Assessing epidemiology of cutaneous leishmaniasis in Isfahan, Iran.

BACKGROUND & OBJECTIVES Leishmaniasis has an annual incidence of 0.5-1.5 million new cases and is endemic in 88 countries throughout the world. About 90% of cases of cutaneous leishmaniasis (CL) are reported from seven countries including Iran. Evidence suggests the increased annual incidence of this disease in Iran. Intracellular protozoan parasite, Leishmania, is an obligatory parasite. Sandflies transfer infectious forms of the parasite or its metacyclic promastigotes to its vertebrate hosts such as humans by biting. In order to review the epidemiology of CL in Isfahan, Iran, factors such as incidence, disease causes, geographic features, age, and sex distribution, nationality, and occupation of patients, and the clinical spectrum of disease were evaluated. METHODS During the study, 1315 patients with CL, who referred to the Dermatology and Leishmaniasis Research Center at Isfahan, were evaluated. RESULTS The highest prevalence of CL was observed in fall (54%) and in northern areas of Isfahan (60.9%). Although CL was prevalent in both men and women, it had higher incidence in men (61.8%). The majority of patients (31.2%) aged 21-30 yr old. Most lesions were nodule-shaped (36.5%) and in upper extremities (48.3%) particularly in men (32.4%). While 81.2% of the subjects were Iranian, others were Afghani or with other nationalities. Most patients had multiple lesions on their bodies and 141 individuals (10.7%) had a previous history of disease. Among all occupations, the highest prevalence of CL was detected in students (18.1%). The response to treatment with compounds of meglumine antimoniate (glucantime) was better than other treatments. INTERPRETATION & CONCLUSION Unfortunately, the results showed that the prevalence of CL has been increasing annually in some provinces of Iran, especially in Isfahan Province. Nevertheless, further studies are required to determine the vectors, reservoirs, and species of disease and to design appropriate strategies to control the disease.