Visceral Leishmaniasis in North Khorasan Province, Iran

Background: Visceral Leishmaniasis (VL) is a Zoonotic infection, caused by Leishmania.infantum ( L. infantum ) in Mediterranean area and Middle East. The epidemiological studies have been shown that the disease occurs in different parts of Iran. The aims of this study were to determine the incidence rate and also the most common clinical and laboratory manifestation of disease in North Khorasan province, north east of Iran. Methods: In this cross-sectional study, the clinical files of the VL cases were diagnosed (from 1990 to 2010) and checked to compute statistics on demographical and clinical details. All documents in the province hospitals and health centers were used. We retrospectively evaluate infants, children and adults with visceral leishmaniasis in the North Khorasan province. Results: In this study, we found 160 infants, children and adults with visceral leishmaniasis in the North Khorasan province. Of this population, 51.2% were male. The majority of them (74.4%) were from rural areas and 13.8% sub-urban. The incidence of the disease in last decade, ranged from 0.99 to 2.53 per 100 000 per year. They aged from 3 months to 55 years old and majority of sufferers (90.6%) were under 10 years old. The disease has been reported from different parts of the province, the diagnosis was confirmed in 93.8% of the patients by demonstration of leishmania amastigotes in bone marrow aspiration (BMA). The most common symptoms were fever (98.6%), splenomegaly (98.2%), anemia (94%), hepatomegaly (91.7%) and Weakness (63.4%). All cases were treated with meglumine antimoniate and 6 patients (3.7%) expired due to infection. Conclusion: Our findings indicate that in recent years the numbers of the cases in this area have increased and the disease is endemic in this province. North Khorasan is one of the most important focus of VL in Iran. Key words: Visceral Leishmaniasis, Epidemiology, Iran, Endemic