First Report on Various Aspects of a Focus of Cutaneous Leishmaniosis in Southwestern Iran

Leishmaniasis is a neglected and re-emerging disease which exists in three types worldwide, including mucocutaneous, visceral, and cutaneous. The disease is among the ten most important parasitic diseases in the tropics. It is widely distributed in ninety countries. The disease is distributed in new foci due to influence of many risk factors, including environmental factors. Evidence indicates an increase in the incidence of disease in the New and Old Worlds at the early years of this century. At present, Cutaneous Leishmaniasis (CL) is one of the most important vector borne diseases in Iran. In Iran, the disease is commonly manifested in 17 out of the 31 provinces of the country, with estimated annual cases exceeding 20000 within the country. There are two dominant types of leishmaniasis in Iran namely kala and azar, and two forms of CL namely urban type and rural type. Considering the current significant situation of CL in the Karun County, the present study was aimed at assessing the epidemiology of the disease and analyzing its potential risk of infection. This is a cross-sectional, descriptive-analytical study conducted during the period of 2013 to 2017 in Karun County. Suspected patients with skin lesions were referred to the Health Center of this county. The diagnosis was dependent largely on clinical examination and Giemsa stain. All slides were viewed under oil immersion for confirming amastigote forms inside or outside macrophages. Patients were examined to evaluate the CL lesion (gender, age, site, size, type, whether lesion is with secretion or without secretion, job, history, number, month, season, method of medicine injection and residential area). A questionnaire was filled through a direct interview with the patients. A P value of p≤0.05 was considered statistically significance. The present study clarified that the highest frequency of the disease had been documented in 2014 with 26 cases. Out of suspected CL cases, 81 were positive by microscopic method and clinical examination. The rate of infection in female and male were 42% and 58%, respectively. The difference in the numbers of patients of both genders was significant. The highest rate of positive (40%) was observed in age group of 20–29 years. In regard to the form of CL lesion, most of them (81.5%) were with secretion. Distribution of CL cases according to residential areas was 58% in villages and 42% in city. The highest rate (19.8%) and the lowest rate (1.2%) of CL were seen in January and August, respectively. The highest rate of CL was observed in winter (44.5%), but 8.4% was seen in summer, which statistically was significant. The highest distribution of CL lesions was observed on hands (43.2%), feet (16%), faces (14.8%), and on few limbs (20.1%). Considering lesions number, the prevalence was as such: single lesion (38.3%), two lesions (24.7%) and three or more lesions (37%), which were significantly different. This study clarifies that CL is a public health problem in districts of Karun County and its preventing must be one of the priorities of health directorate. Therefore, to reduce incidence of this disease, effective control programs are needed.

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