Cutaneous Leishmaniasis Based on Climate Regions in Iran (1998-2021): A Systematic Review and Meta-Analysis.

Background: Climate change can facilitate the expansion of leishmaniasis and create the suitable habitat for vector and reservoir species. The objective of this study was to estimate the prevalence of cutaneous leishmaniasis (CL) at the climatic regions of Iran. Materials and Methods: The literature search was conducted to identify all published studies reporting the prevalence or incidence of CL in humans in Iran. A total of 350 articles that reported leishmaniasis in Iran were retrieved, due to eligibility criteria, only 42 studies were selected to the final systematic review and meta-analysis procedure. Random effects meta-analysis was done with the estimate of heterogeneity being taken from an inverse-variance model. Subgroup analysis was conducted and it stratified the studies according to climatic regions. Between-study heterogeneity was assessed by using I 2 and Cochran's Q method I 2 value of heterogeneity. Meta regression was used to investigate factors potentially contributed the between-study heterogeneity. Results: Individual studies showed that prevalence per 100,000 population estimated the range from 1.5 to 318.7 with the overall random pooled prevalence of 83.3 (95% confidence interval 74.5-92.1). Subgroup analysis by climatic regions showed that many studies were conducted in the desert areas and also, it has more prevalent than the other climatic regions. Conclusions: Leishmaniasis was more prevalent in regions with dry and desert climates than the other climatic regions. One of the advantages of this work is that the majority of selected studies have been conducted on population-base. However, some of the studies have been designed poorly or have had a lack of internal validity.

GIS-based risk mapping of cutaneous leishmaniasis: a survey in an endemic area of Central Iran.

Cutaneous leishmaniasis (CL) is a vector-borne infectious disease that is affected by various environmental agents. The main objective of this study was to determine the spatial distribution of CL incidence by using Geographical Information System (GIS). This is a cross-sectional study that was conducted during 5 years from 2014 to 2018 in Isfahan, Iran. We used the required data on each leishmaniasis patient that were recorded from 44 counties of Isfahan in the databases and archive of the Provincial Health Centre. We used GIS for determining the incidence of CL in the high-risk foci. Moran index was used to identify high risk points (clustering in similar values) compared to the values of neighborhood points. Hot spot analysis was conducted by Getis-Ord-Gi. The highest incidence of the disease occurred in the age group of 18-64 years and 61.6% of patients were male. According to seasonal distribution, autumn (58.6%) had the highest frequency. Time trend of incidence showed that it had both decreasing and increasing, and there was a sudden upward trend of disease in 2018 except only two counties. The hot spots were involved the central areas of the Isfahan province slightly toward to the north and southeast of the province. Moran index showed that the differences for all points were not significant (p-value>0.05). Varzaneh (placed in southeast of Isfahan) was the hottest spot and had the worst position for leishmaniasis compared to all years and all cities.

Combination of continuous wave CO2 laser and topical application of trichloroacetic acid 50% vs CO2 laser alone the treatment of cutaneous leishmaniasis (A case series of 6 patients).

BACKGROUND: Cutaneous leishmaniasis (CL) is an endemic disease of Iran and despite self-healing nature of this disease and many suggested treatments, scar is usually inevitable results of the affection with this cutaneous infection. CO2 laser in CL has a specific thermolysis effect on infected tissues and application of trichloroacetic acid (TCA) 50% solution for treatment of leishmaniasis scars showed promising results. AIM: To evaluate CO2 laser plus TCA 50% versus CO2 laser alone for treatment of CL. PATIENTS/METHODS: In the current report, we present 6 cases of noduloulcerative CL that were treated successfully by the combination of the continuous wave CO2 laser plus topical application of TCA 50%. RESULTS: Five patients improved after 3 weeks of starting treatment, and 1 patient needed to repeat treatment. The scars were flat and good. CONCLUSIONS: The CO2 laser plus topical TCA 50% may be more effective in treatment of the cutaneous leishmaniasis and results in shorter healing time.

Domestic and peridomestic risk factors associated with transmission of cutaneous leishmaniasis in three hypo endemic, endemic, and hyper endemic areas: A randomized epidemiological study.

BACKGROUND: Leishmaniasis is an infection caused by leishmania protozoa. Knowledge about health effects associated with environment situation and human behavior in national and local levels seems to be very necessary. MATERIALS AND METHODS: This cross-sectional case-control study was carried out in three adjacent counties of Isfahan province in Iran. Data were collected by face-to-face interviewing and recorded structured questionnaire. Statistical analysis was performed using Chi-square test and logistic. P < 0.05 was considered as significant. RESULTS: The economic level had significant association with cutaneous leishmaniasis (CL) transmission (P < 0.05). However, there was no significant association between existence of food storage and transmission of CL. We, however, found significant reduction of CL transmission following use of insect control measures (P < 0.05). The odds ratio for peridomestic transmission was 0.420 for houses that weren't round with any old or ruined houses. CONCLUSION: We conclude that among aforementioned risk factors, the impact of peridomestic factors is stronger in CL transmission when compared with domestic and behavioral factors.

Readiness assessment of electronic health records implementation.

INTRODUCTION: During the past 20 years, with huge advances in information technology and particularly, in the areas of health, various forms of electronic records have been discussed, designed or implemented. Although making health records automatically has many advantages but unfortunately in some cases, creation of an Electronic Health Record (EHR) system seems to be complicated. E-health (Electronic health) readiness assessment, as a part of the assessment before implementation is considered essential and prior to implementation. Readiness assessment aims to evaluate preparedness of each organizational component. This process can lead to the correct decision making. Therefore, identifying areas and requirements for such an assessment is so essential. Using the results of this assessment can identify deficiencies in the existing electronic health records to plan their strategies. The aim of this study was first; to show the situation of readiness assessment in EHR implementation roadmap, second, to recognize requirements associated with electronic readiness assessment and main areas of EHR readiness assessment. RESULTS AND DISCUSSION: This study reviewed the literature on EHR readiness assessment with the help of library and also searches engines available at Google. For our searches, we employed the following keywords and their combinations: readiness, assessment, implementation, Electronic Health Record (EHR), Information Technology, road map in the searching areas of title, keywords, abstract, and full text. In this study, more than 100 articles and reports were collected and 45 of them were selected based on their relevancy.