Ecological Niche Modeling of main reservoir hosts of zoonotic cutaneous leishmaniasis in Iran

Predicting current and future potential distributions of the greater bandicoot rat (Bandicota indica) under climate change conditions

BACKGROUND

Rodent infestation is a global problem. Rodents cause huge harm to agriculture, forestry, and animal husbandry around the world and spread various zoonoses. In this study, we simulated the potentially suitable habitats of Bandicota indica and predicted the impact of future climate change on its distribution under different socio-economic pathway scenarios of CMIP6 using a parameter-optimized maximum entropy (MaxEnt) model.

RESULTS

The average area under the receiver operating characteristic curve (AUC) value (0.958 ± 0.006) after ten repetitions proved the high accuracy of the MaxEnt model. Model results show that the annual mean temperature (≥ 15.93 °C), isothermality (28.52-80.49%), annual precipitation (780.13-3863.13 mm), precipitation of the warmest quarter (≥ 204.37 mm), and nighttime light (≥ 3.38) were important limiting environmental variables for the distribution of B. indica. Under current climate conditions, the projected potential suitable habitats for B. indica were mainly in India, China, Myanmar, Thailand, and Vietnam, which cover a total area of 301.70 × 104  km2 . The potentially suitable areas of B. indica in the world will expand under different future climate change scenarios by 1.61-17.65%.

CONCLUSIONS

These results validate the potential influence of climate change on the distribution of B. indica and aid in understanding the linkages between B. indica niches and the relevant environment, thereby identifying urgent management areas where interventions may be necessary to develop feasible early warning and prevention strategies to protect against this rodent's spread. © 2023 Society of Chemical Industry.

Predicting current and future high-risk areas for vectors and reservoirs of cutaneous leishmaniasis in Iran

Climate change will affect the distribution of species in the future. To determine the vulnerable areas relating to CL in Iran, we applied two models, MaxEnt and RF, for the projection of the future distribution of the main vectors and reservoirs of CL. The results of the models were compared in terms of performance, species distribution maps, and the gain, loss, and stable areas. The models provided a reasonable estimate of species distribution. The results showed that the Northern and Southern counties of Iran, which currently do not have a high incidence of CL may witness new foci in the future. The Western, and Southwestern regions of the Country, which currently have high habitat suitability for the presence of some vectors and reservoirs, will probably significantly decrease in the future. Furthermore, the most stable areas are for T. indica and M. hurrianae in the future. So that, this species may remain a major reservoir in areas that are present under current conditions. With more local studies in the field of identifying vulnerable areas to CL, it can be suggested that the national CL control guidelines should be revised to include a section as a climate change adaptation plan.

Current Risk of Dirofilariosis Transmission in the Iberian Peninsula (Spain and Portugal) and the Balearic Islands (Spain) and Its Future Projection under Climate Change Scenarios

Dirofilariosis is a vector-borne zoonotic disease whose distribution is linked to the presence of culicid mosquitoes. Spain and Portugal are considered endemic countries; however, the distribution of dirofilariosis is not uniform. Our aim was to develop a more accurate risk model of dirofilariosis transmission for the Iberian Peninsula (Spain and Portugal) and the Balearic Islands (Spain). To do this, we used a set of key variables related to parasite transmission: the potential distribution of suitable habitats for Culex pipiens calculated via an ecological niche model (ENM) and the potential number of Dirofilaria spp. generations. The resulting model was validated with the prevalence and geolocation of D. immitis-infected dogs from all provinces and districts. In addition, the impact of possible future climatic conditions was estimated. A quantitative estimate of the risk of infection by Dirofilaria spp. was obtained at a resolution of 1 km². The entire analyzed territory was susceptible to contact with the parasite. The highest risk of infection was found throughout the eastern coastal strip and the south of the Iberian Peninsula and the Balearic Islands, as well as in the areas surrounding the basins of the main rivers, and the lowest risk was located in the higher-altitude areas. We found a robust and positive relationship between the risk of dirofilariosis and the observed prevalence of infested dogs in the study area (β ± SE = 3.32 ± 1.43 p < 0.05). In 2080, the percentage of territory gain for Cx. pipiens will increase to 49.98%, which will increase the risk of infection. This new model provides a high predictive value for the current and predicted presence and risk and can serve as a tool for the management and control of dirofilariosis.

Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan

Iran has invariably been under the growing public health threat of cutaneous leishmaniasis (CL), a significant barrier to local development that hinders the prevention and control efforts toward eliminating the disease. So far, no comprehensive and in-depth epidemiological analysis of the CL situation has been carried out nationwide. This study aimed to employ advanced statistical models to analyze the data collected through the Center for Diseases Control and Prevention of Communicable Diseases during 1989-2020. However, we emphasized the current trends, 2013-2020, to study temporal and spatial CL patterns. In the country, the epidemiology of CL is incredibly intricate due to various factors. This fact indicates that the basic infrastructure, the preceding supports, and the implementation plan related to preventive and therapeutic measures need crucial support. The leishmaniasis situation analysis is consistent with desperate requirements for efficient information on the control program in the area. This review provides evidence of temporally regressive and spatially expanding incidence of CL with characteristic geographical patterns and disease hotspots, signifying an urgent need for comprehensive control strategies. This information could be a suitable model and practical experience in the Eastern Mediterranean Region, where over 80% of CL is reported.

Predicting potential transmission risk of Everglades virus in Florida using mosquito blood meal identifications

The overlap between arbovirus host, arthropod vectors, and pathogen distributions in environmentally suitable habitats represents a nidus where risk for pathogen transmission may occur. Everglades virus (EVEV), subtype II Venezuelan equine encephalitis virus (VEEV), is endemic to southern Florida where it is transmitted by the endemic vector Culex cedecei between muroid rodent hosts. We developed an ecological niche model (ENM) to predict areas in Florida suitable for EVEV transmission based upon georeferenced vector-host interactions from PCR-based blood meal analysis from blood-engorged female Cx. cedecei females. Thirteen environmental variables were used for model calibration, including bioclimatic variables derived from Daymet 1 km daily temperature and precipitation values, and land use and land cover data representing percent land cover derived within a 2.5 km buffer from 2019 National Land Cover Database (NLCD) program. Maximum temperature of the warmest month, minimum temperature of the coldest month, and precipitation of the driest month contributed 31.6%, 28.5% and 19.9% to ENM performance. The land cover types contributing the greatest to the model performance were percent landcover of emergent herbaceous and woody wetlands which contributed 5.2% and 4.3% to model performance, respectively. Results of the model output showed high suitability for Cx. cedecei feeding on rodents throughout the southwestern portion of the state and pockets of high suitability along the northern east coast of Florida, while areas with low suitability included the Miami-Dade metropolitan area and most of northern Florida and the Panhandle. Comparing predicted distributions of Cx. cedecei feeding upon rodent hosts in the present study to historical human cases of EVEV disease, as well as antibodies in wildlife show substantial overlap with areas predicted moderate to highly suitable for these vector/host associations. As such, the findings of this study likely predict the most accurate distribution of the nidus of EVEV to date, indicating that this method allows for better inference of potential transmission areas than models which only consider the vector or vertebrate host species individually. A similar approach using host blood meals of other arboviruses can be used to predict potential areas of virus transmission for other vector-borne diseases.

Cutaneous leishmaniasis in Iran: A review of epidemiological aspects, with emphasis on molecular findings

Leishmania parasites can cause zoonotic cutaneous leishmaniasis (CL) by circulating between humans, rodents, and sandflies in Iran. In this study, published data were collected from scientific sources such as Web of Science, Scopus, PubMed, Springer, ResearchGate, Wiley Online, Ovid, Ebsco, Cochrane Library, Google scholar, and SID. Keywords searched in the articles, theses, and abstracts from 1983 to 2021 were cutaneous leishmaniasis, epidemiology, reservoir, vector, climatic factors, identification, and Iran. This review revealed that CL was prevalent in the west of Iran, while the center and south of Iran were also involved in recent years. The lack of facilities in suburban regions was an aggravating factor in the human community. Some parts of southern Iran were prominent foci of CL due the presence of potential rodent hosts in these regions. Rhombomys opimus, Meriones lybicus, and Tatera indica were well-documented species for hosting the Leishmania species in Iran. Moreover, R. opimus has been found with a coinfection of Leishmania major and L. turanica from the northeast and center of Iran. Mashhad, Kerman, Yazd, and sometimes Shiraz and Tehran foci were distinct areas for L. tropica. Molecular identifications using genomic diagnosis of kDNA and ITS1 fragments of the parasite indicated that there is heterogeneity in leishmaniasis in different parts of the country. Although cutaneous leishmaniasis has been a predicament for the health system, it is relatively under control in Iran.

The alteration of the suitability patterns of Leishmania infantum due to climate change in Iran

Leishmaniasis is the most important parasitic infection in Iran. The aim of this study was to model the changing suitability patterns of Leishmania infantum, the causative agent of visceral leishmaniasis for the 21^st century in the country. Temperature, precipitation, and aridity-nature distribution limiting bioclimatic variables were involved in the ecological modelling. The altitudinal trends were considered by using 100 m bars. In Iran, the topographical patterns strongly impact the changing patterns of the suitability of L. infantum due to climate change. In general, climate change will decrease the parasite's suitability in the areas at low altitudes and increase in the middle and higher elevation regions. Increasing values are mainly predicted in the West, the decreasing suitability values in the East part of Iran. The altitudinal shifts and the reduced spatial distribution of L. infantum in the arid regions of East and Central Iran were modelled.

Geographic distribution of Meriones shawi and Psammomys obesus, the main reservoirs and Phlebotomus papatasi vector of zoonotic cutaneous leishmaniasis in Middle East and North Africa

Rodents play a significant role in the balance of a terrestrial ecosystem; they are considered prey for many predators like owls and snakes. However, they present a high risk to agriculture (damaging crops) and health. These rodents are the main reservoirs of some vector-borne diseases like leishmaniasis. Meriones shawi (MS) and Psammomys obesus (PO) are the primary Zoonotic cutaneous leishmaniasis (ZCL) reservoirs in the Middle East and North Africa (MENA). A review on the MS and PO at the MENA scale was explored. A database of about 1500 papers was used. 38 sites were investigated as foci for MS and 36 sites for PO, and 83 sites of Phlebotomus papatasi (Pp) in the studied region. An updated map at the regional scale and the trend of the reservoir distribution was carried out using a performing proper density analysis. In this paper, climatic conditions and habitat characteristics of these two reservoirs were reviewed. The association of rodent density with some climatic variables is another aspect explored in a case study from Tunisia in the period 2009–2015 using Pearson correlation. Lastly, the protection and control measures of the reservoir were analyzed. The high concentration of the MS, PO, and Pp can be used as an indicator to identify the high-risk area of leishmaniasis infection.

Leishmania spp. infection in Rhombomys opimus and Meriones libycus as main reservoirs of zoonotic cutaneous leishmaniasis in central parts of Iran: Progress and implications in health policy

Rodents from the subfamily Gerbillinae are the principal reservoir of cutaneous leishmaniasis (CL) caused by Leishmania major in the center and northeast of Iran. This study was conducted to determine both naturally occurring Leishmania infection rates and the distribution of Leishmania species in the central parts of Iran during 2019-2020. In this regard, presence of Leishmania parasites were confirmed by microscopic examination and the species were identified by nested-PCR using the Internal Transcribed Spacer2- Ribosomal DNA (ITS2-rDNA). Finally, some samples were sequenced and, the blast analysis of L. major samples, showed a 92.45-100% homology to the L. major sequence. Of the 181 wild gerbils collected (Rhombomys opimus=157 and Meriones lybicus=24), 88 (48.6%) tested positive for Leishmania sp. by microscopic examination whereas 162 (89.5%) were positive by nested-PCR. Of the 162 infected gerbils, 103 showed single strain infections (30 L. major, 28 L. gerbilli and 45 L. turanica), 43 showed dual infections with only the non-human species (L. gerbilli and L. turanica), and 16 were mixed infections of L. major and L. turanica (n = 14) or L. gerbilli (n = 2). All single or mixed L. major infections were detected in gerbils from areas with reports of human CL during the last decade. These findings suggest that Rhombomys opimus and Meriones libycus have a potential role in the maintenance of human and non-human transmission of Leishmania species in the CL foci.

Ecological niche modeling of genetic lineages of the great gerbil, Rhombomys opimus (Rodentia: Gerbillinae)

Great gerbil (Rhombomys opimus Lichtenstein, 1823) is distributed in Central Asia and some parts of the Middle East. It is widely found in central and northeast parts of Iran with two distinct genetic lineages: R. o. sodalis in the northern slopes of the Elburz Mountains and R. o. sargadensis in the southern slopes. This large rodent acts as the main host of natural focal diseases. No study has surveyed the ecological niche of the lineages and how their distribution might be influenced by different climatic variables. To examine the distribution patterns of this murid rodent, we aimed to determine the habitat preferences and effects of environmental variables on the ecological niche. Using a species distribution approach for modeling of regional niche specialization, suitable habitats predicted for R. o. sodalis were mainly located in Golestan province in northern Iran, along the northern slope of Elburz, while R. o. sargadensis, showed great potential distribution along the southern slope of Elburz and around the Kavir Desert and the Lut Desert. Despite the widest potential distribution of R. o. sargadensis from northeast to northwest and through Central Iran, the geographic range of R. o. sodalis was smaller and mostly confined to Golestan province. The results support the presence of the two genetic lineages of Rhombomys in Iran and confirm that there is no significant niche overlap between the two subspecies. Furthermore, it provided several perspectives for future taxonomic studies and prevention hygiene programs for public health.

Epidemiological features of cutaneous leishmaniasis and distribution of sand flies in an endemic area in southeast of Iran

Introduction

Cutaneous leishmaniasis (CL) is a widespread tropical infectious disease in the world. It is one of the most important health problem in Iran which is endemic in different parts of country. This study was conducted to determine epidemiological features of CL and distribution of sand flies in Hajiabad County, one of the important CL foci in southeast of Iran.

Methods

This descriptive cross-sectional study was conducted from March 2019 to March 2020.

All of the suspected CL cases with skin lesions who referred to Hajiabad County health centers and all actively detected patients were clinically and parasitologically examined for CL. Demographic and clinical data of all patients were recorded. Moreover, in this study, sand flies were collected monthly from four typical plain and foothill villages during their active season (May–November) using sticky trap. Sand flies were mounted as permanent microscopic slides, using Puri's medium, and identified by taxonomic keys. Data were analyzed using SPSS.21 software and descriptive statistics.

Results and discussion

A total of 70 confirmed cases of CL were recorded; the incidence rate of the disease was 101 per 100,000 people. The most infected age group was 0–10 years, with a rate of 64.3%. Males were infected more than females and the majority of cases (85.7%) were recorded from rural areas. Most of the cases had 1 lesion (51.4%) and the most lesions (55.8%) were in upper extremities. During the study period, 832 sand fly specimens comprised of ten species of Sergentomyia and seven of Phlebotomus were collected and identified. The most prevalent species was P. papatasi (47.12%), followed by P. alexandri (8.41%) and P. salehi (6.25%). Among the collected Phlebotomus species, P. papatasi and P. sergenti are known as the primary vectors of CL and P. alexandri, P. salehi, and P. caucasicus, play the main role as the secondary vectors of CL in Iran.

Conclusion

This study has revealed that CL is endemic in Hajiabad County and there are five CL vectors that are distributed in this County and some of them are more prevalent in plain areas. These findings can be used as a basis for implementation of interventions toward vector control, which may help in suppression of vector density, and consequently, control of CL in the study area.

Human Cutaneous Leishmaniosis in Iran, Up to Date-2019

Cutaneous leishmaniasis is a neglected and parasitic vector borne diseases that is endemic in tropical and subtropical countries, including Iran. The aim of this study was to explain the present status of CL in Iran. This report is based on data that recorded by cutaneous leishmaniasis surveillance system in 2019, and evaluated in Center for Communicable Diseases Management in Ministry of Health in Iran. Iran has been considered an endemic area for cutaneous leishmaniasis in the world. Dependent to activities for cutaneous leishmaniasis control the number of cases decreased from 23202 in 2008 (Incidence rate 32 per 100000) to 13124 in 2019 (Incidence rate 15.8 per 100000), more cases reported from September to December, in 2019, 46% of cases had one lesion and 21% had 2 lesions, 85% of cases diagnosed when the diameter of lesions had 3 centimeters and bellows. Although the Leishmania control program began in 1977, the incidence of the disease has dropped dramatically since 2008 when the new cutaneous leishmaniasis control program have been implemented. Although in some areas the incidence of the disease increased, but the implementation of the new program has reduced the number of cases, in order to continue reducing the disease, permanent support for the control programs is needed.

Climate change and its effect on the vulnerability to zoonotic cutaneous leishmaniasis in Iran

Zoonotic cutaneous leishmaniasis (ZCL) is an important vector-borne disease with an incidence of 15.8 cases per 100,000 people in Iran in 2019. Despite all efforts to control the disease, ZCL has expanded into new areas during the last decades. The aim of this study was to predict the best ecological niches for both vectors and reservoirs of ZCL under climate change scenarios in Iran. Several online scientific databases were searched. In this study, various scientific sources (Google Scholar, PubMed, SID, Ovid Medline, Web of Science, Irandoc, Magiran) were searched. The inclusion criteria for this study included all records with spatial information about vectors and reservoirs of ZCL which were published between 1980 and 2019. The bioclimatic data were downloaded from online databases. MaxEnt model was used to predict the ecological niches for each species under two climate change scenarios in two periods: the 2030s and 2050s. The results obtained from the model were analysed in ArcMap to find the vulnerability of different provinces for the establishment of ZCL foci. The area under the curve (AUC) for all models was >0.8, which suggests the models are able to make an accurate prediction. The distribution of all studied species in different climatic conditions showed changes. The variables affecting each of the studied species are introduced in the article. The predicted maps show that by 2050 there will be more suitable areas for the co-occurrence of vector and reservoir(s) of ZCL in Iran compared to the current climate condition and RCP2.6 scenario. An area in the northwest of Iran is predicted to have suitable environmental conditions for both vectors and reservoirs of ZCL, although the disease has not yet been reported in this area. These areas should be considered for field studies to confirm these results and to prevent the establishment of new ZCL foci in Iran.

An investigation of the effects of environmental and ecologic factors on cutaneous leishmaniasis in the old world: a systematic review study

OBJECTIVES

Leishmaniasis is a neglected and widespread parasitic disease that can lead to serious health problems. The current review study aimed to synthesize the relationship between ecologic and environmental factors (e.g., weather conditions, climatology, temperature and topology) and the incidence of cutaneous leishmaniasis (CL) in the Old World.

CONTENT

A systematic review was conducted based on English, and Persian articles published from 2015 to 2020 in PubMed/Medline, Science Direct, Web of Science and Google Scholar. Keywords used to search articles were leishmaniasis, environmental factors, weather condition, soil, temperature, land cover, ecologic* and topogr*. All articles were selected and assessed for eligibility according to the titles or abstracts. The quality screening process of articles was carried out by two independent authors. The selected articles were checked according to the inclusion and exclusion criteria.

SUMMARY AND OUTLOOK

A total of 827 relevant records in 2015-2020 were searched and after evaluating the articles, 23 articles met the eligibility criteria; finally, 14 full-text articles were included in the systematic review. Two different categories of ecologic/environmental factors (weather conditions, temperature, rainfall/precipitation and humidity) and land characteristics (land cover, slope, elevation and altitude, earthquake and cattle sheds) were the most important factors associated with CL incidence.

CONCLUSIONS

Temperature and rainfall play an important role in the seasonal cycle of CL as many CL cases occurred in arid and semiarid areas in the Old World. Moreover, given the findings of this study regarding the effect of weather conditions on CL, it can be concluded that designing an early warning system is necessary to predict the incidence of CL based on different weather conditions.

Scoping review of distribution models for selected Amblyomma ticks and rickettsial group pathogens

The rising prevalence of tick-borne diseases in humans in recent decades has called attention to the need for more information on geographic risk for public health planning. Species distribution models (SDMs) are an increasingly utilized method of constructing potential geographic ranges. There are many knowledge gaps in our understanding of risk of exposure to tick-borne pathogens, particularly for those in the rickettsial group. Here, we conducted a systematic scoping review of the SDM literature for rickettsial pathogens and tick vectors in the genus Amblyomma. Of the 174 reviewed articles, only 24 studies used SDMs to estimate the potential extent of vector and/or pathogen ranges. The majority of studies (79%) estimated only tick distributions using vector presence as a proxy for pathogen exposure. Studies were conducted at different scales and across multiple continents. Few studies undertook original data collection, and SDMs were mostly built with presence-only datasets from public database or surveillance sources. The reliance on existing data sources, using ticks as a proxy for disease risk, may simply reflect a lag in new data acquisition and a thorough understanding of the tick-pathogen ecology involved.

Cutaneous leishmaniasis in Iran: A systematic review and meta-analysis

Cutaneous leishmaniasis as a public health concern that attracts many attentions in endemic area. There is no exact estimation of cutaneous leishmaniasis in Iran. This study aimed to assess the exact prevalence of disease and carried out in databases including: Pub Med, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Iran doc, Barakatkns and Scientific Information Database (SID) from 2000 to 2019. Totally 84 studies were eligible to be included in this systematic review and Meta-analysis study. Based on a random effect model the pooled prevalence of leishmaniasis was estimated 45% (95% CI: 39%-51%; I^2 = 99.8%P < 0.001). The highest prevalence of CL was related to Isfahan 66% (53%-78%), Golestan 64% (62%-65%) and Fars province 63% (38%-84%) and the lowest prevalence was estimated in Kermanshah province 4% (4%-5%), Hormozgan 10% (8%-11%), Bushehr 12% (1%-35%) and Kerman 15% (9%-22%) provinces respectively. The lowest prevalence was associated with L. trapica spices 23% (11%-38%) and the highest was associated with L. major spices 32% (21%-45%). The prevalence with both L. trapica and L. major spices was achieved 60% (48%-71%). It is essential for health authorities to take steps to control and prevent the epidemic by rapid treatment of patients, destroying gerbils and promotion of general and health education for the local population.

MicroRNAs Expression Induces Apoptosis of Macrophages in Response to Leishmania major (MRHO/IR/75/ER): An In-Vitro and In-Vivo Study

Background:

We aimed to investigate the effect of miR-15a mimic and inhibitor of miR-155 expression on apoptosis induction in macrophages infected with Iranian strain of Leishmania major in-vitro and in-vivo.

Methods:

RAW 264.7 cells were infected with L. major promastigotes (MRHO/IR/75/ER), and then were treated with miRNAs. For in-vivo experiment, BALB/c mice were inoculated with L. major promastigotes, and then they were treated with miRNAs. For evaluation of miRNA therapeutic effect, in-vitro and in-vivo studies were performed using quantitative Real-time PCR, Flow cytometry, lesion size measurement, and Limiting Dilution Assay (LDA). This study was performed in Shahid Beheshti University of Medical Sciences in 2019.

Results:

In-vitro results of flow cytometry showed that using miR-15a mimic, miR-155 inhibitor or both of them increased apoptosis of macrophages. In in-vivo, size of lesion increased during experiment in control groups (P<0.05) while application of both miR-155 inhibitor and miR-15a mimic inhibited the increase in the size of lesions within 6 wk of experiment (P=0.85). LDA results showed that microRNA therapy could significantly decrease parasite load in mimic or inhibitor receiving groups compared to the control group (P<0.05).

Conclusion:

miR-155 inhibitor and miR-15a mimic in L. major infected macrophages can induce apoptosis and reduce parasite burden. Therefore, miRNA-based therapy can be proposed as new treatment for cutaneous leishmaniasis.

Classification of cutaneous leishmaniasis patients based on its risk factors using latent class analysis

Cutaneous leishmaniasis is one of the main health-economic problems around the world. Data were collected from all patients with cutaneous leishmaniasis referred to the health centres of Kermanshah province between 2013 and 2019. Latent class analysis was conducted by PROC LCA in SAS 9.2 and a significant level was set at 0.05. Four latent classes were identified: low (33.8%), moderate (9.8%), high (22.4%) and very high risk (34.0%). The probability of having a travel history was high in the third class. Our study indicated that having history of an eschar has no role in the classification of patients. On the other hand, a positive smear test is important in classifying subjects. Our results indicate that more than half of all patients fell under high risk or very high-risk class. This emphasises the importance of planning preventive intervention by considering different risk factors of cutaneous leishmaniasis simultaneously.

A spatio-temporal agent-based approach for modeling the spread of zoonotic cutaneous leishmaniasis in northeast Iran

BACKGROUND

Zoonotic cutaneous leishmaniasis (ZCL) is a neglected tropical disease worldwide, especially the Middle East. Although previous works attempt to model the ZCL spread using various environmental factors, the interactions between vectors (Phlebotomus papatasi), reservoir hosts, humans, and the environment can affect its spread. Considering all of these aspects is not a trivial task.

METHODS

An agent-based model (ABM) is a relatively new approach that provides a framework for analyzing the heterogeneity of the interactions, along with biological and environmental factors in such complex systems. The objective of this research is to design and develop an ABM that uses Geospatial Information System (GIS) capabilities, biological behaviors of vectors and reservoir hosts, and an improved Susceptible-Exposed-Infected-Recovered (SEIR) epidemic model to explore the spread of ZCL. Various scenarios were implemented to analyze the future ZCL spreads in different parts of Maraveh Tappeh County, in the northeast region of Golestan Province in northeastern Iran, with alternative socio-ecological conditions.

RESULTS

The results confirmed that the spread of the disease arises principally in the desert, low altitude areas, and riverside population centers. The outcomes also showed that the restricting movement of humans reduces the severity of the transmission. Moreover, the spread of ZCL has a particular temporal pattern, since the most prevalent cases occurred in the fall. The evaluation test also showed the similarity between the results and the reported spatiotemporal trends.

CONCLUSIONS

This study demonstrates the capability and efficiency of ABM to model and predict the spread of ZCL. The results of the presented approach can be considered as a guide for public health management and controlling the vector population .

Comparative Expression Profile Analysis of Apoptosis-Related miRNA and Its Target Gene in Leishmania major Infected Macrophages

Background:

Cutaneous Leishmaniasis (CL) is an emerging uncontrollable and neglected infectious disease worldwide including Iran. The aim of this study was to investigate the expression profile of apoptosis-related miRNA and its target gene in macrophages.

Methods:

This study was carried out in the Department of Medical Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran from January 2016 to November 2018. Applying literature reviews, bioinformatics software, and microarray expression analysis, we selected miRNA-24-3p interfering in apoptosis pathway. The expression profile of this miRNA and target gene were investigated in Leishmania major (MRHO/IR/75/ER)-infected primary and RAW 264.7 macrophages (IBRC-C10072) compared with non-infected macrophages (control group) using quantitative Real-time PCR.

Results:

Results of bioinformatics analysis showed that miR-24-3p as anti-apoptotic miRNA inhibits pro-apoptotic genes (Caspases 3 and 7). Microarray expression data presented in Gene Expression Omnibus (GEO) revealed a significant difference in the expression level of selected miRNA and its target gene between two groups. QRT-PCR results showed that the expression of miR-24-3p was upregulated in L. major infectioned macrophages that approved the results of bioinformatics and microarray analysis.

Conclusion:

Parasite can alter miRNAs expression pattern in the host cells to establish infection and its survival. Alteration in miRNAs levels likely plays an important role in regulating macrophage functions following L. major infection. These results could highlight current understanding and new insights concerning the gene expression in macrophages during leishmaniasis and will help to development of novel strategies for control and treatment of CL.

First Autochthonous case of Emerged Zoonotic Cutaneous Leishmaniasis in Mazandaran Province, Northern Iran: kDNA-PCR Evidence Base

BACKGROUND

In the last decade, several cases of cutaneous leishmaniasis (CL) have been recorded by the provincial health center of Mazandaran Province, northern Iran. However, there is no documented report of autochthonous CL in the province yet.

CASE PRESENTATION

The patient, a 59-year-old female, known case of diabetes mellitus, lived in therural area of Kiasar district (in theeastern part of the Mazandaran) with 5 skin lesions suspected of having vasculitis, without ahistory of traveling to the endemic areas of CL,was admitted to Imam Khomeini teaching hospital, Sari. To rule out CL, fine needle aspiration(FNA)procedure was used aseptically for the patient. Laboratory investigations showed Leishman bodies (amastigotes) by direct smear preparation, and species identification confirmed Leishmania major (L. major) by polymerase chain reaction (PCR)molecular method. Accordingly, this is the first documented report of autochthonous CL in Mazandaran Province.

CONCLUSION

Overall, due to the abundance of probable rodent reservoir hosts and confirmation of infectionof sandflies (Phlebotomus papatasi) withL. major in the Kiasar district, where our patient was livingthere, it seems that CL emerged in the eastern part of the province. Therefore, further studies on rodents and sandflies fauna in terms of emerging leishmanial infection in the area is recommended.

Modelling and evaluating the risk of zoonotic cutaneous leishmaniasis in selected areas of Kerman Province, south of Iran

Cutaneous leishmaniasis (CL) remains a public health problem in the world, particularly in tropical and sub-tropical countries. This study aimed to determine the hotspots of CL in Kerman Province of Iran and model their potential for the establishment of new disease foci. All documents related to studies conducted in Kerman Province on CL published between 1978 and 2017 were retrieved and categorized. Spatial distributions of the vector, reservoir and human infection of CL were mapped. MaxEnt ecological model was used to predict the environmental suitability of the vector and reservoir(s) of zoonotic cutaneous leishmaniasis (ZCL). The most hazardous sites with the potential for the establishment of new disease foci were determined for field operations. Statistics of new cases of CL was obtained from the Center for Disease Control (CDC) of the ministry of health for the period 2011-2016. A total of 6,056 cases of CL were recorded, while we found a decreasing pattern in the incidence of CL from 46.48 per 100,000 inhabitants to 22.97. The best ecological niches for Phlebotomus papatasi are located in the central, western, northwest and southwest regions of the province. Also, environmental suitability for the reservoirs was highest in the central, southern and southwestern regions. The model predicted the gerbils can be present in some foci of anthroponotic cutaneous leishmaniasis (ACL). However, this result should be confirmed through a precise field study, and if validated, plans should be made to prevent the emergence of new foci of ZCL in the risk areas.

Epidemiological Study of Cutaneous Leishmaniasis in Neyshabur County, East of Iran (2011-2017)

BACKGROUND:

Cutaneous Leishmaniasis (CL) isn’t a lethal disease, but it has always been taken into consideration due to more involvement of patients with skin ulcers and its long-term treatment. Various factors can play an intervening role in increasing the rate of disease. The present study aimed to evaluate the prevalence and associated factors of disease from 2011-2017 and provide appropriate control strategies for reducing its incidence in Neyshabur county.

METHODS:

All patients with CL, who had medical records in the health centres of Neyshabur from 2011 to 2017, were examined for conducting this cross-sectional analytical study. Data were analyzed by descriptive statistics and chi-square test at a 0.05 using Statistical Package for the Social Sciences (SPSS V.22).

RESULTS:

Findings indicated that the highest annual incidence was in 2016 (229 patients), and the least incidence was in 2014 (100 patients). The majority of patients were under 10 years of age and 51.7% of patients were male. About 59.5% of patients were living in cities and 35% of them were living in North of Neyshabur city. Hands were the most affected part of the body (56.0%) followed by trunk (1.3%). Most patients (69.9%) were treated with topical regimens.

CONCLUSION:

This study showed that CL was hypo-endemic in Neyshabur. Also, the disease was more prevalent in urban areas. Therefore, appropriate health measures to improve environmental conditions, public health educations, and the public awareness of the positive impact of early diagnosis of disease in the success of treatment (especially for inhabitance suburbanite) are essential.

Climate change-based models predict range shifts in the distribution of the only Asian plethodontid salamander: Karsenia koreana

Populations see their range fluctuate in relation to environmental variations, including climate change, and their survival is linked to the maintenance of large enough populations and broad enough distributions during these variations. Most amphibian populations are threatened by numerous ecological and anthropogenic variables acting in synergy with climate change. Accumulating basic ecological data such as range enables the development of population and range dynamics, themselves resulting on adequate conservation plans. Karsenia koreana is the only known Asian plethodontic salamander, occurring in a very restricted area only. Based on presence data, we created an ecological model using six bioclimatic factors with low multicollinearity to define the adequate habitat of the species, and we modelled the predicted suitability of the Korean landscape following four Representative Concentration Pathways (RCPs) predicting climate change scenarios based on CO2 concentrations in 2050 and 2070. The maximum entropy model for the current distribution produced a landscape suitability considerably wider than the current known distribution. The projected ranges for each RCP indicated marked increases, decreases and shifts in areas with suitable landscapes due to climate change. The lowest RCP prediction resulted in an increase in suitable area, although potentially without connectivity with current populations, while the highest RCP predictions resulted in a decrease. Our results highlight the potential negative impact of climate change, thus requiring updates in conservation plans for K. koreana. The methods used here can be replicated with any land-dwelling species, and our results reflect expected range shifts for most amphibians of the northern hemisphere.

Epidemiological aspects of cutaneous leishmaniasis in Southwest of Iran

Background and Aim: Zoonotic rodents (Rodentia: Muridae: Gerbillinae) and Phlebotominae sand flies are the major reservoir hosts and vectors of Leishmania major causing zoonotic cutaneous leishmaniasis, respectively. This study was carried out to evaluate the epidemiological aspects of cutaneous leishmaniasis (CL) in Tangestan County, Southwest Iran. Materials and Methods: This descriptive cross-sectional study was carried out on human cases, probable reservoirs, and vectors of CL at Tangestan County in 2017. The data of patients were taken on health centers and analyzed. To determination faunistic of sand flies, they were collected using sticky paper traps and identified using identification keys. The rodent samples were captured using Sherman live traps and determined for amastigote infection. Results: A total of 436 cases occurred during 2005-2017 and the incidence rate of disease was 0.2-12/100,000 people. Six species of sand flies including three species of Phlebotomus and three species of Sergentomyia including Phlebotomus papatasi, Phlebotomus sergenti, Phlebotomus alexandri, Sergentomyia tiberiadis, Sergentomyia baghdadis, and Sergentomyia clydei were identified. From 185 trapped rodents, 9 species were identified. We founded, 2 out of 132 Tatera indica (1.53%) were positive with Leishmania spp. using the microscopic method. Conclusion: According to the existence of human leishmaniasis cases as a host, T. indica with high abundance and infected to Leishmania as a reservoir, and existence of P. papatasi with high abundance as a suspected vector of disease; there is a potential for transmission of disease in the area. Design of exact control and prevention strategies is highly recommended.

Modeling spatial risk of zoonotic cutaneous leishmaniasis in Central Iran

Zoonotic Cutaneous Leishmaniasis (ZCL) is one of the endemic diseases in central part of Iran. The aim of this cross-sectional study was to find the areas with a higher risk of infection considering the distribution of vector, reservoir hosts and human infection. Passive data recorded the positive cases of cutaneous leishmaniasis in Yazd province health center were collected for 10 years, from 2007 to 2016 at the County level. Considering all earlier studies conducted in Yazd province, records of Phlebotomus papatasi, the main vector of ZCL, and Rhombomys opimus, the main reservoir of ZCL, were collected and entered in a database. ArcGIS and MaxEnt model were used to map and predict the best ecological niches for both vector and reservoir. The most cumulative incidence of the disease was found to be in Khatam County, south of Yazd province. The area under curve (AUC) for R. opimus and P. papatasi was 0.955 and 0.914, respectively. We found higher presence probability of both vector and reservoir in central and eastern parts of the province. The jackknife test indicated that temperature and normalized difference vegetation index (NDVI) had the most effect on the model for the vector and reservoir, respectively. The areas with higher presence probability for the reservoirs and vectors were considered having the higher potential for ZCL transmission. These findings can be used to prevent and control the disease.

An outbreak of Leishmania major from an endemic to a non-endemic region posed a public health threat in Iraq from 2014-2017: Epidemiological, molecular and phylogenetic studies

Background

Cutaneous leishmaniasis (CL) is a neglected worldwide, zoonotic, vector-borne, tropical disease that is a threat to public health. This threat may spread from endemic to non-endemic areas. Current research has exploited epidemiological, molecular and phylogenetical studies to determine the danger of an outbreak of CL in the borderline area between northern and central Iraq from 2014–2017.

Methodology/Principal findings

For the first time, using sequence analysis of the cytochrome b gene, the occurrence of CL in the borderline area between northern and central Iraq was confirmed to be due to Leishmania major. The phylogenetic analysis indicated that it was closely related to the L. major MRHO/IR/75/ER strain in Iran.

Conclusions and significance

In conclusion, the genotype confirmation of the L. major strain will improve our understanding of the epidemiology of the disease. This is important for facilitating control programs to prevent the further spread of CL. Furthermore, this area could be considered as a model for further research on the risk of global CL epidemics in other non-endemic countries where both reservoir hosts and sandfly vectors are present.

Leishmaniasis refers to a disease with three main types of clinical manifestation in infected individuals including cutaneous, mucocutaneous and visceral forms. It is caused by several species of a parasite belonging to the genus Leishmania and is transmitted by a small blood-sucking insect called a sandfly. The disease is mostly confined to the majority of the poorest countries worldwide, including Iraq, and is categorized as a low priority public health concern. The risk of the disease is exacerbated especially when suitable environments assist the sandfly and reservoir host to breed and spread and help the parasite to transfer from high incidence areas to places free from the disease. Therefore, we investigated the risk of the CL form of the disease after an outbreak in a borderline between northern and central of Iraq using the most sensitive diagnostic techniques including PCR and gene sequencing. The epidemiological, molecular and phylogenetic analyses of the parasites were studied, and we found that the parasite species Leishmania major was associated with the outbreak. Phylogeny analysis confirmed that the identified strain of the parasite matched an Iranian strain. These results indicate the risk of the disease spreading from endemic to non-endemic areas.

Spatio-temporal analysis of cutaneous leishmaniasis using geographic information system among Iranian Army Units and its comparison with the general population of Iran during 2005-2014

To investigate the time trend and distribution of cutaneous leishmaniasis in Iranian Army Units (IAUs) and general population (GP). with using census, Data on CL incidence in IAUs (from AJA University of Medical Sciences) and GP (from Ministry of Health) during 2005-2014 were extracted and entered into the GIS software. Cochran-Armitage test, choropleth map, hot-spot analysis and high/low clustering analysis were used to determine time trend, distribution of disease, hot-spots, and possible abnormal clustering, respectively. The number of infected individuals in IAUs and GP were 6533 and 153,499 respectively (with incidence rates of 143.68 per 100,000 and 25.86 per 100,000, respectively). Time trend analysis revealed the departure from linear trend for the incidence in IAUs (p < 0.001), but no such time trend was found in GP. According to choropleth maps; in IAUs, Khozestan from southwest, Esfahan from central and Kermanshah from west parts of Iran and among GP; Fars, Yazd, and Kerman in southern-east of Iran showed a high incidence rates. In IAUs, Esfahan and Khuzestan provinces was hot-spots of CL (p < 0.05), but in GP, provinces like Fars and Khorasan-shomali was hot-spots (p < 0.05). No clustering pattern of disease was observed in either study populations. Observed spatiotemporal variability in CL among IAUs and GP warrants proper health programs particularly to Khozestan and Esfahan in IAUs and Fars and Khorasan-shomali in GP are highly recommended.

Prevalence of Leishmania species in rodents: A systematic review and meta-analysis in Iran

Leishmaniasis are diverse group of diseases caused by numerous species of genus Leishmania. Herein we have contrived a systematic review and meta-analysis on the prevalence of Leishmania species in rodents of Iran. For this purpose, following the general methodology recommended for systematic reviews and meta-analysis, six English databases (PubMed, Science Direct, Scopus, Ovid, Web of Science and Google Scholar) and four Persian databases (Magiran, SID, Iran Doc and Iran Medex) were explored during January 1995 till June 2015. Papers were selected based on 8 pre-defined inclusion criteria. During the years, a total number of 4485 different rodents were captured; among which 1291 cases were Leishmania positive. The calculated weighted prevalence of Leishmania species in rodents was 23% (95% CI=18-28). Given geographical zones of Iran, the highest and lowest prevalence rate was belonged to North 50% (95% CI=40-61) and West 11% (95% CI=5-17), respectively. Rhombomys opimus (1766), Meriones lybicus (1258) and Tatera indica (488) were the three most abundant captured rodents, while the highest prevalence of Leishmania species was observed in Nesokia indica 48% (95% CI=42-54) and followed by R. opimus 39% (95% CI=30-47). Egger's regression test was performed to detect publication bias, which revealed it may not have a significant influence on overall weighted prevalence estimate (P=0.317). Meta-regression analysis demonstrated that there is no significant relationship between overall prevalence with sample size (P=0.1) and year of publication (P=0.7). The results showed remarkable prevalence of Leishmania species in rodent reservoirs. In future, adopting a suitable strategy for control and combat with rodents is necessary.

A time series analysis of environmental and metrological factors impact on cutaneous leishmaniasis incidence in an endemic area of Dehloran, Iran

The aim of this study was to investigate the relationship between the environmental and metrological variables and cutaneous leishmaniasis (CL) transmission and its prediction in a region susceptible to this disease prevalence using a time series model. The accurate locations of 4437 CL diagnosed from 2011 to 2015 were obtained to be used in the time series model. Temperature, number of days with temperature over 30 °C, and number of earthquake were related to CL incidence using the Seasonal Auto-correlated Integrated Moving Average (SARIMA) model according to the Box-Jenkins method. In addition, the relationship between land use and surface soil type in 500- and 1000-m radius around the CL patients were investigated. The SARIMA models showed significant associations between environmental and meteorological variables and CL incidence adjusted for seasonality and auto-correlation. The result indicated that there are need more robust preventive programs in earthquake-prone areas with high temperature and inceptisol soil type than other areas. In addition, the region with these characteristics should be considered as high-risk areas for CL prevalence.

Predicting the potential distribution of main malaria vectors Anopheles stephensi, An. culicifacies s.l. and An. fluviatilis s.l. in Iran based on maximum entropy model

Malaria is considered as a major public health problem in southern areas of Iran. The goal of this study was to predict best ecological niches of three main malaria vectors of Iran: Anopheles stephensi, Anopheles culicifacies s.l. and Anopheles fluviatilis s.l. A databank was created which included all published data about Anopheles species of Iran from 1961 to 2015. The suitable environmental niches for the three above mentioned Anopheles species were predicted using maximum entropy model (MaxEnt). AUC (area under Roc curve) values were 0.943, 0.974 and 0.956 for An. stephensi, An. culicifacies s.l. and An. fluviatilis s.l respectively, which are considered as high potential power of model in the prediction of species niches. The biggest bioclimatic contributor for An. stephensi and An. fluviatilis s.l. was bio 15 (precipitation seasonality), 25.5% and 36.1% respectively, followed by bio 1 (annual mean temperature), 20.8% for An. stephensi and bio 4 (temperature seasonality) with 49.4% contribution for An. culicifacies s.l. This is the first step in the mapping of the country's malaria vectors. Hence, future weather situation can change the dispersal maps of Anopheles. Iran is under elimination phase of malaria, so that such spatio-temporal studies are essential and could provide guideline for decision makers for IVM strategies in problematic areas.

Situation analysis of cutaneous leishmaniasis in an endemic area, south of Iran

OBJECTIVE

To update current situation of the cutaneous leishmaniasis (CL) in Kazerun County, southwest of Iran and to analyse the epidemiological aspects of the disease during 2005-2015.

METHODS

Data on CL were obtained from the Health Center of Kazerun County, and then were analysed and mapped using SPSS and Arc GIS 10.3.

RESULTS

A total of 700 cases of CL were recorded during the study period with an overall decreasing trend from 2005 to 2015. More than 60% of the patients were inhabitants of rural areas and males were infected more than females. Although there was not a significant difference between gender, job categories, residence and CL infection (P > 0.05), age groups were significantly different (P < 0.05). But there was no significant correlation between monthly cases of the disease with average temperature (P > 0.05). Most of the acute lesions were found to be present on the hand, leg and face, respectively. The average CL incidence in the study area was calculated as 24.9/100000 population. A hot spot for the disease was found in southern part of the area (P < 0.05).

CONCLUSIONS

This study revealed that CL is present in Kazerun country. Thus, effective monitoring and sustained surveillance system is crucial in counteracting the disease, and if possible, to eliminate it.

Advances and Limitations of Disease Biogeography Using Ecological Niche Modeling

Mapping disease transmission risk is crucial in public and animal health for evidence based decision-making. Ecology and epidemiology are highly related disciplines that may contribute to improvements in mapping disease, which can be used to answer health related questions. Ecological niche modeling is increasingly used for understanding the biogeography of diseases in plants, animals, and humans. However, epidemiological applications of niche modeling approaches for disease mapping can fail to generate robust study designs, producing incomplete or incorrect inferences. This manuscript is an overview of the history and conceptual bases behind ecological niche modeling, specifically as applied to epidemiology and public health; it does not pretend to be an exhaustive and detailed description of ecological niche modeling literature and methods. Instead, this review includes selected state-of-the-science approaches and tools, providing a short guide to designing studies incorporating information on the type and quality of the input data (i.e., occurrences and environmental variables), identification and justification of the extent of the study area, and encourages users to explore and test diverse algorithms for more informed conclusions. We provide a friendly introduction to the field of disease biogeography presenting an updated guide for researchers looking to use ecological niche modeling for disease mapping. We anticipate that ecological niche modeling will soon be a critical tool for epidemiologists aiming to map disease transmission risk, forecast disease distribution under climate change scenarios, and identify landscape factors triggering outbreaks.