Holakouie-Naieni Kourosh, Mostafavi Ehsan, Boloorani Ali Darvishi, Mohebali Mehdi, Pakzad Reza
Dept. of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Dept. of Epidemiology, Pasteur Institute of Iran, Tehran, Iran.
Acta Trop. 2017 Feb;166:67-73. doi: 10.1016/j.actatropica.2016.11.004. Epub 2016 Nov 9.
Cutaneous Leshmaniasis (CL), a parasitic skin infection caused by Leishmania species, is endemic in some regions of Iran. In this study, the effect of location on the incidence and distribution of CL in Iran was studied.
We collected datas including the number of Cutaneous Leishmaniasis cases and populations at-risk of disease in Iran's different provinces reported by the Iranian ministry of health and the National Bureau of Statistics, respectively. Spatial modeling was performed using Arc GIS software. Descriptive maps, hotspot analysis, and high/low clustering analysis were used to demonstrate distribution of the cutaneous leishmaniasis, to determine regions at risk of disease's incidence, and to reach the most appropriate method for clustering of disease.
The total number of cases of cutaneous leishmaniasis reported through the study period was 589,913. The annual incidence of CL was estimated to be 30.9 per 100,000 in Iranian population. We also demonstrated that Cutaneous leishmaniasis most prominently occurs in regions with dry and desert climates as well as in central parts of Iran. It affected the southwest of Iran between 1983 and 1997, and subsequently developed towards the center and the eastern between 1998 and 2013. Disease hotspots were focused in the provinces of Yazd, Khozestan and Kohgiloyeh-Boyer-Ahmad (p<0.05). No pattern of spatial clustering was observed.
Cutaneous leishmaniasis is a major health problem which could be a serious threat for inhabitants who live in high-risk provinces of Iran; much more resources need to be allocated in these areas, to warrant the prevention as well as effectively management of this disease.
皮肤利什曼病（CL）是由利什曼原虫属引起的一种寄生虫性皮肤感染，在伊朗的一些地区呈地方性流行。在本研究中，我们对地理位置对伊朗皮肤利什曼病发病率和分布的影响进行了研究。
我们分别收集了伊朗卫生部和国家统计局报告的伊朗不同省份皮肤利什曼病病例数和疾病高危人群数据。使用Arc GIS软件进行空间建模。通过描述性地图、热点分析和高/低聚类分析来展示皮肤利什曼病的分布，确定疾病发病风险区域，并找到最合适的疾病聚类方法。
在研究期间报告的皮肤利什曼病病例总数为589,913例。估计伊朗人群中皮肤利什曼病的年发病率为每10万人30.9例。我们还证明，皮肤利什曼病最显著地发生在干旱和沙漠气候地区以及伊朗中部。它在1983年至1997年期间影响了伊朗西南部，随后在1998年至2013年期间向中部和东部发展。疾病热点集中在亚兹德省、胡齐斯坦省和科吉卢耶 - 博耶 - 艾哈迈德省（p<0.05）。未观察到空间聚类模式。
皮肤利什曼病是一个主要的健康问题，对生活在伊朗高危省份的居民可能构成严重威胁；需要在这些地区分配更多资源，以确保对该疾病的预防和有效管理。
