A Comprehensive Review of Epidemiology, Environmental Factors, and Control Strategies for Zoonotic Cutaneous Leishmaniasis in Iran: Challenges and Prospects Publisher

Summary: Zoonotic cutaneous leishmaniasis is alarmingly rising in Iran, driven by climate change and urbanization. Can targeted strategies reverse this trend? #Leishmaniasis #PublicHealth

Feizhaddad MH ; Khorami S
Source: Advanced Biomedical Research Published:2025

Abstract

Zoonotic cutaneous leishmaniasis (ZCL) remains a significant public health challenge in Iran, which reported an incidence rate of 15.8 cases per 100,000 individuals in 2019. Among the countries of the Eastern Mediterranean region, Iran bears a disproportionate burden of this neglected tropical disease, with 18 out of its 31 provinces affected. ZCL is especially prevalent in rural and semiurban areas, where ecological and environmental factors create suitable conditions for disease transmission. Rodent reservoirs, particularly Meriones species, and specific vectors, such as Phlebotomus sandflies, play critical roles in the epidemiology of ZCL in Iran. Recent studies have highlighted dynamic changes in the distribution of ZCL in Iran, with newly identified hotspots in regions such as Beyza district (Fars province), Isfahan, and Razavi Khorasan. These shifts are attributed to climate change, urbanization, and altered land use patterns, which influence vector habitats and reservoir dynamics. Notably, the COVID‑19 pandemic has exacerbated the spread of ZCL, redirecting health priorities and increasing the vulnerability of already high‑risk areas. The interplay between these ecological factors underscores the importance of understanding localized transmission patterns. Despite the growing prevalence of ZCL, research remains limited in its focus on epidemiological aspects specific to Iran. This review aims to address this gap by examining the geographic distribution, reservoirs, vectors, and ecological drivers of ZCL within Iran. By identifying high‑risk provinces and emerging trends, such as those in Fars, Isfahan, and Razavi Khorasan, this study provides a foundation for designing targeted control strategies. Effective interventions, informed by these findings, are crucial in mitigating the future burden of ZCL, particularly as vector habitats are expected to expand due to climatic changes. © 2025 Elsevier B.V., All rights reserved.