Epidemiological Study and Geographical Distribution of Cutaneous Leishmaniasis (CL) in Behbahan County,Southwestern Iran Using the Geographic Information System (GIS) During ۲۰۰۲ – ۲۰۲۱

Background: Cutaneous leishmaniasis (CL) is a protozoan infection caused by a flagellated parasite complexknown as Leishmania spp. CL is the most widespread form, and the majority of CL cases occur in North Africa,the Middle East, and South America. Some provinces of Iran such as Fars, Isfahan, Khorasan, Ilam, and Khuzestanare endemic areas of CL. The current study used GIS to map the geographical distribution and epidemiologicalfactors of CL in Behbahan County, southwestern Iran, from ۲۰۰۲ to ۲۰۲۱.Methods: For this cross-sectional study, we collected demographic and clinical data from ۷۸۷ patients with CL inBehbahan county between ۲۰۰۲ and ۲۰۲۱. This included information on their gender, age, occupation,residential area, place of work, the month of illness incidence, duration of illness, counties with the disease,nationality, types of wound tissue, shape, number, and size of ulcers, and drug treatment. Patient locations wereplotted on a point shapefile of villages, towns, and cities in Behbahan County, and geographic data wereanalyzed using ArcGIS version ۱۰. The Behbahan County shapefile polygon layer was purchased online.Results: Among the ۷۸۷ cases studied, ۵۱۲ (۶۵%) were male. The highest prevalence of the disease wasobserved among people aged ۲۱-۳۰. Lesions were found in various locations, with ۴۱% of patients having themon their hands, ۱۸% on their face, ۳۵% on their feet, ۴% on their trunk, and ۲% on their neck and head. Thehighest annual incidence occurred in ۲۰۰۹, with an estimated rate of ۴۰ cases per ۱۰۰,۰۰۰ population, while thelowest incidence was ۵.۸ per ۱۰۰,۰۰۰ in ۲۰۰۲. Significant differences in disease prevalence were observedamong non-Iranian, rural (pastoral and around the cities), male, and young patients. GIS analysis revealed thatthe most affected counties were located in the central (Behbahan or Markazi part) and south (Zeydoon) areas ofthe topographic map.Conclusion: The results suggest that effective prevention and control measures, including health educationcampaigns and vector control strategies (especially in areas with high prevalence according to GIS topography),are necessary to reduce the burden of CL in Behbahan County.

Keywords:

Cutaneous Leishmaniasis (CL) , Geographic Information System (GIS) , Epidemiology