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Sharifi I, Khosravi A, Aflatoonian MR, Salarkia E, Bamorovat M, Karamoozian A, Moghadam MN, Sharifi F, Afshar AA, Afshari SAK, Gharachorloo F, Shirzadi MR, Amiri B, Zainali M, Doosti S, Zamani O, Gouya MM. Cutaneous leishmaniasis situation analysis in the Islamic Republic of Iran in preparation for an elimination plan. Front Public Health 2023; 11:1091709. [PMID: 37188278 PMCID: PMC10176454 DOI: 10.3389/fpubh.2023.1091709] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/30/2023] [Indexed: 05/17/2023] Open
Abstract
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.
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Affiliation(s)
- Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmad Khosravi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Ehsan Salarkia
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Bamorovat
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Karamoozian
- Research Center for Modeling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mahmoud Nekoei Moghadam
- Research Center for Health Services Management, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Sharifi
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Aghaei Afshar
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Faranak Gharachorloo
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Reza Shirzadi
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Behzad Amiri
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Mohammad Zainali
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Sara Doosti
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Omid Zamani
- Universal Health Coverage for Communicable Diseases (UHC: CD), World Health Organization, Country Office, Tehran, Iran
| | - Mohammad Mahdi Gouya
- Center for Communicable Diseases Control, Ministry of Health and Medical Education, Tehran, Iran
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Aghaei Afshar A, Hojjat F, Yaghoobi-Ershadi MR, Rassi Y, Akhavan AA, Gorouhi MA, Yousefi S, Hanafi-Bojd AA. Modelling and evaluating the risk of zoonotic cutaneous leishmaniasis in selected areas of Kerman Province, south of Iran. Transbound Emerg Dis 2020; 67:1271-1283. [PMID: 31883433 DOI: 10.1111/tbed.13465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/25/2019] [Accepted: 12/19/2019] [Indexed: 11/27/2022]
Abstract
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.
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Affiliation(s)
- Abbas Aghaei Afshar
- Department of Medical Entomology & Vecotr Control, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Fahimeh Hojjat
- Department of Medical Entomology & Vecotr Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Yaghoobi-Ershadi
- Department of Medical Entomology & Vecotr Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Yavar Rassi
- Department of Medical Entomology & Vecotr Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ahmad Akhavan
- Department of Medical Entomology & Vecotr Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Gorouhi
- Department of Medical Entomology & Vecotr Control, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Saideh Yousefi
- Department of Medical Entomology & Vecotr Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Ali Hanafi-Bojd
- Department of Medical Entomology & Vecotr Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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