Majidnia Mostafa, Khoshkchali Atefeh, Khosravi Ahmad
Department of Epidemiology and Biostatistics, School of Medicine, Kurdistan University of Medical Sciences, Kurdistan, Iran.
Student Research Committee, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran.
BMC Infect Dis. 2025 Jan 3;25(1):15. doi: 10.1186/s12879-024-10436-7.
Cutaneous Leishmaniasis (CL) is a zoonosis infection which is endemic in more than 100 countries in Asia, Africa, Europe and America. It was estimated that nearly 20 thousand of new cases are reported in Iran annually. This study aimed to investigate the impact of floods on the incidence of leishmaniasis in Golestan province (northeast of Iran) over nine years, from 2015 to 2023.
Interrupted Time Series Analysis (ITSA) is a study design used to study the effects of an intervention, disaster, or natural event on occurrence of a disease over time. In March 2019, a major flood occurred in Golestan Province, and it had a particularly strong effect on the Gonbad Kavous county (region 1). The trend of CL incidence before and after the flood was assessed using ITSA. In addition, the flood impact on CL incidence was compared between Gonbad Kavous county (region 1) with other counties (13 counties, as the region 2).
Throughout the study, a total of 8953 cases were identified with 2148 (24%) infected with leishmaniasis before the flood and 6805 (76%) after that. A comparison of leishmaniasis between the two regions before and after the flood revealed a significant increase in Gonbad Kavous County following the flood. Also, in the multivariate regression analysis, the average difference in the baseline occurrence level before the flood in regions 1 and 2 was 30.3 per 10 population, which was statistically significant. Additionally, the average difference in the occurrence of leishmaniasis after the flood between the two regions was 37.3 cases per 10 population. The difference in trend of incidence between the two regions increased to 30.4 per 10 population after the flood, compared to 5.5 per 10 before the flood. Also, the long-term trend difference after the flood between the two regions has reached 27.3 per 10 population.
Natural disasters such as floods, earthquakes, and climate change can increase the spread of diseases such as leishmaniasis. Some interventional strategies are needed to decrease the risk of leishmaniasis outbreaks in flooded areas. Besides informing the community, allocating more financial resources for healthcare activities is essential. Environmental and individual protective activities, regular waste collection and disposal, and combating reservoirs and vectors are particularly crucial.
皮肤利什曼病（CL）是一种人畜共患感染病，在亚洲、非洲、欧洲和美洲的100多个国家呈地方性流行。据估计，伊朗每年报告的新病例近2万例。本研究旨在调查2015年至2023年这九年期间洪水对伊朗东北部戈勒斯坦省利什曼病发病率的影响。
中断时间序列分析（ITSA）是一种用于研究干预措施、灾害或自然事件随时间对疾病发生影响的研究设计。2019年3月，戈勒斯坦省发生了一场重大洪水，对贡巴德卡武斯县（第1地区）产生了特别强烈的影响。使用ITSA评估洪水前后皮肤利什曼病发病率的趋势。此外，比较了贡巴德卡武斯县（第1地区）与其他县（13个县，作为第2地区）洪水对皮肤利什曼病发病率的影响。
在整个研究期间，共确定了8953例病例，其中2148例（24%）在洪水前感染利什曼病，6805例（76%）在洪水后感染。对两个地区洪水前后的利什曼病进行比较发现，洪水后贡巴德卡武斯县的发病率显著增加。此外，在多变量回归分析中，第1地区和第2地区洪水前基线发病水平的平均差异为每10人30.3例，具有统计学意义。此外，两个地区洪水后利什曼病发病率的平均差异为每10人37.3例。洪水后两个地区发病率趋势的差异增加到每10人30.4例，而洪水前为每10人5.5例。此外，洪水后两个地区的长期趋势差异已达到每10人27.3例。
洪水、地震和气候变化等自然灾害会增加利什曼病等疾病的传播。需要一些干预策略来降低洪水泛滥地区利什曼病暴发的风险。除了向社区宣传外，为医疗活动分配更多财政资源至关重要。环境和个人防护活动、定期垃圾收集和处理以及防治蓄水池和病媒尤为关键。
