Visceral Leishmaniasis in Ardabil Province, Northwest of Iran: A Retrospective Epidemiological, Clinical and Paraclinical Study (1985-2018)
-
Soheila Molaie
,
Hamed Zandian
,
Akbar Molaie
,
Telma Zahirian
,
Mehdi Mohebali
,
Zabih Zarei
,
Babak Nakhostin
,
Dariush Emdadi
,
Behnaz Akhoundi
,
Seyyedeh-Negar Modares-Sadrani
,
Hamed Abdollahzadeh
,
Zahra Rakhshidan
,
Ezat Ezati
,
Zahra Heidari
Abstract
Background: We aimed to investigate the epidemiological, clinical and paraclinical aspects of Visceral Leishmaniasis in Ardabil Province, from 1986 to 2018.
Methods: The disease has been diagnosed by a serological validate test as Direct Agglutination Test, parasitological methods, and clinical manifestations. The data were collected and then analyzed.
Results: Overall, 2824 out of 69007cases (4.1%) had anti-Leishmania antibodies at titers≥1:3200. The majority of VL cases belonged to Meshkin-Shahr, and then Germi County. The percentages of both male and female cases were 52.8 % and 46.6%, respectively. Approximately 78.1% of cases were less than 5 yr old. The high incidence rate of the disease was recorded in the years 1987 and 2003. 48.6%, 3.2%, and 1.9% of the patients had low titer (1:3200), high titer (1:102400), and suspicious titer (1:1600), respectively. Out of 1200 bone marrow aspiration, 23% were positive, and 77% were negative. Fever, paleness, and hepatosplenomegaly were the main symptoms in patients. Moreover, abdominal swelling, edema, weight loss, lymphadenopathy and jaundice were some other symptoms in the patients. Among biochemistry factors, the levels of aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, triglyceride and cholesterol have been increased. The death rate was estimated to be 2.8%, mainly related to the Ardabil and Germi cases.
Conclusion: Kala-Azar is still one of the most important infectious diseases in Ardabil Province, and is responsible for considerable death rate in infants. More attention should be done to parasite control and early diagnosis.
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2. Hatam GR, Adnani SJ, Asgari Q, et al (2010). First report of natural infection in cats with Leishmania infantum in Iran. Vector Borne Zoonotic Dis, 10(3):313-316.
3. Sarkari B, Hatam GR, Adnani SJ, et al (2009). Seroprevalence of feline leishman-iasis in areas of Iran where Leishmania infantum is endemic. Ann Trop Med Parasi-tol, 103(3):275-277.
4. Shirzadi M, Esfahania S, Mohebalia M, et al (2015). Epidemiological status of leish-maniasis in the Islamic Republic of Iran, 1983-2012. East Mediterr Health J, 21(10).
5. Oshaghi MA, Ravasan NM, Javadian E-A, et al (2009). Vector incrimination of sand flies in the most important visceral leish-maniasis focus in Iran. Am J Trop Med Hyg, 81(4): 572-577.
6. Mohebali M (2012). Epidemiological status of visceral leishmaniasis in Iran: experi-ences and review of literature. J Clinic Ex-periment Pathol, 3:1-5.
7. Soleimanzadeh G, Edrissian GH, Movah-hed-Danesh A (1993). Epidemiological aspects of kala-azar in Meshkin-Shahr, Iran: human infection. Bull World Health Organ, 71(6):759.
8. Mohebali M, Edrissian GH, Shirzadi MR, et al (2011). An observational study on the current distribution of visceral leishmani-asis in different geographical zones of Iran and implication to health policy. Travel Med Infect Dis, 9(2):67-74.
9. Ahadi A, Barak M, Sharghi A, et al (2019). Epidemiological and clinical characteris-tics of infants with visceral leishmaniasis hospitalized in Ardabil city Hospital dur-ing 2011–2016. IJMDC, 3(9):34–38.
10. Mohebali M (2013). Visceral leishmaniasis in Iran: review of the epidemiological and clinical features. Iran J Parasitol, 8(3):348.
11. Strelkova MV, Ponirovsky EN, Morozov EN, et al (2015). A narrative review of visceral leishmaniasis in Armenia, Azer-baijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, the Crimean Peninsula and Southern Russia. Parasit Vectors, 8(1):330.
12. Moradi-Asl E, Hanafi-Bojd AA, Rassi Y, et al (2017). Situational analysis of visceral leishmaniasis in the most important en-demic area of the disease in Iran. Iran J Arthropod Borne Dis, 11(4):482.
13. Ebrahimzade-Parikhani H, Mohebali M, Za-rei Z, et al (2017). Seroprevalence of vis-ceral leishmaniasis in children up to 12 yr old among nomadic tribes from rural ar-eas of Pars Abad, northwestern Iran: an observational study in 2015. Iran J Arthro-pod Borne Dis, 11(2):331.
14. Sarkari B, Pedram N, Mohebali M, et al (2010). Seroepidemiological study of vis-ceral leishmaniasis in Booyerahmad dis-trict, south-west Islamic Republic of Iran. East Mediterr Health J,16 (11), 1133-1136.
15. Sarkari B, Hatam G, Ghatee (2012). Epide-miological features of visceral leishmania-sis in Fars province, southern Iran. Iran J Public Health, 41(4): 94-99.
16. Choobineh H, Mamishi S, Bahonar A, et al (2005). Clinical and epidemiological as-pects of Kala-Azar in hospitalized cases in Children’s Medical Center (1988-2004). Iran J Pediatr, 15(4): 327-332.
17. Khan AM, Dutta P, Khan SA, et al (2014). Kala-azar and Post–Kala-azar Dermal Leishmaniasis, Assam, India. Emerg Infect Dis, 20(3):487.
18. Molaie S, Mohebali M, Gangi A, et al (2010). Seroepidemiological study of visceral leishmaniasis (Kala-azar) in Ardabil Prov-ince, Iran, 1986–2009. YUMSJ, 15(3): 262-272.
19. Varma N, Naseem S (2010). Hematologic changes in visceral leishmaniasis/kala azar. Indian J Hematol Blood Transfus, 26(3):78-82.
20. Dutra RA, Dutra LF, Reis MdO, et al (2012). Splenectomy in a patient with treatment-resistant visceral leishmaniasis: a case re-port. Rev Soc Bras Med Trop, 45(1):130-131.
21. Sarkari B, Naraki T, Ghatee MA, et al (2016). Visceral leishmaniasis in southwestern Iran: A retrospective clinico-hematological analysis of 380 consecutive hospitalized cases (1999–2014). PloS One, 11(3): e0150406.
22. Malafaia G, Serafim TD, Silva ME (2009). Protein‐energy malnutrition decreases immune response to Leishmania chagasi vaccine in BALB/c mice. Parasite Immunol, 31(1):41-49.
23. Gani ZH, Hassan MK, Jassim AM (2010). Sero-epidemiological study of visceral leishmaniasis in Basrah, Southern Iraq. J Pak Med Assoc, 60(6): 464-469.
24. Ready PD (2014). Epidemiology of visceral leishmaniasis. Clin Epidemiol, 6:147-154.
25. Harhay MO, Olliaro PL, Vaillant M, et al (2011). Who is a typical patient with vis-ceral leishmaniasis? Characterizing the demographic and nutritional profile of patients in Brazil, East Africa, and South Asia. Am J Trop Med Hyg, 84(4): 543-550.
26. Reis LLd, Balieiro AAdS, Fonseca FR, et al (2017). Changes in the epidemiology of visceral leishmaniasis in Brazil from 2001 to 2014. Rev Soc Bras Med Trop, 50(5): 638-645.
27. Tadese D, Hailu A, Bekele F, et al (2019). An epidemiological study of visceral leish-maniasis in North East Ethiopia using serological and leishmanin skin tests. Plos One, 14(12): e0225083.
28. Collin S, Davidson R, Ritmeijer K, et al (2004). Conflict and kala-azar: determi-nants of adverse outcomes of kala-azar among patients in southern Sudan. Clin Infect Dis, 38(5): 612-619.
29. Moshfe A, Mohebali M, Edrissian G, et al (2008). Seroepidemiological study on ca-nine visceral leishmaniasis in Meshkin-Shahr district, Ardabil province, north-west of Iran during 2006-2007. Iran J Parasitol, 3(3):1-10.
30. Moradi-Asl E, sRassi Y, Hanafi-Bojd AA, et al (2019). Spatial distribution and infec-tion rate of leishmaniasis vectors (Dip-tera: Psychodidae) in Ardabil Province, Northwest of Iran. Asian Pac J Trop Bio-med, 9(5): 181.
2. Hatam GR, Adnani SJ, Asgari Q, et al (2010). First report of natural infection in cats with Leishmania infantum in Iran. Vector Borne Zoonotic Dis, 10(3):313-316.
3. Sarkari B, Hatam GR, Adnani SJ, et al (2009). Seroprevalence of feline leishman-iasis in areas of Iran where Leishmania infantum is endemic. Ann Trop Med Parasi-tol, 103(3):275-277.
4. Shirzadi M, Esfahania S, Mohebalia M, et al (2015). Epidemiological status of leish-maniasis in the Islamic Republic of Iran, 1983-2012. East Mediterr Health J, 21(10).
5. Oshaghi MA, Ravasan NM, Javadian E-A, et al (2009). Vector incrimination of sand flies in the most important visceral leish-maniasis focus in Iran. Am J Trop Med Hyg, 81(4): 572-577.
6. Mohebali M (2012). Epidemiological status of visceral leishmaniasis in Iran: experi-ences and review of literature. J Clinic Ex-periment Pathol, 3:1-5.
7. Soleimanzadeh G, Edrissian GH, Movah-hed-Danesh A (1993). Epidemiological aspects of kala-azar in Meshkin-Shahr, Iran: human infection. Bull World Health Organ, 71(6):759.
8. Mohebali M, Edrissian GH, Shirzadi MR, et al (2011). An observational study on the current distribution of visceral leishmani-asis in different geographical zones of Iran and implication to health policy. Travel Med Infect Dis, 9(2):67-74.
9. Ahadi A, Barak M, Sharghi A, et al (2019). Epidemiological and clinical characteris-tics of infants with visceral leishmaniasis hospitalized in Ardabil city Hospital dur-ing 2011–2016. IJMDC, 3(9):34–38.
10. Mohebali M (2013). Visceral leishmaniasis in Iran: review of the epidemiological and clinical features. Iran J Parasitol, 8(3):348.
11. Strelkova MV, Ponirovsky EN, Morozov EN, et al (2015). A narrative review of visceral leishmaniasis in Armenia, Azer-baijan, Georgia, Kazakhstan, Kyrgyzstan, Tajikistan, Turkmenistan, Uzbekistan, the Crimean Peninsula and Southern Russia. Parasit Vectors, 8(1):330.
12. Moradi-Asl E, Hanafi-Bojd AA, Rassi Y, et al (2017). Situational analysis of visceral leishmaniasis in the most important en-demic area of the disease in Iran. Iran J Arthropod Borne Dis, 11(4):482.
13. Ebrahimzade-Parikhani H, Mohebali M, Za-rei Z, et al (2017). Seroprevalence of vis-ceral leishmaniasis in children up to 12 yr old among nomadic tribes from rural ar-eas of Pars Abad, northwestern Iran: an observational study in 2015. Iran J Arthro-pod Borne Dis, 11(2):331.
14. Sarkari B, Pedram N, Mohebali M, et al (2010). Seroepidemiological study of vis-ceral leishmaniasis in Booyerahmad dis-trict, south-west Islamic Republic of Iran. East Mediterr Health J,16 (11), 1133-1136.
15. Sarkari B, Hatam G, Ghatee (2012). Epide-miological features of visceral leishmania-sis in Fars province, southern Iran. Iran J Public Health, 41(4): 94-99.
16. Choobineh H, Mamishi S, Bahonar A, et al (2005). Clinical and epidemiological as-pects of Kala-Azar in hospitalized cases in Children’s Medical Center (1988-2004). Iran J Pediatr, 15(4): 327-332.
17. Khan AM, Dutta P, Khan SA, et al (2014). Kala-azar and Post–Kala-azar Dermal Leishmaniasis, Assam, India. Emerg Infect Dis, 20(3):487.
18. Molaie S, Mohebali M, Gangi A, et al (2010). Seroepidemiological study of visceral leishmaniasis (Kala-azar) in Ardabil Prov-ince, Iran, 1986–2009. YUMSJ, 15(3): 262-272.
19. Varma N, Naseem S (2010). Hematologic changes in visceral leishmaniasis/kala azar. Indian J Hematol Blood Transfus, 26(3):78-82.
20. Dutra RA, Dutra LF, Reis MdO, et al (2012). Splenectomy in a patient with treatment-resistant visceral leishmaniasis: a case re-port. Rev Soc Bras Med Trop, 45(1):130-131.
21. Sarkari B, Naraki T, Ghatee MA, et al (2016). Visceral leishmaniasis in southwestern Iran: A retrospective clinico-hematological analysis of 380 consecutive hospitalized cases (1999–2014). PloS One, 11(3): e0150406.
22. Malafaia G, Serafim TD, Silva ME (2009). Protein‐energy malnutrition decreases immune response to Leishmania chagasi vaccine in BALB/c mice. Parasite Immunol, 31(1):41-49.
23. Gani ZH, Hassan MK, Jassim AM (2010). Sero-epidemiological study of visceral leishmaniasis in Basrah, Southern Iraq. J Pak Med Assoc, 60(6): 464-469.
24. Ready PD (2014). Epidemiology of visceral leishmaniasis. Clin Epidemiol, 6:147-154.
25. Harhay MO, Olliaro PL, Vaillant M, et al (2011). Who is a typical patient with vis-ceral leishmaniasis? Characterizing the demographic and nutritional profile of patients in Brazil, East Africa, and South Asia. Am J Trop Med Hyg, 84(4): 543-550.
26. Reis LLd, Balieiro AAdS, Fonseca FR, et al (2017). Changes in the epidemiology of visceral leishmaniasis in Brazil from 2001 to 2014. Rev Soc Bras Med Trop, 50(5): 638-645.
27. Tadese D, Hailu A, Bekele F, et al (2019). An epidemiological study of visceral leish-maniasis in North East Ethiopia using serological and leishmanin skin tests. Plos One, 14(12): e0225083.
28. Collin S, Davidson R, Ritmeijer K, et al (2004). Conflict and kala-azar: determi-nants of adverse outcomes of kala-azar among patients in southern Sudan. Clin Infect Dis, 38(5): 612-619.
29. Moshfe A, Mohebali M, Edrissian G, et al (2008). Seroepidemiological study on ca-nine visceral leishmaniasis in Meshkin-Shahr district, Ardabil province, north-west of Iran during 2006-2007. Iran J Parasitol, 3(3):1-10.
30. Moradi-Asl E, sRassi Y, Hanafi-Bojd AA, et al (2019). Spatial distribution and infec-tion rate of leishmaniasis vectors (Dip-tera: Psychodidae) in Ardabil Province, Northwest of Iran. Asian Pac J Trop Bio-med, 9(5): 181.
| Files | ||
| Issue | Vol 51 No 8 (2022) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v51i8.10274 | |
| Keywords | ||
| Visceral leishmaniasis Epidemiological Clinical Paraclinical Iran | ||
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How to Cite
1.
Molaie S, Zandian H, Molaie A, Zahirian T, Mohebali M, Zarei Z, Nakhostin B, Emdadi D, Akhoundi B, Modares-Sadrani S-N, Abdollahzadeh H, Rakhshidan Z, Ezati E, Heidari Z. Visceral Leishmaniasis in Ardabil Province, Northwest of Iran: A Retrospective Epidemiological, Clinical and Paraclinical Study (1985-2018). Iran J Public Health. 2022;51(8):1875-1885.
