[Seroepidemiology of canine visceral leishmaniasis in Kerman city, 2011]

Visceral leishmaniosis [VL] is a sporadic disease in many provinces of Iran, while it is considered endemic in other parts. This study was designed to assess the seroprevalence of canine VL in the Kerman city. Samples were randomly selected from the referred household dogs to the veterinary hospital of Shahid Bahonar university, Kerman, Iran and stray dogs, euthanized by Kerman municipality. Blood samples were taken after complete clinical examination. All collected sera were tested by a commercial indirect ELISA kit for the presence of anti Leishmania infantum antibodies. In addition, complete blood count tests were performed in all dogs to detect hematological alterations. Collected data were analyzed through SPSS software and using chi[2] and fishers' exact tests. The overall seroprevalence was 7.03%, which was calculated 11.1% in stray dogs. Seroprevalence of disease was significantly higher in dogs over 5 years old in comparison to younger dogs [P<0.01]. Seroprevalence had no significant relationship with sex and hematological alterations. Although the seroprevalence of canine VL in Kerman city was less than that in endemic parts, stray dogs could be a potential risk factor for public health in this area. Further complementary ecological studies on vectors and reservoirs in different areas of Kerman province seem to be necessary

Cutaneous leishmaniasis in Bam: a comparative evaluation of pre- and post- earthquake years [1999-2008]

The recent devastating earthquake of December 26 in Bam, 2003 created various risk factors; caused a sharp increase in incidence of anthroponotic cutaneous leishmaniasis [ACL] cases and reached to an epidemic proportion. The objective of this study was to evaluate the status of ACL cases five years before the earthquake compared to the cases occurred five years after the earthquake [1999-2008]. Status of disease was assessed retrospectively for the five years before the earthquake and prospectively for the five years after the earthquake. Identification was confirmed by smear and polymerase chain reaction [PCR]. The mean annual incidence of ACL for the period from 1999 to 2003 was 1.9 per 1000 comparing to post earthquake period, which was 7.6 per 1000. Most of the infection was in individuals of <20 years, more frequently in females before the earthquake, whilst in contrast, there was a progressive rise in the number of cases, significantly in male individuals of >20 years [P< 0.0001] in post earthquake era. The anatomical distribution of lesions considerably changed during the two periods. Most of the cases were limited to three zones within the city prior to the earthquake, whereas it was spread throughout different zones after the earthquake. PCR indicated that the CL was due to Leishmania tropica in the city. The results strongly suggest that in natural disasters such as earthquakes various precipitating factors in favor of disease will be created, which in turn provide a suitable condition for propagation of the vector and the transmission of the parasite

[ epidemiology of cutaneous leishmaniasis in the city and suburb of bam in 2010: active case - finding, treatment and health education of the school children]

Cutaneous leishmaniasis [CL] is one the major health problem in tropical and sub- tropical countries. Bam district in Iran is an old focus of anthroponotic CL [ACL]. The aim of this survey was to assess the prevalence rate of CL by case- finding, treatment of cases and training of primary school children in the city and suburb of Bam in 2010. All school children in three levels [18501 children] were included. Children were physically examined for presence of sores or scars. Suspected cases were referred to the center for cutaneous leishmaniasis control [CCLC] for diagnosis and the CL positive children were treated, accordingly. School children were trained and also educational and informative pamphlets were given to their parents. After initial physical examination, 117 suspected school children [6.9%] were referred to the CCLC and 48 children [28 per 10000] diagnosed as CL patients, comprising of 19 females [39.5%] and 29 males [60.5%]. Fifteen [31.2%] school children were identified as lupoid leishmaniasis, failure to treatment or non - healing cases. The prevalence rate was decreased about 18- fold as compared to the previous investigation in 2005. Establishment of the CCLC, active case- finding and subsequent treatment, seem to be a successful model for controlling CL in the endemic countries

[Q fever a forgotten disease in Iran]

There have already been a few studies on Q fever in Iran and most of them go back to more than 50 years ago. Preliminary serologic studies on ruminants and febrile patients in Southeast Iran show a high seropositivity in this region. Misdiagnosis as well as poor attention of public health authorities to this infection can facilitate the epidemic spread of Q fever. Further studies on the diagnosis of acute and chronic types of Q fever and detection of Coxiella burnetii are in progress by the authors

[To evaluate the costs of prevention on incidence of cutaneous leishmaniasis due of earthquake in Bam]

Cutaneous leishmaniasis [CL] is an endemic disease in district of Bam. It has created considerable concerns by people and health authorities. The objective of this study was to assess the effect of the earthquake and costs of prevention on CL prevalence after earthquake This research is based on a natural intervention, in which the information related to the costs and prevalence of CL were collected and analyzed three years after the earthquake [2006-2008] and then compared with similar data three years before the earthquake [2000-2002] as control group. The earthquake increased the CL prevalence approximately 5.2 fold, although the cost of prevention had no significant effect on control of disease. The average cost of prevention was determined to be two US dollars per capita during the years after the earthquake. It figures up an overall estimation of 600000 US dollars for the three years after the earthquake. Meanwhile the cost of prevention before the earthquake was determined less than 5% comparing to after earthquake. The findings of this cost-analysis showed that the current and conventional methods of CL prevention seem not useful. It could be concluded that current preventive measures such as spraying and impregnated bed nets particularly in natural disasters would have no effect on control of disease. Further researches are needed to find out the best method of prevention of CL disease. At present, it seems that early case-finding and prompt treatment of cases would be a proper method to control anthropometric CL

Prevalence rate of cutaneous leishmaniasis in bam district during 20 years [1988-2007]

Cutaneous leishmaniasis [CL] has been endemic in Bam district for many years and several epidemics have already occurred. Following a silent period, another outbreak of CL occurred after the earthquake in 2003. This study was performed to find the trend of CL during 20 years [1988-2007] in Bam district. In a retrospective study, data of 29395 CL patients were collected from medical records of Center for CL Control and Treatment and also from previous published studies and analyzed. Before the earthquake there were three periods of outbreak, control and silent. The highest prevalence [8.3%, 6734 cases] was in 2000, whereas the lowest [0.2%, 215 cases] was in 2003 just prior to the earthquake. Again, in 2006 CL prevalence increased to an epidemic level [2.6%, 2880 cases]. During these 20 years, age of patients has increased and after the earthquake males infected more than females. Lesion sites has changed from face to hands and legs. The causative agent and the vector have been Leishmania tropica and phlebotomus sergenti, respectively. Epidemiology of CL varies with environmental changes and due to the immunity after infection, the incidence rate becomes equivalent to the birth rate. Increase in the prevalence of CL after the earthquake is mainly due to the immigration of non-immune individuals to this area. In endemic areas with frequent natural disasters such as earthquake, it is very essential to consider preventive programs in advance

[Evaluation of the cost - effectiveness of cutaneous leishmaniasis treatment after the earthquake in Bam]

Cutaneous leishmaniasis [CL] is a vector - borne disease and at present it is one of the important health problems in tropical and sub - tropical countries including Iran. Due to imposed expenses to the people and government, this study was performed to evaluate the cost - effectiveness of cutaneous leishmaniasis treatment in the years after the earthquake in Bam/Iran. In a descriptive cross-sectional study data about treatment costs CL-patients during 2006-7 were collected. Overall, 100 recovered patients were randomly selected and their treatment costs were analyzed. For 5320 CL patients about 2570 million rials was spend by the government that was equal to per capita cost of 483676 rials. In addition, 1150 million rials were spent by the patients themselves in private clinics which increase the per capita cost to 216320 rials. Overall, 3% of the patients referred to private sectors that had 2 million rials costs and 25% referred to both governmental and private sectors which has led to a per capita cost of 550000 rials. In total, over 90% of the costs were direct and 10% were indirect costs. The per capita treatment cost in this study shows a significant difference with those by other national and international reports. The establishment of CL Treatment Center after the earthquake in bam has reduced the disease costs and provided an efficient, free and easy accessible service for the patients. This experience could be a suitable model to be used nationally as well as globally

[ epidemic of cutaneous leishmaniasis in baft district in Kerman province and its probable causative risk factors]

In Iran, cutaneous leishmaniasis [CL] as a health problem is increasing and presenting two epidemiological forms; Zoonotic CL [ZCL] and anthroponotic CL [ACL]. The objective of the present study was to introduce the CL epidemic in Baft district, Kerman province. This study was conducted in 3 villages; Soltanabad, Vakilabad and Shahmaran as a census between spring and autumn of 1998 in Orzoeihe region, Baft district. Various epidemiological aspects of this epidemic including prevalence and related demographic factors, diagnosis by direct smears, identification of the causative species by immunological and biological methods were determined. Population of the 3 villages was 13721; mean 21.8 +/- 13.9 years, 50.7% males and 49.3% females. The prevalence rate of 12.3% with mean age of 16.3 +/- 12.1 years was infected. Most of the cases were in 10-20 years of age and in Soltanabad [30.6%]. The mean number of lesions was 2.58, majority with >/= 2 lesions, frequently located on the legs and hands. No previous history of CL scar was observed. All 100 IFAT, 30 ELISA tests and 18 inoculated mice showed L.major as the overall causative agent. This is the first epidemic of CL occurred in the southern villages of Baft district with high severity in all age and sex groups in a new agricultural region. Probably the source of infection was the new comers who arrived the region from endemic areas for agricultural purposes and infecting the gerbils. Thus, this new agricultural development has created an extraordinary suitable condition for propagation of rodents and sand fly populations, then the occurrence of the new epidemic in rural residence, consequently

Epidemiology of cutaneous leishmaniasis and it's relationship with blood groups in Bam, 2007

Cutaneous leishmahiasis [CL] is a health problem, especially in tropical and subtropical countries. In spite of new scientific developments in recent years, several questions related to this disease have been raised that have still no answer. The objective of this research was to study the epidemiology of CL and its relationship with blood groups in the city of Bam in 2007. of 3000 suspected CL patients referred to the CL control clinic, 240 patients were randomly selected and after the diagnosis of CL their blood groups and RH factors were determined and recorded in a questionnaire. Similarly 360 volunteers referring to the Blood transfusion center were randomly selected [30 individuals per month] and their blood group and RH factor were determined with a similar method. Data were analyzed by descriptive and analytical statistics and using chi [2] test. Most of the 240 CL patients were in the range group of 16-50 years [65.4%]. In whole, 52.2% of the lesions were on hand and 60% of the patients had single lesion and there was no significant difference between two sexes. There was no significant difference between the case and control groups in regard to the frequency of blood groups and RH. After matching of 108 individuals regarding the sex, age and place of residence, in a case-control study, individuals with AB blood group had been infected 1.3 times more than those with other blood groups, although it was not'Statistically significant. As CL disease is becoming more complex, it is necessary to conduct further clinical basic studies as well as epidemiological cohort observations in endemic areas

[Prevalence of cutaneous leishmaniasis in school children in Bam and Barawat/Iran in 2006]

Cutaneous leishmaniasis is an important public health problem in many tropical and sub-tropical countries including Iran. In Iran, it presents in two forms of anthroponotic CL [ACL] and zoonotic CL [ZCL]. Bam is one of the oldest foci of ACL and the earthquake of 2003 December, 26th made a significant change in the population and environmental factors and subsequently in epidemiological feature of the disease. The objective of this study was to assess the prevalence of CL in school children and treatment of patients. The results of this study can be used for prevention and planning future control programs in the district of Bam. The survey was conducted as a cross-sectional descriptive study during spring 2006. A total of 4931 children from 30 primary schools [6-10 years], elementary schools [11-14 years] and high schools [15-18 years] were selected randomly and examined physically in Bam and Barawat. The suspected CL cases were referred to the CL clinic. Smear scrapings were taken from the active lesions for direct microscopic examination and treatment of the confirmed cases. A questionnaire was completed for each case, indicating demographic and medical aspects. SPSS software was used for data entry and further analysis. The chi [2] test was used to determine any significant difference in disease prevalence. In whole, 4.9% of the school children had active lesions and there was a significant difference between boys [6.3%] and girls [3.6%] in this regard [P<0.01]. Lupoid lesions were significantly more in boys comparing to girls [80.9% versus 19.1%, P<0.005]. The prevalence rate of scar in students was 14.9% and there was a significant difference in this regard between elementary schools children and the children in two other levels [P<0.05]. In whole, 74.5% had one lesion, 17.3% had two lesions and 8.2% had three or more lesions. Hand was the most frequent site of involvement [47.8%], followed by face [33.8%], legs [14.9%] and other body parts [3.5%]. The present study indicated that the epidemiological features of CL have changed significantly as compared to the previous reports. The main differences are higher prevalence rate of the disease, particularly in boys than girls and significant higher rate of lupoid lesions in boys rather than girls. Moreover, the number and location of lesions and the clinical features of the disease have been changed significantly. These findings emphasize further researches on epidemiological aspects especially on causative agent, host and suspected accidental hosts for future planning and implementation of suitable control programs

[ study on the immunity level of 5-25 years old population of Baft and Kahnooj districts [Kerman, Iran] before and after M.R. vaccination mass campaign in 2003]

Measles Involves 45 millions and Kills 1.1 Millions in the World Annually. In Iran before mass campaign, the incidence rate of measles had increased dramatically. This study was done on 5-25 years old individuals in Baft and Kahnooj districts in order to compare their Immunity level, against measles, after and before the national mass campaign for M.R. vaccination [2003]. In this study, blood sampling was done twice. The first four weeks before and the other four weeks after mass campaign. Total number of cases were 1089, of whom 552 cases before and 537 cases after mass campaign were tested by E.nzygnost-Anti Measles Virus IgG Kit. In addition, demographic data such as sex, age, place of residency and history of vaccination were collected through a questionnaire. According to the results mass campaign vaccination was considerably effective and increased seropositive cases from 42.6 percent to 100%. Before mass campaign, the level of seropositive cases among four age groups of 5-9, 10-14, 15-19 and 20-25 years were 46%,46%,41.7%, and 34.1% respectively. In regard to sex, before mass campaign, 46.4% of males and 34.3% of females had seropositive responses. In Baft district 54.5% and in Kahnooj district 31.3% were seropositive. In urban areas 47.1% and in rural areas 32.6% of cases had seropositive responses. All mentioned rates, increased to 100% after Mass campaign. According to the results, before M.R. mass compaign immunity had reverse relation with age and M.R. mass campaign was significantly effective in rising the immunity to a favorite level [from 42.6% to 100%]