Epidemiological Study and Reservoir Identification of Cutaneous Leishmaniasis From Ardestan in Isfahan, Iran (2015-2016)

Fatemeh Aghdaei, Monir Doudi, Ladan Rahimzadeh Torabi, Mohammad Hossein Pazandeh, Aiiar Ahmadijazi
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Abstract

Background and aims: Cutaneous leishmaniasis (CL) has been considered one of the most common serious parasitic diseases. Some cities in Iran are known as the center of this important parasitic disease. The World Health Organization (WHO) defines CL as an infectious parasitic disease in the tropics, which can be challenging. The aim of this study was to investigate the epidemiological situation of CL (the identification of parasite, vector, and reservoir) in Ardestan. Methods: This descriptive-analytical cross-sectional study was performed in 2015-2016. Overall, 121 patients with CL who referred to Ardestan Dermatology and Leishmaniasis Center were sampled, and the Leishmania species were determined in the samples using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, following the amplification of the internal transcribed spacer 1 (ITS1) region in the parasite genome. Finally, the vector and reservoir species were detected by zoology experts according to identification keys. Results: The incidence of the disease had the highest (57.8%) and lowest (4.1%) levels in summer and spring, respectively. The disease was prevalent in both women and men but was more common in men (51.2%). The majority of patients (27.3%) were in the age group of 21-30 years, and most of the wounds (71.1%) were nodules. More than one wound on the body was observed in 54.5% of patients, and the disease was prevalent in 13.2% of patients and their family members. Occupationally, students showed the highest disease frequency (32%). The response to treatment with meglumine antimoniate (glucantime) was more effective than the other treatments. The species of the Leishmania vector in the Ardestan region was identified as Phlebotomus papatasi, and the species of the reservoirs in this region were Rhombomys opimus and Meriones libycus. Conclusion: Further research is needed to determine the carriers and reservoirs of the disease in other regions in order to reach a constructive decision for appropriate strategies to control the disease.
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2015-2016年伊朗伊斯法罕地区阿尔德斯坦皮肤利什曼病流行病学研究及病源鉴定
背景和目的:皮肤利什曼病被认为是最常见的严重寄生虫病之一。伊朗的一些城市被认为是这种重要寄生虫疾病的中心。世界卫生组织(世卫组织)将CL定义为热带地区的一种传染性寄生虫病,这可能具有挑战性。本研究的目的是调查阿尔德斯坦地区CL(寄生虫、媒介和宿主鉴定)的流行病学情况。方法:本描述性分析横断面研究于2015-2016年进行。总体而言,我们收集了121例就诊于Ardestan皮肤病和利什曼病中心的CL患者的样本,利用聚合酶链反应-限制性片段长度多态性(PCR-RFLP)方法,在寄生虫基因组中扩增内部转录间隔区1 (ITS1)区域,确定了样品中的利什曼原虫种类。最后由动物学专家根据识别键对病媒和库种进行检测。结果:该病发病率以夏季最高(57.8%),春季最低(4.1%);该病在女性和男性中均普遍存在,但在男性中更为常见(51.2%)。年龄以21 ~ 30岁为主(27.3%),创面以结节为主(71.1%)。54.5%的患者体表有一个以上创面,13.2%的患者及其家属患病。职业方面,学生患病率最高(32%)。与其他治疗方法相比,氨酸甲氨胺(葡聚糖)治疗的疗效更好。阿德斯坦地区利什曼原虫病媒蚊鉴定为papatasi白蛉,储存库蚊鉴定为大鼠鼠和利比亚沙鼠。结论:需要进一步研究确定该疾病在其他地区的携带者和宿主,以便为采取适当的控制策略做出建设性的决策。
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