Visceral Leishmaniasis in Iran: An Update on Epidemiological  Features from 2013 to 2022

Mehdi  Mohebali; Gholamhossein  Edrissian; Behnaz  Akhoundi; Mohammedreza  Shirzadi; Gholamreza  Hassanpour; Atefeh  Behkar; Yavar  Rassi; Homa  Hajjaran; Hossein  Keshavarz; Mohammad Mehdi  Gouya; Shahnam  Arshi; Mohammad  Zeinali; Zabihollah  Zarei; Iraj  Sharifi; Zahra  Kakooei

doi:10.18502/ijpa.v18i3.13751

Mehdi Mohebali Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Gholamhossein Edrissian Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Behnaz Akhoundi Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Mohammedreza Shirzadi Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
Gholamreza Hassanpour Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
Atefeh Behkar Center for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
Yavar Rassi Department of Vector Biology and Control of Diseases, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Homa Hajjaran Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Hossein Keshavarz Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Mohammad Mehdi Gouya Center for Communicable Diseases Management, Ministry of Health Treatment and Medical Education, Tehran, Iran
Shahnam Arshi Center for Communicable Diseases Management, Ministry of Health Treatment and Medical Education, Tehran, Iran
Mohammad Zeinali Center for Communicable Diseases Management, Ministry of Health Treatment and Medical Education, Tehran, Iran
Zabihollah Zarei Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Iraj Sharifi Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
Zahra Kakooei Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijpa.v18i3.13751

Keywords: Visceral leishmania-sis; Iran; Direct agglutination test; Human; Canine

Abstract

Background: Visceral leishmaniasis (VL) is one of the most important neglected tropical diseases. The zoonotic form of VL is endemic in some areas of Iran. We aimed to determine the status of VL identified in humans and canines in different parts of Iran from 2013 to 2022.

Method: A national representative cross-sectional study was conducted in 10 provinces of Iran, including the national leishmaniasis reference lab. We employed the direct agglutination test (DAT) as a reliable serological method to detect anti-Leishmania infantum antibodies in humans and animal reservoir hosts. Additionally, a narrative literature review was conducted to identify relevant studies on VL seroprevalence in Iran from 2013 to 2023.

Results: The results of 21281 human and 5610 canine serum samples from 2013 to 2022 are reported. Altogether, 448 (2.1%, 95%CI: 2.0-2.3) human serum samples showed anti-L. infantum antibody levels of ≥1:3200. Of these samples, 13716 (64.5%) were collected actively, which showed a seroprevalence of 0.6% (95% CI: 0.5-0.8) and 7565 (35.5%) were collected passively, which showed a seroprevalence of 4.8% (95%CI: 4.3-5.3). Overall, 1035 (20.1%, 95%CI: 19.0-21.2) of 5160 domestic dogs (Canis familiaris) samples showed anti-L. infantum antibody levels of ≥1:320. Northwest (2.8%) and northeast (0.96%) regions had the highest human VL seroprevalence, while northwest (21.5%) and south (14.4%) regions had the highest canine VL seroprevalence.

Conclusion: Zoonotic VL, an endemic parasitic disease, is still present in several different distinct areas across Iran. While human VL cases have shown a declining trend over the last decade, the prevalence of canine VL remains significant.