Abstract

Abstract
Background: The Mediterranean form of visceral leishmaniasis (VL), or kala-azar, is a potentially fatal vector-borne
zoonotic disease. At the present time, VL caused by Leishmania infantum is recognized as an important parasitic disease in Iran.
Objective: The aim of the study was to review the epidemiological aspects of VL in Iran during 1996-2010.
Methods: Twenty seven eligible journal articles on VL epidemiological aspects were indexed in electronic
databases (ISI and MEDLINE) from 1996 to 2010 and selected for this review accompanied by my personal
experiences over two decades. For the detection of VL in humans and animal reservoir hosts, anti-Leishmania
antibodies were detected using direct agglutination test (DAT). Parasitological examinations were performed
on suspected VL patients and all captured wild canines and rodents. Different molecular methods were
used for identification of Leishmania species isolated from infected humans, animal reservoirs, and vectors.
Results: More than 3000 cases of symptomatic VL were detected in 31 provinces of Iran from 1996 to
2010. The majority of VL cases (92.8%) were found among children up to 12 years old. DAT surveillance
could help decrease mortality and morbidity in VL endemic areas of Iran. The principal animal reservoir
hosts of the infection were domestic and wild canines. Infections of man and desert rodents were accidental.
Phlebotomus kandelakii; P. perfiliewi in northwest Iran; and P. major, P. keshishiani, and P. alexandri
in southern parts of Iran were parasitologically or molecularly shown to be the principal VL vectors.
Conclusion: The Mediterranean form of VL is a serious zoonotic disease that occurs sporadically
in all geographical zones of Iran except northwestern and southern Iran, where the disease is endemic

Keywords: Visceral leishmaniasis; Epidemiological aspects; Iran