Demographic statistical study of people with Leishmaniasis in Ahvaz city during 2014-2022

Demographic statistical study of people with Leishmaniasis in Ahvaz city during 2014-2022 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Demographic statistical study of people with Leishmaniasis in Ahvaz city during 2014-2022 Mohammad Javad Mohammadi, Majid Farhadi, Farid yousefi, Homayoun Amiri, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8000389/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction : Leishmaniasis is one of the most important parasitic diseases between humans and animals. Cutaneous leishmaniasis (Leishmaniasis) is transmitted to a healthy person through the bite of a sandfly from the family Psichidae, subfamily Phlebotominae, from animal reservoirs (mainly domestic and wild carnivores and rodents) and humans. The present study aimed to investigate the demographic statistics of people with leukoplakia in Ahvaz city during the years 1380–1400. Method : This is a retrospective descriptive-analytical study. The samples of this study are patients who were diagnosed with Salix disease in Ahvaz city health centers and clinically and laboratory confirmed, and were treated and followed up in 1380–1400. After extraction, the patients' information was entered into the relevant checklist and then the data were statistically analyzed using SPSS version 25 software. results : Of the 1494 affected patients in Ahvaz city, 889 were men (59.5%) and 605 were women (40.5%). The mean age and standard deviation of the affected patients was 21.26 ± 17.18 (minimum 1 year and maximum 90 years). The most common age group was 0–10 years old. The prevalence of this disease was higher in the winter season (45%) than in other seasons. The most lesions were observed in the hands (51.7%) and the least in the trunk (15.3%). Also, most of the affected patients had 3 or less ulcers (75%). Conclusion : The results of this study can be used for appropriate planning and policy-making by the authorities. In this study, the incidence of bedbugs in different seasons and months of the year and the characteristics of the individuals were identified. Given the relatively high rate of bedbug cases in this city, education and preventive measures should be given more attention than before. Cutaneous leishmaniasis Epidemiology Ahvaz Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Introduction Today, despite the increasing advances in medical science, especially in the control of infectious diseases, some of these diseases, such as leishmaniasis, are still considered a health problem( 1 , 2 ) ( 1 , 2 ). Leishmaniasis is one of the most important parasitic diseases between humans and animals, which has three forms: cutaneous, visceral, and mucocutaneous. Cutaneous leishmaniasis is transmitted to a healthy person through the bite of a sandfly from the family Psichidae, subfamily Phlebotominae, from animal reservoirs (mainly domestic and wild carnivores and rodents) and humans. This mosquito is infected with Leishmania, a protozoan of the flagellate group, family Trypanosomatidae, and genus Leishmania. Its symptoms manifest as a raised, volcano-shaped sore with a sunken center that may remain as sores on the body, face, hands, feet, etc. for up to a year( 3 , 4 , 5 ). Due to the health importance it attaches to this disease, the World Health Organization has placed it among the 6 most important diseases in tropical and subtropical regions. This disease is prevalent on all continents of the world and has been observed in 88 countries of the world, 82% of which (72 countries) are developed. So far, 12 million people in the world have been infected with cutaneous leishmaniasis, 90% of which are in Afghanistan, Saudi Arabia, Pakistan, Syria, Turkey, Iran, Algeria, Peru and Brazil. There are 2 million new cases of this disease annually, of which 1-1.5 million people are infected with the cutaneous form and 500,000 people are infected with the visceral form. Also, reports indicate that about 350 million people worldwide are exposed to this disease annually( 6 , 7 , 8 ). In Iran, this disease has been introduced as the second most endemic arthropod-borne disease after malaria, which has caused widespread problems in more than 15 provinces of the country. More than 90% of leishmaniasis cases have occurred in 88 counties of the country. In 2008, the number of cases of this disease was estimated at 26,000, with an incidence rate of 27 cases per 100,000 people. In 2011, this number was 20,585 cases, with an incidence rate of 37 per 100,000 people( 9 , 10 ). Cutaneous leishmaniasis is observed in Iran in two forms: rural leishmaniasis (wet lesion) and urban leishmaniasis (dry lesion). Rural leishmaniasis is a common disease between humans and animals and is called ZCL (Zoonotic Cutaneous Leishmaniasis). Urban leishmaniasis is known as anthroponotic cutaneous leishmaniasis (ACL). The predominant type in most regions of Iran is ZCL ( 11 , 12 ). The urban type of cutaneous leishmaniasis is more common in large and medium-sized cities. The cities of Tehran, Karaj, Bam, Mashhad, Sabzevar, Neyshabur, Rafsanjan and Khomeinishahr in Isfahan are the areas where urban leishmaniasis has been reported. The majority of Iranian leishmaniasis (about 80%) is of the rural leishmaniasis type, which is mostly seen in the cities of Isfahan, Fars, Kerman, Khorasan Razavi, North Khorasan, Golestan, Bushehr, Hormozgan, Semnan, Yazd, Natanz, Kashmar, Sarakhs, Baft and Khuzestan. ( 10 , 13 ). The increase in the incidence of cutaneous leishmaniasis and its foci in Iran may be due to factors such as migration of people to endemic areas of the disease, development of agricultural projects, construction of residential houses near rodent nests, environmental changes such as construction of dams, and rapid and unplanned expansion of cities( 9 , 14 ). Given the hot and dry weather conditions of Ahvaz, the frequent visits of local residents with cutaneous leishmaniasis in this city, and the lack of comprehensive studies on the mode of infection and its epidemiological aspects in Ahvaz, this study was conducted to investigate cutaneous leishmaniasis and compare it with other regions of the country. Method The statistical population of this retrospective descriptive-analytical study included all individuals who were diagnosed with cutaneous leishmaniasis in health centers of Ahvaz city and had clinical and laboratory confirmation, and were treated and followed up from 2014 to 2022. By referring to health centers, patient records were extracted from the archives and then the required information was collected based on a checklist prepared, which included demographic information such as age, sex, occupation, place of residence, season of disease occurrence, number of skin lesions, and year of occurrence. In this way, information related to 1494 affected patients was extracted. In describing quantitative data, appropriate statistical indicators such as mean, standard deviation and range of variation were used, and for qualitative data, frequency and relative frequency were used. Statistical charts such as bar, pie and line charts were also used. The obtained data were statistically analyzed using SPSS software. Results In this study, 1494 patients with cutaneous leishmaniasis registered in Ahvaz city between 2014 and 2022 were examined. The mean age of these patients was 26.21 ± 17.18 (minimum 1 year and maximum 90 years). According to the defined age groups, the highest frequency was observed in the age group under 10 years with 24.2% of cases, and the lowest frequency was in the age group 41–50 years with 9.4%. In terms of gender, 605 (40.5%) were female and 889 (59.5%) were male. The highest occupational frequency was for children with 28.8% and the lowest was for livestock keepers and farmers with 1.6%. The disease was observed in all seasons of the year, and the highest number of patients visiting health centers was in the winter season, 671 people (45%), and the lowest number of visits was in the summer season, 159 people (10.6%). An examination of the temporal distribution of the disease showed that the highest number of cases occurred in January and the lowest number in July. Of the 1494 patients with cutaneous leishmaniasis, 606 had only one lesion (40.6%), 514 (34.4%) had 2 to 3 lesions, and 374 (25%) had more than 4 lesions .Wounds were observed more frequently on the hands than on other parts of the body (51.7%) and less frequently on the trunk than on other parts (4%). Discussion This study showed that in 2014–2022, 1494 people were infected with leishmaniasis in Ahvaz city, and the incidence of this disease was higher in men than in women (59.5% versus 40.5%), which could be due to various reasons such as men's jobs, which are usually outside the home. Women are less exposed to mosquito bites than men due to greater coverage ( 3 , 4 ). The results of the present study are similar to the results of previous studies, which are mentioned below. Nejati et al. reported a prevalence of 56% in men and 34% in women. Kasheri et al. observed a prevalence of 62.38% in men and 37.61% in women. In the study by Soufizadeh et al., the prevalence was reported to be 55.3% in men and 44.7% in women. Khajedaluee et al. reported a prevalence of 52% in men and 48% in women( 15 , 16 , 17 , 18 ). Also, the results of the present study differ from the results of the study conducted by Karimi Zarchi et al., who observed the disease rate as 45.7% in men and 52.9% in women, Dehghan et al., who reported the disease prevalence rate as 42.1% in men and 57.9% in women, and Cherabin et al., who observed the disease incidence as 49.8% in men and 50.2% in women( 19 , 20 , 21 ). The higher incidence of leishmaniasis in men in this study could be due to various reasons, including working outdoors, being less covered than women, traveling more in desert areas, and thus increasing the likelihood of contact with mosquito bites, etc. Also, things that can lead to a decrease in leishmaniasis include resting in covered places, using mosquito nets, and using insect repellents( 22 ). The results of this study show that although canker sores were observed in all age groups, the highest incidence was in the 0–10 year age group with 24.2%, which is consistent with the results of studies by Mesgarian et al., Soufizadeh et al., Dehghan et al., Cherabin et al., Ahmadi et al., and Hanafi Bejad et al.( 17 , 19 , 20 , 22 , 23 , 24 , 25 ). The results of the present study also contradicted the results of the studies that will be mentioned below. Nazari et al. observed the highest incidence in the age group of 16–45 years. Nejati et al. reported the highest prevalence of the disease in the age group of 15–24 years. Kathiri et al. reported the highest incidence in the age group over 30 years( 15 , 18 , 22 ). The lowest infection rate was in the age group of 41–50 years with 9.4%. This was not consistent with the results of any study, but the results of the present study were different from the results of the following studies. Mesgarian et al. reported the lowest in the age group over fifty years. Soufizadeh et al. observed the lowest percentage of infection in the age group over 70 years( 17 , 24 ). The results of the present study showed that the highest seasonal incidence was related to the winter season (45%) and the lowest was related to the summer season (10.6%). The results of the present study are consistent with the results of the study by Kasheri et al., who reported the highest incidence of the disease in the winter season, and Aflatonian and Sharifi, who reported the highest and lowest incidence in the winter and summer, respectively ( 15 , 26 ). However, this is in contrast to the studies of Soufizadeh et al., who reported the highest and lowest times of referral to treatment centers in autumn and spring, and Behbahani et al., who reported the highest and lowest times of referral to treatment centers in summer and winter ( 17 , 27 ). According to the results of the study, the incidence of the disease was observed in all months of the year. The highest incidence of cutaneous leishmaniasis was in January (23.8%) and the lowest incidence was in July (2.5%). The results of this study are consistent with studies conducted by Khajeh Deloui et al. who reported the lowest incidence of the disease in July, and Aflatonian and Sharifi who reported the highest incidence of the disease in winter ( 16 , 26 ). It also contradicts the results of studies by Maqsood et al., who observed the highest and lowest in the months of Mehr and Shahrivar, and by Mesgarian et al., who reported the highest and lowest in the months of Aban and Azar( 6 , 15 ). In this study, leishmaniasis patients were examined in 6 occupational groups, with the highest incidence in children (28.8%) and the lowest in farmers (1.6%). The results of this study are consistent with the study by Jayrvand and Waziri, who observed the lowest incidence in farmers( 9 ). The observed results are in contrast to the study by Ramezani et al., in which the most infected individuals were reported to be workers and the least to be employees, and Dodgar et al., in which the most infected individuals were housewives and the least to be drivers ( 28 , 29 ). The findings show that the number of ulcers in patients varied. Most patients had one ulcer (40.6%), followed by 2–3 ulcers (34.4%). The results of this study are consistent with the study by Jayrvand et al., who reported that most patients had between 1–3 ulcers. This study also showed that the highest number of wounds in patients was on the hands (51.7%), which is consistent with most studies. Jayrvand et al., Saghafipour et al., Katheri et al., and Abdollahzadeh et al. reported the highest number of wounds on the hands( 9 , 15 , 30 , 31 ). Babaei-Roodehi et al. reported the highest number of wounds on the feet, which is inconsistent with the present study( 31 ). Conclusion The results of this study can be used for appropriate planning and policy-making by the authorities. In this study, the incidence of leishmaniasis in different seasons and months of the year and the characteristics of the individuals were identified. Given the relatively high rate of leishmaniasis cases in this city, education and preventive measures should be given more attention than before. Declarations Competing interests: The authors had no competing interests. Acknowledgments: This article is part of the results of a research project approved by Ahvaz Jundishapour University of Medical Sciences and Health Services with project code 01s89 and ethics code IR.AJUMS.REC.1401.594. We would like to express our gratitude to the Vice Chancellor for Research and Technology of the University, the Faculty of Health, and the East and West Ahvaz Health Centers. References CHEGENI SA, Amani H, Kayedi M, Yarahahmadi A, Saki M, Mehrdad M, et al. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8000389","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":538185149,"identity":"ad17af16-a38c-403c-b749-d3eb91f1e96e","order_by":0,"name":"Mohammad Javad Mohammadi","email":"","orcid":"","institution":"Department of Environmental Health Engineering, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 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07:21:03","extension":"png","order_by":7,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":44026,"visible":true,"origin":"","legend":"","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-8000389/v1/78157d03d54f2372e6ab1d54.png"},{"id":94991641,"identity":"5ba30fe8-0f87-4b32-a631-52da2ab3415d","added_by":"auto","created_at":"2025-11-03 07:21:04","extension":"xml","order_by":8,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":69115,"visible":true,"origin":"","legend":"","description":"","filename":"rs80003890structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8000389/v1/16aafb2b5cab502acf48878e.xml"},{"id":94991616,"identity":"20e1ae9f-d457-4ba1-a6b9-f883f04c5097","added_by":"auto","created_at":"2025-11-03 07:21:04","extension":"html","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":78434,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8000389/v1/a076c3c5a83f56600f9de83a.html"},{"id":94991619,"identity":"7862fada-10c0-4bc9-ba57-f96f6ff42b92","added_by":"auto","created_at":"2025-11-03 07:21:04","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":184471,"visible":true,"origin":"","legend":"\u003cp\u003eGeographical location of Ahvaz County in Khuzestan Province, southwest of Iran.This map shows the study area where the research on cutaneous leishmaniasis was conducted.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8000389/v1/e1447e9266142b637ec09514.png"},{"id":94991608,"identity":"7fc09269-4fee-4553-b818-9c78edfa6835","added_by":"auto","created_at":"2025-11-03 07:21:03","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":52482,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8000389/v1/a15cd07d0ac6e41550ac8bfe.png"},{"id":94991605,"identity":"17f4e25e-e063-4d7d-a8b8-51e289694bc2","added_by":"auto","created_at":"2025-11-03 07:21:03","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":21725,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-8000389/v1/42c5eefa2e67ef4bbe533114.png"},{"id":94991604,"identity":"bf7a769a-84d4-4d3a-9e45-893d295eb078","added_by":"auto","created_at":"2025-11-03 07:21:03","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":104392,"visible":true,"origin":"","legend":"\u003cp\u003eSeasonal distribution of cutaneous leishmaniasis cases in Ahvaz, Iran, based on frequency and percentage. The highest incidence was observed during the winter season (45%), suggesting a possible relationship between disease occurrence and seasonal environmental conditions.\u003c/p\u003e","description":"","filename":"4.png","url":"https://assets-eu.researchsquare.com/files/rs-8000389/v1/7cae0bb82c6d759a91fa0901.png"},{"id":94991643,"identity":"136ae1a0-2db0-4032-b1f1-02339ab57cf3","added_by":"auto","created_at":"2025-11-03 07:21:04","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":73505,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend.\u003c/p\u003e","description":"","filename":"5.png","url":"https://assets-eu.researchsquare.com/files/rs-8000389/v1/3b83f6ec2cb7abe378ba8032.png"},{"id":94991607,"identity":"141d952d-f0cc-4905-a2be-bb08a261b82a","added_by":"auto","created_at":"2025-11-03 07:21:03","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":31503,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend.\u003c/p\u003e","description":"","filename":"6.png","url":"https://assets-eu.researchsquare.com/files/rs-8000389/v1/d572cf9a2373d2c5a4d6c491.png"},{"id":95001654,"identity":"cb84a839-4436-4896-b745-16beea7fd8c6","added_by":"auto","created_at":"2025-11-03 09:02:43","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":738127,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8000389/v1/47fecc56-1326-48fb-881e-8d04965e6feb.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eDemographic statistical study of people with Leishmaniasis in Ahvaz city during 2014-2022\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eToday, despite the increasing advances in medical science, especially in the control of infectious diseases, some of these diseases, such as leishmaniasis, are still considered a health problem(\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e). Leishmaniasis is one of the most important parasitic diseases between humans and animals, which has three forms: cutaneous, visceral, and mucocutaneous. Cutaneous leishmaniasis is transmitted to a healthy person through the bite of a sandfly from the family Psichidae, subfamily Phlebotominae, from animal reservoirs (mainly domestic and wild carnivores and rodents) and humans. This mosquito is infected with Leishmania, a protozoan of the flagellate group, family Trypanosomatidae, and genus Leishmania. Its symptoms manifest as a raised, volcano-shaped sore with a sunken center that may remain as sores on the body, face, hands, feet, etc. for up to a year(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). Due to the health importance it attaches to this disease, the World Health Organization has placed it among the 6 most important diseases in tropical and subtropical regions. This disease is prevalent on all continents of the world and has been observed in 88 countries of the world, 82% of which (72 countries) are developed. So far, 12\u0026nbsp;million people in the world have been infected with cutaneous leishmaniasis, 90% of which are in Afghanistan, Saudi Arabia, Pakistan, Syria, Turkey, Iran, Algeria, Peru and Brazil. There are 2\u0026nbsp;million new cases of this disease annually, of which 1-1.5\u0026nbsp;million people are infected with the cutaneous form and 500,000 people are infected with the visceral form. Also, reports indicate that about 350\u0026nbsp;million people worldwide are exposed to this disease annually(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). In Iran, this disease has been introduced as the second most endemic arthropod-borne disease after malaria, which has caused widespread problems in more than 15 provinces of the country. More than 90% of leishmaniasis cases have occurred in 88 counties of the country. In 2008, the number of cases of this disease was estimated at 26,000, with an incidence rate of 27 cases per 100,000 people. In 2011, this number was 20,585 cases, with an incidence rate of 37 per 100,000 people(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Cutaneous leishmaniasis is observed in Iran in two forms: rural leishmaniasis (wet lesion) and urban leishmaniasis (dry lesion). Rural leishmaniasis is a common disease between humans and animals and is called ZCL (Zoonotic Cutaneous Leishmaniasis). Urban leishmaniasis is known as anthroponotic cutaneous leishmaniasis (ACL). The predominant type in most regions of Iran is ZCL (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The urban type of cutaneous leishmaniasis is more common in large and medium-sized cities. The cities of Tehran, Karaj, Bam, Mashhad, Sabzevar, Neyshabur, Rafsanjan and Khomeinishahr in Isfahan are the areas where urban leishmaniasis has been reported. The majority of Iranian leishmaniasis (about 80%) is of the rural leishmaniasis type, which is mostly seen in the cities of Isfahan, Fars, Kerman, Khorasan Razavi, North Khorasan, Golestan, Bushehr, Hormozgan, Semnan, Yazd, Natanz, Kashmar, Sarakhs, Baft and Khuzestan. (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e). The increase in the incidence of cutaneous leishmaniasis and its foci in Iran may be due to factors such as migration of people to endemic areas of the disease, development of agricultural projects, construction of residential houses near rodent nests, environmental changes such as construction of dams, and rapid and unplanned expansion of cities(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). Given the hot and dry weather conditions of Ahvaz, the frequent visits of local residents with cutaneous leishmaniasis in this city, and the lack of comprehensive studies on the mode of infection and its epidemiological aspects in Ahvaz, this study was conducted to investigate cutaneous leishmaniasis and compare it with other regions of the country.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e"},{"header":"Method","content":"\u003cp\u003e The statistical population of this retrospective descriptive-analytical study included all individuals who were diagnosed with cutaneous leishmaniasis in health centers of Ahvaz city and had clinical and laboratory confirmation, and were treated and followed up from 2014 to 2022. By referring to health centers, patient records were extracted from the archives and then the required information was collected based on a checklist prepared, which included demographic information such as age, sex, occupation, place of residence, season of disease occurrence, number of skin lesions, and year of occurrence. In this way, information related to 1494 affected patients was extracted. In describing quantitative data, appropriate statistical indicators such as mean, standard deviation and range of variation were used, and for qualitative data, frequency and relative frequency were used. Statistical charts such as bar, pie and line charts were also used. The obtained data were statistically analyzed using SPSS software.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn this study, 1494 patients with cutaneous leishmaniasis registered in Ahvaz city between 2014 and 2022 were examined. The mean age of these patients was 26.21\u0026thinsp;\u0026plusmn;\u0026thinsp;17.18 (minimum 1 year and maximum 90 years). According to the defined age groups, the highest frequency was observed in the age group under 10 years with 24.2% of cases, and the lowest frequency was in the age group 41\u0026ndash;50 years with 9.4%.\u003c/p\u003e\n\u003cp\u003eIn terms of gender, 605 (40.5%) were female and 889 (59.5%) were male. The highest occupational frequency was for children with 28.8% and the lowest was for livestock keepers and farmers with 1.6%.\u003c/p\u003e\n\u003cp\u003eThe disease was observed in all seasons of the year, and the highest number of patients visiting health centers was in the winter season, 671 people (45%), and the lowest number of visits was in the summer season, 159 people (10.6%).\u003c/p\u003e\n\u003cp\u003eAn examination of the temporal distribution of the disease showed that the highest number of cases occurred in January and the lowest number in July.\u003c/p\u003e\n\u003cp\u003eOf the 1494 patients with cutaneous leishmaniasis, 606 had only one lesion (40.6%), 514 (34.4%) had 2 to 3 lesions, and 374 (25%) had more than 4 lesions .Wounds were observed more frequently on the hands than on other parts of the body (51.7%) and less frequently on the trunk than on other parts (4%).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study showed that in 2014\u0026ndash;2022, 1494 people were infected with leishmaniasis in Ahvaz city, and the incidence of this disease was higher in men than in women (59.5% versus 40.5%), which could be due to various reasons such as men's jobs, which are usually outside the home. Women are less exposed to mosquito bites than men due to greater coverage (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e). The results of the present study are similar to the results of previous studies, which are mentioned below. Nejati et al. reported a prevalence of 56% in men and 34% in women. Kasheri et al. observed a prevalence of 62.38% in men and 37.61% in women. In the study by Soufizadeh et al., the prevalence was reported to be 55.3% in men and 44.7% in women. Khajedaluee et al. reported a prevalence of 52% in men and 48% in women(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). Also, the results of the present study differ from the results of the study conducted by Karimi Zarchi et al., who observed the disease rate as 45.7% in men and 52.9% in women, Dehghan et al., who reported the disease prevalence rate as 42.1% in men and 57.9% in women, and Cherabin et al., who observed the disease incidence as 49.8% in men and 50.2% in women(\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). The higher incidence of leishmaniasis in men in this study could be due to various reasons, including working outdoors, being less covered than women, traveling more in desert areas, and thus increasing the likelihood of contact with mosquito bites, etc. Also, things that can lead to a decrease in leishmaniasis include resting in covered places, using mosquito nets, and using insect repellents(\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). The results of this study show that although canker sores were observed in all age groups, the highest incidence was in the 0\u0026ndash;10 year age group with 24.2%, which is consistent with the results of studies by Mesgarian et al., Soufizadeh et al., Dehghan et al., Cherabin et al., Ahmadi et al., and Hanafi Bejad et al.(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e). The results of the present study also contradicted the results of the studies that will be mentioned below. Nazari et al. observed the highest incidence in the age group of 16\u0026ndash;45 years. Nejati et al. reported the highest prevalence of the disease in the age group of 15\u0026ndash;24 years. Kathiri et al. reported the highest incidence in the age group over 30 years(\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e). The lowest infection rate was in the age group of 41\u0026ndash;50 years with 9.4%. This was not consistent with the results of any study, but the results of the present study were different from the results of the following studies. Mesgarian et al. reported the lowest in the age group over fifty years. Soufizadeh et al. observed the lowest percentage of infection in the age group over 70 years(\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). The results of the present study showed that the highest seasonal incidence was related to the winter season (45%) and the lowest was related to the summer season (10.6%). The results of the present study are consistent with the results of the study by Kasheri et al., who reported the highest incidence of the disease in the winter season, and Aflatonian and Sharifi, who reported the highest and lowest incidence in the winter and summer, respectively (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). However, this is in contrast to the studies of Soufizadeh et al., who reported the highest and lowest times of referral to treatment centers in autumn and spring, and Behbahani et al., who reported the highest and lowest times of referral to treatment centers in summer and winter (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). According to the results of the study, the incidence of the disease was observed in all months of the year. The highest incidence of cutaneous leishmaniasis was in January (23.8%) and the lowest incidence was in July (2.5%). The results of this study are consistent with studies conducted by Khajeh Deloui et al. who reported the lowest incidence of the disease in July, and Aflatonian and Sharifi who reported the highest incidence of the disease in winter (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). It also contradicts the results of studies by Maqsood et al., who observed the highest and lowest in the months of Mehr and Shahrivar, and by Mesgarian et al., who reported the highest and lowest in the months of Aban and Azar(\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). In this study, leishmaniasis patients were examined in 6 occupational groups, with the highest incidence in children (28.8%) and the lowest in farmers (1.6%). The results of this study are consistent with the study by Jayrvand and Waziri, who observed the lowest incidence in farmers(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). The observed results are in contrast to the study by Ramezani et al., in which the most infected individuals were reported to be workers and the least to be employees, and Dodgar et al., in which the most infected individuals were housewives and the least to be drivers (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). The findings show that the number of ulcers in patients varied. Most patients had one ulcer (40.6%), followed by 2\u0026ndash;3 ulcers (34.4%). The results of this study are consistent with the study by Jayrvand et al., who reported that most patients had between 1\u0026ndash;3 ulcers. This study also showed that the highest number of wounds in patients was on the hands (51.7%), which is consistent with most studies. Jayrvand et al., Saghafipour et al., Katheri et al., and Abdollahzadeh et al. reported the highest number of wounds on the hands(\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e). Babaei-Roodehi et al. reported the highest number of wounds on the feet, which is inconsistent with the present study(\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e).\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe results of this study can be used for appropriate planning and policy-making by the authorities. In this study, the incidence of leishmaniasis in different seasons and months of the year and the characteristics of the individuals were identified. Given the relatively high rate of leishmaniasis cases in this city, education and preventive measures should be given more attention than before.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eCompeting interests:\u003c/h2\u003e\u003cp\u003eThe authors had no competing interests.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eAcknowledgments:\u003c/h2\u003e\u003cp\u003e This article is part of the results of a research project approved by Ahvaz Jundishapour University of Medical Sciences and Health Services with project code 01s89 and ethics code IR.AJUMS.REC.1401.594. We would like to express our gratitude to the Vice Chancellor for Research and Technology of the University, the Faculty of Health, and the East and West Ahvaz Health Centers.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eCHEGENI SA, Amani H, Kayedi M, Yarahahmadi A, Saki M, Mehrdad M, et al. Epidemiological survey of cutaneous leishmaniasis in Lorestan province (Iran) and introduction of disease transmission in new local areas. 2011.\u003c/li\u003e\n \u003cli\u003eLeishmaniases WECotCot. Control of the leishmaniases: report of a WHO expert committee. Control of the leishmaniases: Report of a WHO Expert Committee1990. p. 158-.\u003c/li\u003e\n \u003cli\u003eZahirnia A, Moradi A, Nourouzi N, BATHAEI S, ERFANI H, MORADI A. Epidemiological survey of cutaneous Leishmaniasis in Hamadan province (2002-2007). 2009.\u003c/li\u003e\n \u003cli\u003ePostigo JAR. Leishmaniasis in the world health organization eastern mediterranean region. International journal of antimicrobial agents. 2010;36:S62-S5.\u003c/li\u003e\n \u003cli\u003eAyatollahi J, Karimi M. The prevalence of cutaneous leishmaniasis (CL) in the villages of Abarkouh (Yazd Province). Iranian J Infect Dis. 2005;10(30):13-8.\u003c/li\u003e\n \u003cli\u003eMaghsoud A, Pourmohamadi A, Hoseinizijvad M, Tavakoli G, Kolivand M. Survey prevalence of cutaneous leishmaniasis in Pakdasht county in 2012. Pajouhan Scientific Journal. 2014;12(2):37-46.\u003c/li\u003e\n \u003cli\u003eDesjeux P. Focus: Leishmaniasis. Nature Reviews Microbiology. 2004;2(9):692-.\u003c/li\u003e\n \u003cli\u003eOrganization WH. WHO Tech Rep SerNo. 701. 1984. Expert committee: the leishmaniasis.2-4.\u003c/li\u003e\n \u003cli\u003eJayrvnd AA, Vaziri F. Epidemiology of cutaneous leishmaniasis in the city of Hawizeh in 2014-2015. Journal of Health in the Field. 2017;4(3):46-50.\u003c/li\u003e\n \u003cli\u003eShirzadi M. Cutaneous leishmaniasis control guideline in Iran. Tehran: Raz Nahan. 2012.\u003c/li\u003e\n \u003cli\u003eFarahmand M, Nahrevanian H, Shirazi HA, Naeimi S, Farzanehnejad Z. An overview of a diagnostic and epidemiologic reappraisal of cutaneous leishmaniasis in Iran. The Brazilian Journal of Infectious Diseases. 2011;15(1):17-21.\u003c/li\u003e\n \u003cli\u003eParvizi P, Baghban N, Novin EA, Absavaran A. Detection, identification and molecular typing of Leishmania major in Phlebotomus papatasi from a focus of zoonotic cutaneous leishmaniasis in central of Iran. Experimental parasitology. 2010;124(2):232-7.\u003c/li\u003e\n \u003cli\u003eMokhtari H, Golmakani M. Evaluation of epidemiologic causes in cutaneous leishmanious patients referred to health care center of mashhad moghadas province from 2008 to 2013. 2017.\u003c/li\u003e\n \u003cli\u003eAlvar J, V\u0026eacute;lez ID, Bern C, Herrero M, Desjeux P, Cano J, et al. Leishmaniasis worldwide and global estimates of its incidence. PloS one. 2012;7(5):e35671.\u003c/li\u003e\n \u003cli\u003eKassiri H, Mortazavi HS, Kazemi S. The epidemiological study of cutaneous leishmaniasis in Khorram-Shahr City, Khuzestan Province, south-west of Iran. Jundishapur Journal of Health Sciences. 2011;3(2):11-20.\u003c/li\u003e\n \u003cli\u003eKhajedaluee M, Yazdanpanah MJ, SeyedNozadi S, Fata A, Juya MR, Masoudi MH, et al. Epidemiology of cutaneous leishmaniasis in population covered by Mashhad University of Medical Sciences in 2011. Medical Journal of Mashhad university of Medical sciences. 2014;57(4):647-54.\u003c/li\u003e\n \u003cli\u003eSofizadeh A, Cherabin M, Mehravaran A. Cutaneous leishmaniasis in Gonbad Kavoos, North of Iran (2009-11): an epidemiological study. Journal of Gorgan University of Medical Sciences. 2012;14(4):100-6.\u003c/li\u003e\n \u003cli\u003eNejati J, Mojadam M, Hanafi Bojd AA, Keyhani A, Habibi Nodeh F. An epidemiological study of cutaneous leishmaniasis in Andimeshk (2005-2010). Journal of Ilam University of medical sciences. 2014;21(7):94-101.\u003c/li\u003e\n \u003cli\u003eCherabin M, Sofizadeh A, Palideh A, Yapanggharavi A, YAPANG GM. Epidemiological characteristics of Cautaneous Leishmaniasis in Maraveh tapeh district, Golestan province during 2006-2010. 2012.\u003c/li\u003e\n \u003cli\u003eDehghan A, Ghahramani F, Hashemi B. The epidemiology of anthroponotic cutaneous leishmaniasis (ACL) in Larestan, 2006-2008. Pars Journal of Medical Sciences. 2022;8(3):8-11.\u003c/li\u003e\n \u003cli\u003eKarimi Zarchi A, Mahmood Zadeh A, Vatani H. Shir Bazoo Sh.[An epidemiologic study of cutaneous Leishmaniasis (Reservoirs and vectors) in border villages of Sarakhs in Khorasan province]. J Shaheed Sadoughi Univ Med Sci. 2004;12(1):30-5.\u003c/li\u003e\n \u003cli\u003eNazari M. Cutaneous leishmaniasis in Hamadan, Iran (2004-2010). 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Study of the frequency of Cutaneous Leishmaniasis in Omidieh district, Khouzestan province, south west of Iran (2008-2010). Jundishapur Journal of Health Sciences. 2012;4(4):37-46.\u003c/li\u003e\n \u003cli\u003eDoroodgar A, Mahbobi S, Nematian M, Siah M, DrodGar M. An epidemiological study of cutaneous leishmaniasis in Kashan (2007-2008). Koomesh. 2009;10(3):177-84.\u003c/li\u003e\n \u003cli\u003eRamezani Y, Mousavi SGA, Bahrami A, Fereydooni M, Parsa N, Kazemi B. Epidemiological study of cutaneous leishmaniasis in Aran and Bidgol from April to September 2009. Feyz Medical Sciences Journal. 2011;15(3):254-8.\u003c/li\u003e\n \u003cli\u003eAbdollahzadeh R, Khoubfekr H, Sarbishgi Moghadam M. Epidemiological study of cutaneous Leishmaniasis and factors affecting it in South Khorasan Province, 1391-1395 (2012-2016). Pars Journal of Medical Sciences. 2022;16(1):59-66.\u003c/li\u003e\n \u003cli\u003eBABAEI GR, Shayan A. An epidemiological study of cutaneous leishmaniasis and the investigation of scars with emphesis on seasons, age and sex groups in Paalam, South of Lorestan province. 2003.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Ahvaz Jundishapur University of Medical Sciences","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cutaneous leishmaniasis, Epidemiology, Ahvaz","lastPublishedDoi":"10.21203/rs.3.rs-8000389/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8000389/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction\u003c/strong\u003e: Leishmaniasis is one of the most important parasitic diseases between humans and animals. Cutaneous leishmaniasis (Leishmaniasis) is transmitted to a healthy person through the bite of a sandfly from the family Psichidae, subfamily Phlebotominae, from animal reservoirs (mainly domestic and wild carnivores and rodents) and humans. The present study aimed to investigate the demographic statistics of people with leukoplakia in Ahvaz city during the years 1380–1400.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethod\u003c/strong\u003e: This is a retrospective descriptive-analytical study. The samples of this study are patients who were diagnosed with Salix disease in Ahvaz city health centers and clinically and laboratory confirmed, and were treated and followed up in 1380–1400. After extraction, the patients' information was entered into the relevant checklist and then the data were statistically analyzed using SPSS version 25 software.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eresults\u003c/strong\u003e: Of the 1494 affected patients in Ahvaz city, 889 were men (59.5%) and 605 were women (40.5%). The mean age and standard deviation of the affected patients was 21.26 ± 17.18 (minimum 1 year and maximum 90 years). The most common age group was 0–10 years old. The prevalence of this disease was higher in the winter season (45%) than in other seasons. The most lesions were observed in the hands (51.7%) and the least in the trunk (15.3%). Also, most of the affected patients had 3 or less ulcers (75%).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The results of this study can be used for appropriate planning and policy-making by the authorities. In this study, the incidence of bedbugs in different seasons and months of the year and the characteristics of the individuals were identified. Given the relatively high rate of bedbug cases in this city, education and preventive measures should be given more attention than before.\u003c/p\u003e","manuscriptTitle":"Demographic statistical study of people with Leishmaniasis in Ahvaz city during 2014-2022","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-03 06:52:05","doi":"10.21203/rs.3.rs-8000389/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2034c32a-58b7-42ea-819e-8c8640e894f5","owner":[],"postedDate":"November 3rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-11-03T06:52:05+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-03 06:52:05","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8000389","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8000389","identity":"rs-8000389","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}