Eco-Epidemiology of Cutaneous Leishmaniasis in Golestan Province, Northeastern Iran: A Systematic Review

Background and objective: zoonotic cutaneous leishmaniasis (ZCL) is one of the most important health problems in Golestan Province, northeastern Iran. Several studies have investigated various aspects of the disease in this province. Herein, we provide a detailed review of the results of all studies related to leishmaniasis to give a reliable insight into the state of the disease in this province. Methods: The search for articles was performed in PubMed, Scopus, and Web of Science without language restriction until the beginning of 2019. Articles in Persian were retrieved from the Magiran, Scientific Information Database, and IranMedex. Overall, 41 articles were subjected to content analysis under the different themes. Results: Counties of Gonbad-e-Kavus and Maraveh Tappeh are endemic areas of ZCL with an incidence rate 99.4-379.1 in 100000 population and has mesoendemic situation in these counties. Leishmania major is the dominant (99.1%) agent of leishmaniasis. Among 18 sandflies species detected in the province, Phlebotomus papatasi was the main vector of the disease with a mean infection rate of 9.2%. Peak of sandflies activity was recorded in the mid-July and mid-September. Rhombomys opimus and Meriones libycus were the main reservoirs of this disease with a mean infection rate of 25.3 and 31.8%. The density of sandflies and wild rodents were highest in the endemic areas for ZCL. Conclusion: In Golestan Province, ZCL has been in a hypoendemic situation and in some areas in a mesoendemic situation and has increased significantly in recent years, so it is recommended to investigate the reasons for this increase.