Study on epidemiology of cutaneous leishmaniasis in Fars province, southern Iran, during 2017

Background: Although Cutaneous Leishmaniasis (CL) is endemic in 98 countries, roughly75% of cases are reported in only ten countries including Iran. Prevalence and incidence of CLis remarkable in 17 provinces of the country. Leishmania species are the main etiological agentsof CL, and mammals and sand flies maintain and transmit the parasites, respectively. This studyfocused on the monitoring of Leishmania agent infections and updating the distribution data ofthese species in suspected patients of CL from Shiraz and Kharameh townships using variousmethods of microscopy, culture, and polymerase chain reaction (PCR) in Fars province, during2017. The results will help for a better planning of disease control in these areas.Matrials and Methods: Cutaneous slit biopsies were prepared from 350 suspected humancases to CL in Shiraz and Kharameh. Patient demographic data such as age, gender, thenumber, and location of each lesion were recorded in the forms which were consisted ofinformed and free consent part that filled by volunteers. Biopsies were checked by microscopy,culture, and PCR assays. For PCR, four different genes were detected including minicirclekDNA, and cysteine protease B (CPB) genes for Leishmania detection, and glyceraldehyde-3-phosphate dehydrogenase (GAPDH), and internal transcribed spacer 1 (ITS1) genes forCrithidia.Results: Among 350 suspected cases of CL, 68% and 65.3% of were positive by microscopyand cultivation methods. The most CL patients were aged 11-30 years. In PCR assay, L. major,and L. tropica were detected in 86.2% (238/276), and 13.1% (36/276) of CL cases,respectively. Also, dermal L. infantum strain was isolated from 0.7% (2/276) of suspectedpatients to post kala-azar dermal leishmaniasis (PKDL). In addition, Crithidia sp. was detectedin two of CL patients who chronically infected with L. major.Conclusions: Despite various control strategies, especially CL against, considerable cases ofleishmaniasis are recorded from Iran every year. Clinical and epidemiological diversity, lackof data, and non-health effects of the disease, such as stigmatization and poverty, havecomplicated the assessment of the burden of leishmaniasis. Therefore, more epidemiological,ecological, and gene polymorphism studies are needed to understand the pathogenic role ofLeishmania species in humans in leishmaniasis life cycle.

کلیدواژه ها:

Epidemiology ، Cutaneous Leishmaniasis ، Fars ، Iran