Epidemiological Study of Leishmaniasis in Iran and the Middle East in the Last Two Decades

Leishmaniasis is one of the most forgotten diseases in the world affecting poor people in large numbers. At present, 350 million people are at risk and 2 million new cases are reported annually, of which 1.5 million are cutaneous leishmaniasis and the rest are related to visceral leishmaniasis. The World Health Organization and Tropical Diseases Research (TDR) division ranks leishmaniasis in the first group of emerging and uncontrolled disease. Leishmaniasis appears in three form; Cutaneous Leishmaniasis ( CL), muco-Cutaneous Leishmaniasis (MCL) and Viceral Leishmaniasis (VL). More than 90% of cutaneous leishmaniasis are in Iran, Afghanistan, Nepal, Syria, Saudi Arabia and Peru. Viceral leishmaniasis in terms of geographical conditions divided into five different types;Indian Leishmaniasis, is human disease reservoir type and sand fly of Phlebotomus argenti is vector. African leishmaniasis or Sudanese leishmaniasis is second and common in Sudan and Kenya. Gerbils, otters, dogs and cats are reservoirs and the vector is Phlebotomus orientalis.Russian type is the third form and prevalent in Turkmenistan and Caucasus (Soviet Union). Dogs and foxes are the main reservoirs and Phlebotomus archablensis is disease vector . The fourth is American type and affects American countries and dogs and jackals carry the disease and Phlebotomus intermedius are vectors of the disease.The fifth is Mediterranean Leishmaniasis also called Middle Eastern type which is common in the Middle East countries among people under the age of 10 and in Iran observe in the provinces of Khuzestan, Fars, Isfahan, Chaharmahal and Bakhtiari, Ardabil and Khorasan.