The Geographical Distribution of Cutaneous Leishmaniasis Causative Agents in Iran and Its Neighboring Countries, A Review

Abstract

Leishmania tropica and Leishmania major are both the main cause of anthroponotic (ACL) and zoonotic cutaneous leishmaniasis (ZCL), respectively, in the Old World. Leishmania infantum and Leishmania donovani, which are important causes of visceral leishmaniasis, have also occasionally been reported in CL patients. The present study investigates the current distribution of causative species of CL in Iran and neighboring countries in the Middle East. There has been expansion of L. tropica into new urban and rural foci in Iran, with well-documented cases of visceralization, a substantial increase of CL in Syria, and the emergence of new foci and outbreaks in Turkey and Iraq, especially due to L. major. Civil war in Syria and Iraq, population movement, poverty, and climatic change play important roles in the changing CL distribution in this region. Control programs should adopt a multidisciplinary approach based on active surveillance and case finding, especially in vulnerable refugee populations, determination of hazard maps for CL hot points using GIS and other advanced technology, the free distribution of drugs, rodent control, and greater community engagement in poor and marginalized populations. Comprehensive molecular studies that could show the species and strains of Leishmania in different areas of each country can give a better view from the distribution of CL in this region.

Relevance of epidemiological surveillance in travelers: an imported case of Leishmania tropica in Mexico

“…To the best of our knowledge, this case represents the first record of LCL caused by Leishmania tropica reported in Mexico. This species is registered mainly in the Middle Eastand Russia, representing one of the most widely distributed species causing cutaneous leishmaniasis in the Old World 5,7,17,18 . The incidence of this pathogen has increased in the urban areas of Israel and also in regions with armed conflicts in the Middle East 16 .…”

Şanlıurfa’da Leishmania infantum’un Etken Olduğu Kutanöz Leyşmanyazis (Şark Çıbanı) Olguları

“…P.alexandri Türkiye'de herhangi bir bölgede baskın tür olmamasına rağmen Şanlıurfa ile bazı KL ve VL endemik alanlardaki varlığı bildirilmiştir Leyşmanyazis, Türkiye'nin güneydoğusu ile Suriye, Irak ve İran gibi komşu ülkelerde önemli bir sağlık sorunudur 18 . Dünyada en fazla KL olgusunun olduğu 12 ülke arasında bulunan Suriye'de, KL etkeni olarak L.tropica, L.major, VL etkeni olarak da L.infantum yaygındır 19 . Sivil savaş nedeni ile yedi milyondan fazla insan Suriye'den komşu ülkelere, yarısından fazlası ise Türkiye'ye göç etmiştir.…”

Clinical-Pathological Conference Series from the Medical University of Graz

“…Leishmania parasites are transmitted by the bite of phlebotomine female sand flies [21]. While Leishmania tropica and Leishmania major cause cutaneous, mucocutaneous and diffuse cutaneous leishmaniasis, Leishmania infantum and Leishmania donovani are associated with visceral leishmaniasis (also known as kala-azar or black disease due to a peculiar gray discoloration of the skin of the hands, feet, abdomen and face) [22,23]. Visceral leishmaniasis, which is a systemic infection of the reticuloendothelial system, is endemic in more than 60 countries, including southern Europe, North Africa, the Middle East, Central and South America and the Indian subcontinent [24].…”