A 6-years Epidemiologic Study of Cutaneous Leishmaniasis

Major endemic foci of cutaneous leishmaniasis are present in different areas of Iran, including the city of Yazd, and it is one of the important parasitic diseases in tropical and subtropical regions. The first step in reduction of the disease cases is acknowledging its epidemiologic status. The present descriptive cross-sectional study was performed during 6 years, from autumn of 2000 to autumn of 2006 on the 1020 cases referred for diagnosis to the Yazd Central (reference) Medical Laboratory. The scraping method was used for preparation of direct smears, which were stained with Giemsa. From the 1020 cases suspected of cutaneous leishmaniasis (450 males and 570 females, comprising 44.1% and 55.9% of them, respectively), in 615 patients (60.3%) the amastigote form of parasites were found, of them 290 patients (47.2%) were males and 325 patients (52.8%) were females, showing no significant difference (P value=0.22). The most common location of the lesion was hand (In 148 patients or 24% of cases), followed by face, forearm, foot, arm, and trunk. In 394 patients (64%) there was a single ulcer, and 221 cases (36%) had more than one lesion, including a patient with 16 lesions. The most commonly affected age groups were 10-19 years (23.5%) and 20-29 years (21.5%). Also it was shown that the most common areas of residence in patients (in 155 cases, or 25.2%) was in the Imam Khomeini street (Hazira and Ghale Asadan areas) of Yazd city, where there are many ancient houses located on destroyed water channels and the resident people are in a low socioeconomic status. Considering the high (60.3%) positivity rate of leishmaniasis in referred cases from the physicians, it seems necessary to raise the clinical index of suspicion in cutaneous ulcers. It can also be suggested that health system officials pay more attention to detection of vectors and reservoirs of leishmania, in addition to educating the people at risk, for recognition of cutaneous leishmaniasis and its ways of control.