سرواپیدمیولوژی بیماری کالاآزار و تشخیص آزمایشگاهی به روش DAT استان اردبیل از سال 1380 لغایت 1393

Title

Seroepidemiological Investigation of Kala-Azar Disease (Infantum Type) Using Laboratory Diagnosis of DAT between 2001 and 2014 in Ardabil Province, Iran

English Abstract

Background and aim: Visceral leishmaniasis (VL), also known as kala-azar is one of the diseases transmitted between animals and humans caused by intracellular protozoan parasites of the genus Leishmania. Kala-azar is transmitted by endemic in some regions of Iran including Ardabil, East Azarbaijan and Fars provinces. There is a Mediterranean type of the disease in the country caused by Leishmania infantum and mostly children under five are suffering from this disease. Dogs and Canine are the main reservoirs. Kala-azar is one of the oldest and most common zoonotic diseases in Ardabil province, and the city of Meshkinshahr is the old center. Laboratory diagnostic methods for Kala-azar are DAT, IFA, ELISA, RK39 and bone marrow examination; currently, using direct agglutination test (DAT) is the most common method. The present study was conducted with the aim of discovering and identifying new focus of disease in the province, using the laboratory diagnosis of DAT. Materials and methods: This study was a cross-sectional study on 377 patients with kala-azar since 2001 till 2014 in Ardebil province who have been diagnosed and treated using laboratory diagnosis by antigen-DAT (1.1600 and higher titer). In recent years, integrated disease care program in the network system of health care in endemic cities (Meshginshahr and Germi) as well as strengthen and intensify the caring programs and awareness in this regard have been led to a decrease in the number of cases and preventing morbidity and mortality because of the disease in patients; so that number of patients has decreased from 81 cases in 2001 to 7 cases in 2014 and there have been no deaths from disease. Of the total number of cases, 63% were related to the city of Meshkinshahr, 26% were observed in the city of Germi and 11% were in the cities of Ardebil, Bilesavar and Parsabad, which are neighboring cities in terms of geographical location. Of the total cases, 56% were female and 44% were male and 95% were rural and 5% were urban. In terms of age group, 68% were less than two years, 23% were between 2 and 5 years and 9% were over 5 years. Results: In addition to the city of Meshginshahr, as the oldest focus of disease in the country and the province, local transmission of disease have taken place in the cities of Germi, Bilesavar and Parsabad where are the new focus of disease in the province. Prevalence of the disease is higher in children under 5 years (91%) and in rural areas. According to integrated disease care program in the network system, strengthen and intensify the caring programs and awareness in the province as well as intervention programs, leading to a decrease in the number of cases and death in endemic cities, therefore it is recommended in order to maintain the present status and control the disease and prevent the risk of morbidity and mortality in children under 5 years of age, it is necessary to strengthen and intensify the screening programs (diagnosis and treatment of human cases) as well as identify and eliminate the reservoirs of infection (infected dogs). Key words: Kala-Azar, Meshkinshahr, DAT, network system Visceral leishmaniasis (VL), also known as kala-azar is one of the diseases transmitted between animals and humans caused by intracellular protozoan parasites of the genus Leishmania. Kala-azar is transmitted by endemic in some regions of Iran including Ardabil, East Azarbaijan and Fars provinces. There is a Mediterranean type of the disease in the country caused by Leishmania infantum and mostly children under five are suffering from this disease. Dogs and Canine are the main reservoirs. Kala-azar is one of the oldest and most common zoonotic diseases in Ardabil province, and the city of Meshkinshahr is the old center. Laboratory diagnostic methods for Kala-azar are DAT, IFA, ELISA, RK39 and bone marrow examination; currently, using direct agglutination test (DAT) is the most common method. The present study was conducted with the aim of discovering and identifying new focus of disease in the province, using the laboratory diagnosis of DAT. Materials and methods: This study was a cross-sectional study on 377 patients with kala-azar since 2001 till 2014 in Ardebil province who have been diagnosed and treated using laboratory diagnosis by antigen-DAT (1.1600 and higher titer). Results: In addition to the city of Meshginshahr, as the oldest focus of disease in the country and the province, local transmission of disease have taken place in the cities of Germi, Bilesavar and Parsabad where are the new focus of disease in the province. Prevalence of the disease is higher in children under 5 years (91%) and in rural areas. According to integrated disease care program in the network system, strengthen and intensify the caring programs and awareness in the province as well as intervention programs, leading to a decrease in the number of cases and death in endemic cities, therefore it is recommended in order to maintain the present status and control the disease and prevent the risk of morbidity and mortality in children under 5 years of age, it is necessary to strengthen and intensify the screening programs (diagnosis and treatment of human cases) as well as identify and eliminate the reservoirs of infection (infected dogs).

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