The Present Status of Cutaneous Leishmaniasis in a Recently Emerged Focus in South-West of Kerman Province, Iran

Background: The objective of this study was to assess the magnitude of the cutaneous leishmaniasis (CL) disease and identification of the causative agent by nested-PCR for current control strategy. Methods: This study was carried out as descriptive house-to-house visits in Orzoieh district in Kerman Province, south–east Iran, during 2011-2012. A questionnaire was completed for each individual consisting of demographic and clinical data. Suspected individuals were examined by direct smear microscopy and subsequent identification by nested-PCR. X2-test was used for any significance (P<0.05). Results: A total of 18308 inhabitants (mean age; 22.7 yr) consisting of 9011 males (49.2%) and 9297 females (50.8%) were examined for the presence of active or chronic lesions. The overall prevalence was 4.7%, including 30 cases of active and 839 cases of scar, distributed more significantly (P<0.01) in females (5.2%) than males (4.3%). Individuals <10 years of age showed the highest (6.3%) and >50 years the lowest rate of CL disease, respectively (P<0.001). The proportion of infection was the highest in Soltanabad (14.7%), followed by Vakilabad (6.8%), Dolatabad (3.2%) and Shahmaran (2.8%). The majority of cases had 2 lesions (mean; 2.1 lesions). Hand was the most common site of involvement (35%), and then face (26%), and multiple locations (39%). Nested-PCR displayed 29 isolates as Leishmania major and one isolate L. tropica. The CL disease first emerged in 1998 as epidemic in the area and appeared endemics, thereafter. Conclusion: L. major was the sole species caused ZCL. These findings are necessary for future control programs and strategic planning.