Reemergence of zoonotic cutaneous leishmaniasis in an endemic focus, northeastern Iran

Abstract

Zoonotic cutaneous leishmaniasis (ZCL) is a form of disease, which is mostly caused by Leishmania major (L.major ) in the Old World with high incidence through early life. Recently, the high incidence of CL has been reported in Jajarm County, northeastern Iran. The aim of the present study was to investigate the epidemiological aspects of CL and to identify Leishmania spp. in the area. Between 2012 and 2018, patients with active lesions suspected of CL were examined. Diagnosis was performed by methods of clinical examination and direct smears. Conventional kDNA polymerase chain reaction (PCR) was used to identify species of Leishmania . During the seven-year study period, 629 subjects were diagnosed as CL cases by clinical and microscopic examination. Considering the population of the study area, the average incidence rate was 237.8 per 100,000 population. Most (29.4%) of the subjects with ZCL were aged <10 years. Most of the patients (58.7%) were male and the rest were female. Most ulcers were observed on the face (32.2%) and hands (23.7%), respectively. Most patients (90%) had two or more ulcers on their body. The highest incidence was in the autumn in October (32%). Our data revealed that an ongoing reemergence of ZCL focus caused by L.major has arisen in the study area. Moreover, direct PCR on the smears for identifying Leishmania showed 100% specificity, and the species was identified as L. major using species -specific kDNA PCR. The use of conventional PCR on skin smears seems to provide a valuable method for confirming the clinical diagnosis of ZCL, which is very specific and sensitive particularly for clinical correlative studies. Further investigations are needed to improve planning strategies of vectors and reservoirs populations.

Epidemiological features of leishmaniasis and implications for public health in the eastern region of Morocco

“…Our results are consistent with those of other studies showing that LC lesions in L. major are located in the upper and lower limbs, unlike those in L. tropica. Indeed, studies in Ecuador and Tunisia have shown that LC lesions caused by L. tropica are mainly located on the face and then on the upper limbs, while those caused by L. major are preferentially located on the upper and lower limbs [13,14]. This can be attributed to the sandfly vectors of L. major CL: Phlebotomus papatsi.…”

“…This can be attributed to the sandfly vectors of L. major CL: Phlebotomus papatsi. In addition, the force of transmission of this form, which is considered more important, leads to a greater risk of suffering several infectious bites at different sites over a short period before the establishment of a protective immune response [13,15].…”

Epidemiological Aspects of Zoonotic Cutaneous Leishmaniasis (ZCL) in Iran, the Middle East, and Worldwide: A Comprehensive Systematic Review

“…Other factors affecting the incidence or spread of cutaneous leishmaniasis (ZCL); consist of atmospheric factors such as rainfall, temperature, sunshine, and humidity, males and those aged <10 years, and The emergence of the Coronavirus Disease 2019 (COVID-19) pandemic in Fars province (101). climatic factors in Kerman province (1), age groups in Ilam province (18), and seven criteria, including mean temperature, mean humidity, mean rainfall, elevation, distance from river, land use, and soil texture.…”

“…,49,55,63,72,98-100,122 . ) Other factors affecting the incidence or spread of cutaneous leishmaniasis (ZCL); consist of atmospheric factors such as rainfall, temperature, sunshine, and humidity, males and those aged <10 years, and The emergence of the Coronavirus Disease 2019 (COVID-19) pandemic in Fars province(101 ). climatic factors in Kerman province (1).…”

Leishmania tarentolae as Potential Live Vaccine Co-Expressing Distinct Salivary Gland Proteins Against Experimental Cutaneous Leishmaniasis in BALB/c Mice Model

“…In 2020, more than 85% of the cases belonged to 10 countries including Iran, where about 20,000 new cases occur per year (2). Two different forms of CL including zoonotic cutaneous leishmaniasis (ZCL) and anthroponotic cutaneous leishmaniasis (ACL) occur in Iran (3). The causative agent of ZCL which is observed in the rural area is Leishmania major (L. major) while ACL is related to urban areas and caused by Leishmania tropica (L. tropica) (4)(5)(6).…”