A Declining Trend of Leishmaniasis Based on Previous Data in Larstan, South of Iran 2007–2017

Introduction: Cutaneous Leishmaniasis is a unicellular of the Leishmania type, and 0.7 to 1.2 million people are annually infected by Cutaneous Leishmaniasis. Larestan is one of the southern cities of Fars Province. Every year, some issues of Cutaneous Leishmaniasis are reported from Larestan. This study aims to analyze the prevalence of Cutaneous Leishmaniasis in Larestan from 2007 to 2017. Methodology: The present study is a cross-sectional descriptive-analytical study which is carried out in Larestan. The study population consists of those people who are infected by Cutaneous Leishmaniasis during 2007 to 2017 and are referred to health care centers. The methodology and data collection are done based on the recorded information. Results: Among 4,965 Cutaneous Leishmaniasis infected patients who referred to health care centers of Larestan, 2407 patients (48.47%) are males and 2558 patients (51.53%) are females. In the ten-year time period of the study, 1,315 (26.6%) were infected to Cutaneous Leishmaniasis in 2010. The maximum infected group consisted of 1,303 patients ranging from 0–5 years old, and the minimum infected group consisted of 90 patients ranging from 55–60 years old. Discussion: This study showed that female subjects were more polluted in Larestan city. There is also a significant relationship between age and cutaneous leishmaniasis. Finally, it was found that the disease in the city of Larestan has been decreasing.

Introduction: Cutaneous Leishmaniasis is a unicellular of the Leishmania type, and 0.7 to 1.2 million people are annually infected by Cutaneous Leishmaniasis. Larestan is one of the southern cities of Fars Province. Every year, some issues of Cutaneous Leishmaniasis are reported from Larestan. This study aims to analyze the prevalence of Cutaneous Leishmaniasis in Larestan from 2007 to 2017. Methodology: The present study is a cross-sectional descriptive-analytical study which is carried out in Larestan. The study population consists of those people who are infected by Cutaneous Leishmaniasis during 2007 to 2017 and are referred to health care centers. The methodology and data collection are done based on the recorded information. Results: Among 4,965 Cutaneous Leishmaniasis infected patients who referred to health care centers of Larestan, 2407 patients (48.47%) are males and 2558 patients (51.53%) are females. In the ten-year time period of the study, 1,315 (26.6%) were infected to Cutaneous Leishmaniasis in 2010. The maximum infected group consisted of 1,303 patients ranging from 0-5 years old, and the minimum infected group consisted of 90 patients ranging from 55-60 years old. Discussion: This study showed that female subjects were more polluted in Larestan city. There is also a significant relationship between age and cutaneous leishmaniasis. Finally, it was found that the disease in the city of Larestan has been decreasing.
In Iran, Leishmania gerbil and Leishmania Turanica are recognized in rodents. However, the pathogenic role of these types is not confirmed in human beings [13].

Methodology
The present study is a cross-sectional descriptive-analytical study which is carried out in Larestan. Larestan is located in Southern part of Fars Province 915 meters above sea level. Its area is nearly 30,960 km 2 . According to the latest census statistics, this city had a population of 226,879 in 2017 [14]. This city consists of eight towns: Lar, Khur, Latifi, Evaz, Beyram, Banaruiyeh, Juyom, emad Deh, and Sharafuyeh [14] The study population consists of all the Cutaneous Leishmaniasis infected patients who referred to health centers from 2008 to 2017. The methodology and data collection are done based on the recorded information of these patients. For the analysis process, gender, duration of infection, age, the infected organ, and living place of the patient are used as main parameters. Then, the collected data are analyzed in SPSS software.

Code of Ethics
All of the ethical provisions are observed in this project.

Results
Among 4,965 Cutaneous Leishmaniasis infected patients who referred to health care centers of Larestan, 2,407 patients (48.47%) are males and 2,558 patients (51.53%) are females. This study indicated that more females, in comparison with males, are suffering from Cutaneous Leishmaniasis in Larestan. In the diagram of Figure 1, the frequency years of males and females are indicated, respectively. In the ten year time period of the study, maximum infection reports-1,315 (26.06%)-were in autumn in 2010 and the minimum infection reports-160 (3.23%)were in winter 2013 (Figure 2). The maximum infected group consisted of 1,303 patients ranging from 0-5 years old, and the minimum infected group consisted of 90 patients ranging from 55-60 years old (Figure 3). The most frequently infected organ was the face. After that, hands and feet had the maximum infection reports, which   Spring  10  70  73  25  32  24  15  19  14  15  19   Summer  101  309  418  215  98  80  50  75  49  65  80   Autumn  242  670  775  368  148  132  93  171  190

LEISHMANIASIS PREVALENCE
Spring Summer Autumn Winter is indicated in the diagram of Figure 4. In the ten-year time period of the study, the number of reported urban Cutaneous Leishmaniasis were less than rural Cutaneous Leishmaniasis (Figure 5).

Discussion
The endemic Leishmaniasis is reported from Fars Province ant its cities, especially Larestan. A significant number of infections are reported from this city every year [15]. They reported that the prevalence of this disease is 51% in males and 49% in females. The results of these two studies are in contrast with the results of the present study [19]. It can be said that the possible reason for this contrast is the insignificant relationship between this disease and gender. The year-based results of this study indicated that Cutaneous Leishmaniasis in Larestan has a decreasing trend. In the study of Moghateli et al. which was conducted in Khash, the decreasing trend of this Member of the disease disease is reported [19]. These results are consistent with the results of the present study. The possible reason for this decreasing trend can be increased awareness, drought, and increased level of hygiene (health). The results of this study indicated that the range of 0-5 years old makes the maximum infected group, and the range of 55-60 years old makes the minimum infected group. In the study of Moghateli et al. (2013), the range of 0-4 years old made the maximum infected group [19]. Moreover, in the studies of Daloui et al. and Tallari et al. the range of 0-10 years old made the maximum infected group [20][21]. The results of their study are consistent with the results of the present study. The reasons for this high prevalence in some age ranges can be less immunity and more bites of sandflies. The created ulcers of this disease are mostly in the face. It indicates that Anthroponotic Cutaneous Leishmaniasis in Larestan is more than Zoonotic Cutaneous Leishmaniasis.
The results of our study are consistent with the results of the Dehghani et al. (2008) study, which was conducted in Larestan [19].