The Effect of a Combined Intervention on the Emergence of Cutaneous Leishmaniasis in Qasr-e-Shirin in 2015 - 2016

Abstract

Background: Zoonotic cutaneous leishmaniasis (ZCL) or tropical sore is a parasitic disease, which is considered the second leading parasitic disease after malaria by the World Health Organization in terms of its reservoirs, carriers and characteristics. Objectives: The present study was conducted to investigate the effect of combined fighting methods on this disease in Qasr-e-Shirin, Iran, as the indigenous region of this disease. Methods: The present quasi-experimental community trial selected Qasr-e-Shirin for administering ZCL control programs in 2015-2016 based on the disease incidence, and compared the incidence in 2015-2016 with that in 2013-2014. This intervention comprised three parts, including fighting the reservoir by using rodenticides, fighting the carrier by spraying and using foggers as well as public education. The patients' epidemiological data were then collected, and the incidence was analyzed and compared before and after the intervention. Results: The incidence of ZCL reduced in Qasr-e-Shirin from 14.5 in every 10,000 individuals in 2013 to 7 in 2016 through taking control measures and interventions, suggesting statistically significant differences in the incidence before and after the intervention (P<0.05). Conclusion: Given the climatic conditions and types of carrier, reservoir, soil and building texture in Qasr-e-Shirin, the combined method of fighting, i.e. fighting the reservoir, fighting the carrier and public education, could reduce the incidence of ZCL to more than one third in March 2017 compared to in 2014. The multilateral intervention was also found to be the most effective method of fighting this disease.