Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran.
Department of Preventive Medicine, AJA University of Medical Sciences, Tehran, Iran.
BMC Infect Dis. 2024 Nov 16;24(1):1310. doi: 10.1186/s12879-024-10200-x.
Cutaneous leishmaniasis is one of the few infectious diseases whose global prevalence is on the rise. Iran ranks among the eight most affected countries in the world. Iranian military personnel are often sent to endemic areas for cutaneous leishmaniasis without prior immunity, and they have fewer health facilities in military centers than the general population. This study aims to comprehensively investigate the situation of cutaneous leishmaniasis in Iranian military personnel across all units from 2018 to 2022 and predict the disease trend using time series analysis up to the end of 2025.
We analyzed data from the Iranian Ministry of Health to perform spatiotemporal and descriptive analyses based on patient frequency. Variables examined included age distribution, cutaneous leishmaniasis types (zoonotic or anthroponotic), month of healthcare facility visits, and lesion locations. This study employed the ARIMA model (p = 2, d = 0, q = 1)(P = 3, D = 0, Q = 0), for time series analysis and forecasting the disease trend up to 36 months after 2022.
Over five years, 2,894 patients were reported. The Esfahan, Khuzestan, and Ilam provinces had the highest average patient counts, with hot spots primarily found in central, south, southwestern, and western Iran. Although the total number of patients with zoonotic cutaneous leishmaniasis was almost equal to anthroponotic cutaneous leishmaniasis, in high-risk provinces such as Esfahan, Khuzestan, and Ilam, the confirmed cases of zoonotic cutaneous leishmaniasis were much more than anthroponotic cutaneous leishmaniasis. patient numbers peak in October and November. Demographic analysis revealed that younger patients outnumbered older patients. Lesion locations were frequent on the forelimbs and lower limbs. The time series analysis for 36 months after 2022 indicated the seasonal pattern of the disease and predicted an upward trend after 2022.
While overall cases have declined, provinces such as Esfahan exhibit an upward trend. The expansion of hotspots from the west and southwestern to the center and south of Iran, coupled with an increasing trend in time series analysis, suggests the potential emergence of new foci and a rise in patient numbers in the future. In provinces with high disease prevalence, preventive measures should be prioritized, particularly in Ilam, Khuzestan, and Esfahan.
皮肤利什曼病是少数全球流行率呈上升趋势的传染病之一。伊朗是世界上受影响最严重的八个国家之一。伊朗军人在没有预先免疫的情况下经常被派往流行地区，而且他们在军事中心的卫生设施比普通民众少。本研究旨在全面调查 2018 年至 2022 年期间伊朗所有部队军人的皮肤利什曼病情况，并通过时间序列分析预测至 2025 年底的疾病趋势。
我们分析了伊朗卫生部的数据，根据患者频率进行时空和描述性分析。检查的变量包括年龄分布、皮肤利什曼病类型（动物源或人间）、就诊月份和病变部位。本研究采用 ARIMA 模型（p=2，d=0，q=1）（P=3，D=0，Q=0）进行时间序列分析和预测 2022 年后 36 个月的疾病趋势。
五年间报告了 2894 例患者。伊斯法罕、胡齐斯坦和伊拉姆省的平均患者人数最高，热点主要分布在伊朗中部、南部、西南部和西部。尽管动物源皮肤利什曼病的总病例数几乎与人间皮肤利什曼病相等，但在伊斯法罕、胡齐斯坦和伊拉姆等高风险省份，动物源皮肤利什曼病的确诊病例数远远超过人间皮肤利什曼病。患者人数在 10 月和 11 月达到峰值。人口统计学分析显示，年轻患者多于老年患者。病变部位常见于前肢和下肢。2022 年后 36 个月的时间序列分析表明了疾病的季节性模式，并预测了 2022 年后的上升趋势。
虽然总体病例数有所下降，但伊斯法罕等省份呈上升趋势。热点从西部和西南部向伊朗中心和南部扩展，加上时间序列分析的上升趋势，表明未来可能出现新的焦点和患者人数增加。在疾病流行率高的省份，应优先采取预防措施，特别是在伊拉姆、胡齐斯坦和伊斯法罕。
