بررسي مخازن و فراواني ليشمانيوز جلدي در شهرستان ابركوه، استان يزد

Survey of Reservoirs and Frequency of Cutaneous Leishmaniasisin Abarkooh County, Yazd Province

مقدمه: ليشمانيوز پوستي روستايي از مهم‌ترين بيماري‌هاي انگلي در ايران است كه در نواحي روستايي17 استان از 31 استان وجود دارد. در سال‌هاي اخير ليشمانيوز پوستي روستايي يكي از جدي‌ترين مشكلات بهداشتي استان يزد به حساب مي‌آيد. به دنبال اپيدمي اين بيماري در شهرستان ابركوه مطالعاتي در زمينه عفونت انساني و مخازن حيواني اين بيماري انجام گرفت. اين تحقيق براي نخستين بار به منظور تعيين وضع ليشمانيوز جلدي شهر ستان ابركوه اجرا گرديد. هدف اين مطالعه بررسي فراواني بيماري و ساير خصوصيات آن نزد انسان ومخزن معين گرديد. روش كار: اين مطالعه از نوع توصيفي و به روش مقطعي طي سال‌هاي 1389-1388 در شهرستان ابركوه انجام گرفت. جهت بررسي فراواني بيماري، در پايان پاييز اقدام به بازديد خانه به خانه از 300 خانوار شامل 1130 نفر در شهر ابركوه و روستاهاي اسفندآباد و هاروني گرديد. در اين بازديدها وضعيت افراد هر خانواراز نظر بيماري بررسي و در فرم‌هاي مخصوص ثبت مي‌شد. به منظور بررسي فون جوندگان منطقه و تعيين مخازن بيماري در فصول تابستان و پاييز سال 1388 هر 15روز يكبار اقدام به نصب 20 عدد تله زنده‌گير در مجاورت لانه‌هاي فعال جوندگان گرديد. جوندگان صيد شده، تعيين هويت شده و از نظر آلودگي به انگل ليشمانيا مورد آزمايش ميكروسكپي قرار گرفتند. نتيجه‌گيري: ليشمانيوز جلدي روستايي در شهرستان ابركوه شايع شده است. رومبوميس اپيموس احتمالاً مخزن اصلي بيماري در اين شهرستان مي‌باشد.جونده كشي طبق دستورالعمل مركز مديريت بيماري‌هاي واگير،آموزش عمومي افراد ساكن در منطقه و بهسازي محيط از جمله مواردي است كه مي‌تواند در كنترل بيماري مؤثر واقع گردد.

Introduction: Zoonotic cutaneous leishmaniasis (ZCL) is one of the most important parasitic diseases in Iran and common in rural districts of 17 of the 31 provinces of the country. In recent years, ZCL has become a serious and increasing public health problem in Yazd province. Following the epidemic of CL in the Abarkooh county, Yazd province, the purpose of this study was to determine the frequency of the disease and was carried out to determine the animal reservoir hosts and human infection in 2009 - 2010. Methods: In order to investigate the frequency of the disease, at the end of autumn, 300 hundred households whose buildings were located near each other were visited and all members of the households were examined from each district, including 1130 people in Abarkooh city and the villages of Esfandabad and Haroni. Rodents were caught by 20 live traps biweekly from the summer and autumn of 2009. The rodents were identified morphologically and microscopic examination was performed. Results: Eighteen (1.59%) cases had acute lesions of CL in the study area. Of these, 27.77% were male and 72.23% were female. A total of 353 cases had scars, of these 49% were male and 51% were female. The frequency of active lesions and scars among households with a total population of 1130 in three infected districts were calculated at 1.59 and 31.23, respectively. The frequency of the disease at the end of autumn was 328 per thousand. The most highly infected age group for acute lesions was under 4 years old (8.82%). Forty rodents (Rhombomys opimus) were collected and microscopic examination showed 35% Leishmania infiction rate. Conclusions: Zoonotic cutaneous leishmaniasis (ZCL) is endemic in the Abarkooh county. The main reservoir host in this area is probably Rhombomys opimus. For rodent control, according to the guidelines of Centre of Communicable Diseases Management, public education and improving the environment is suggested.