Sharifi Iraj, Aflatoonian Mohammad Reza, Fekri Ali Reza, Hakimi Parizi Maryam, Aghaei Afshar Abbas, Khosravi Ahmad, Sharifi Fatemeh, Aflatoonian Behnaz, Khamesipour Ali, Dowlati Yahya, Modabber Farrokh, Nadim Abolhasan
Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran.
Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran.
Iran J Public Health. 2015 Mar;44(3):299-307.
Cutaneous leishmaniasis (CL) remains a serious public health concern in Kerman Province, eastern Iran. This study was aimed to conduct a comprehensive review and highlights various aspects of CL in the province of Kerman.
This article mainly focuses on the studies published in the past 26 years on CL in the province. Current data for the present status were obtained through the provincial health system.
Bam was the most infected district (63.6%), followed by Kerman (24.7%) and other districts to a less extent. Leishmania tropica is the major causative agent (95.5%) of CL in Kerman province, however, L. major accounts for 4.5% of the total cases. Bam, Kerman and southern districts of Kerman province were purely anthroponotic CL (ACL), while Rafsanjan, Baft, and Sirjan showed both ACL and zoonotic CL (ZCL). In contrast, Orzoieh district was merely endemic to ZCL type. Phlebotomus sergenti was the main vector in ACL foci while Ph. papatasi was the major vector in the ZCL district of Orzoieh. Localized CL was the most prevalent form (80%) of the disease, while leishmaniasis recidivans was the most uncommon clinical manifestation (18.7%).
Due to recent rises in CL disease both in regard of increases in incidence rate and expansion of the disease to new foci, and presence of various risk factors in the province, control measures and health strategies should have high priorities to help treat the existing cases and prevent the expansion of the disease to new areas.
皮肤利什曼病（CL）仍是伊朗东部克尔曼省严重的公共卫生问题。本研究旨在对克尔曼省的CL进行全面综述，并突出其各个方面。
本文主要关注过去26年中该省发表的关于CL的研究。通过省级卫生系统获取当前现状的数据。
巴姆是感染最严重的地区（63.6%），其次是克尔曼（24.7%），其他地区感染程度较低。热带利什曼原虫是克尔曼省CL的主要病原体（95.5%），然而，硕大利什曼原虫占总病例的4.5%。巴姆、克尔曼和克尔曼省南部地区为纯人源性CL（ACL），而拉夫桑詹、巴夫特和锡尔詹则同时存在ACL和动物源性CL（ZCL）。相比之下，奥尔佐伊地区仅为ZCL型地方病。塞尔金白蛉是ACL疫源地的主要传播媒介，而巴氏白蛉是奥尔佐伊ZCL地区的主要传播媒介。局限性CL是该疾病最常见的形式（80%），而复发型利什曼病是最罕见的临床表现（18.7%）。
由于近期CL疾病发病率上升且疾病向新疫源地扩散，以及该省存在各种风险因素，控制措施和卫生策略应高度优先，以帮助治疗现有病例并防止疾病向新地区扩散。
