of Cutaneous Leishmaniasis As A New Focus Of Iran

Cutaneous leishmaniasis in Iran has imposed of great economic and society with respect to the lack of adequate information about the disease in Kashan. To our knowledge, this is the first report of outbreak of cutaneous leishmaniasis in this area. The present study was conducted in 1995-2003 to determine the prevalence of cutaneous leishmaniasis in patients referring to laboratories in Kashan. This study was carried on 3028 patients referred to Kashan laboratories during the 9 years period. Initial variable included age, sex, occupation, place of residence and number of lesions that were all were recorded in an information data. With a total number of 3028 infected persons 50.8 percent were female and 49.2 percent male. The highest prevalence rate (37.9%) was in 0-10 years old. More than one active lesion was seen in 30.3% of individuals. The rang of the commonly affected site of the body were hands (45.6%). All patients treated with Meglomine antimonate (Glucantime) successfully. In this study the leishmania major strain was identified in majority of cases. The clinical finding pattern belonged to different endemic strains of L. major in Isfahan, which indicates the possible transmission of infection from Isfahan to this area.

Social Impact of Leishmaniasis, Afghanistan

Social Impact of Leishmaniasis, Afghanistan

The epidemiology of leishmaniases in Lebanon

The prevalence of leishmaniasis in Lebanon was studied in 1993–1997 for a Lebanese population sample of about 81000 subjects (60% rural and 40% urban) constituting roughly 3·4% of the total population. The prevalence of cutaneous leishmaniasis was found to be 0·18% in the rural versus 0·41% in the urban areas. Visceral leishmaniasis was practically non-existent in both environments. In addition, skin tests were done and anti- Leishmania antibodies were sought in a sample of the population at risk in the rural area. Skin tests were positive in 2·5% of the tested subjects, and 1% of the normal population had elevated levels of anti- Leishmania antibodies. The difference between the prevalence of clinical disease and positive skin testing and/or antibodies may be due to the existence of past or present subclinical disease. An unexpected finding was that the prevalent dermotropic parasite in Lebanon belongs to the L. donovani complex. Further characterization of the isolates by molecular techniques and definition of the transmission cycle of this parasite may explain our epidemiological findings.

The epidemiology of cutaneous leishmaniasis in subtropical Ecuador.

An epidemiologic survey (n = 466) was conducted in an area of subtropical rainforest in north-west Ecuador with the following objectives: (1) to determine the prevalence of cutaneous leishmaniasis (CL), (2) to identify the Leishmania species causing human disease, (3) to investigate the major clinical manifestations of leishmaniasis, (4) to study cellular and humoral immune response indicators associated with disease status and (5) to identify risk factors for CL. Fourteen percent of subjects had parasitologically confirmed CL; 33% had evidence of prior disease. However, 17.2% of subjects with a negative CL clinical history presented with a positive Montenegro skin test (MST), indicating the possibility of subclinical infection. The species isolated from subject lesions were L. guyanensis (63%), L. panamensis (33%), and L. brazilensis (4%). Mean specific anti-Leishmania IgG and IgM OD serum levels were highest in subjects diagnosed with current CL, followed by those with prior CL, and were lowest in healthy subjects, respectively (0.56 +/- 0.27 vs 0.33 +/- 0.2 vs 0.22 +/- 0.14; F-ratio = 74; P < 0.00001) and (665 +/- 270 vs 481 +/- 220 vs 301 +/- 128.5; F-ratio = 37; P < 0.00001). Likewise, subjects with present CL had measurably higher MST reactions (13 +/- 6.7 mm) than those with prior CL (10.9 +/- 7.8 mm) or healthy individuals (2.4 +/- 2.5 mm; F-ratio = 106; P < 0.00001). Serum concentrations of IgG were predicted by lesion number (t = 2.5; P = 0.018), size (t = 3.7; P = 0.0006), and duration (t = 3.5; P = 0.0013). Furthermore, the MST induration size increased as a function of lesion number (t = 3.0; P = 0.005) and size (t = 3.4; P = 0.022). Subject age and sex did not predict serum IgG or IgM concentrations or MST reactions in the 3 disease groups. Although no sex differences were found with respect to clinical characteristics, children < or = 12 years of age were almost 3 times more likely to have CL lesions or scars located on the face and head area compared to adults (OR = 2.75; 95% CI = 1.4-5.6, P = 0.004). The risk factors associated with disease included age under 5 years (AOR = 1.5; 95% CI = 0.48-2.35), male gender in adults (AOR = 2.8; 95% CI = 1.1-7.8), and wood and/or cane exterior house walls (AOR = 1.8; 95% CI = 1.4-2.5). In contrast, electric home lighting was associated with decreased risk (AOR = 0.7; 95% CI = 0.4-2.3). The results suggest that it may be possible to modify a portion of the risk of CL by making changes in the housing environment which may help to reduce the amount of human-vector contact.

Skin Diseases in Asir, Saudi Arabia

Skin Diseases in Asir, Saudi Arabia

Species composition of sand flies and population dynamics of Phlebotomus papatasi (Diptera: Psychodidae) in the southern Jordan Valley, an endemic focus of cutaneous leishmaniasis.

The species composition of sand flies and the seasonality of Phlebotomus papatasi Scopoli were studied in the southern Jordan Valley from May to November 1992 using CDC light traps. Eleven species of sand flies were recorded, including P. kazeruni Theodor & Mesghali and P. tobbi Adler & Theodor, which are new records for the study area, and Sergentomyia squamipleuris Newstead, which is reported for the first time from Jordan. P. papatasi was the most abundant Phlebotomus species collected from domestic habitats as well as Psammomys obesus Cretzschmar burrows, comprising 89.4 and 99.5% of the total Phlebotomus catches, respectively. The catch of P. papatasi in CDC light traps was compared among domestic habitats, P. obesus burrows in an agriculturally modified semiarid rural habitat, and P. obesus burrows in a natural semiarid rural habitat. Peak P. papatasi abundance occurred in September and October and then declined sharply by late November. The abundance and temporal association of P. papatasi activity with the prevalence of cutaneous leishmaniasis in the study area pointed to the significance of this sand fly in the transmission of the parasite.

Prevalence of cutaneous leishmaniasis along the Nile River north of Khartoum (Sudan) in the aftermath of an epidemic in 1985.

Based on a pilot clinical study of the prevalence of cutaneous leishmaniasis (CL) among school children in villages on both banks of the Nile River north of Khartoum, Sudan in the aftermath of a 1985 epidemic, we studied a random sample (303 individuals) from one of these villages to determine the prevalence of infection and exposure to CL. Four percent of the population had active CL lesions, 47% had healed lesions, and another 43% reacted positively to sensitization with leishmanin in the absence of past or active CL lesions. Ninety-one percent of the total population reacted positively to leishmanin. The present status of CL in the area and possible reasons for the emergence of the epidemic are discussed, and gaps in our knowledge about the epidemic are identified.