- Volume 73 , Number 2
- Page: 129–30
Leprosy profile in Isfahan (a province of Iran)
ABSTRACT
In Iran, there have been a few cases of leprosy in several provinces, however, native physicians believe that leprosy is not present primarily in an Isfahan endemic area. We performed an investigation either to approve or rule out this idea. We found 25 lepra patients who were registered and followed in Isfahan Leprosy Health Registeration Center, all of whom were infected in other regions and migrated to Isfahan city at a later time. Final analysis proved that there are not any cases of leprosy by itself in Isfahan as an endemic region at the time of this study (1975 to 2002).To the Editor:
In Iran, there have been a few well-known cases of leprosy in the provinces such as Azarbayjan, Khorasan, Lorestan, Khousestan, Boushehr, Hormozgan, and Baluchestan in itself (1). In Isfahan, however, there has been a common belief among medical personnel that there are not any endemic cases of leprosy in the native population of this province area. According to this proposed idea, we decided either to attempt to prove or disprove it by an overall survey on this disease.
MATERIALS AND METHODS
In this descriptive retrospective cross-sectional study, we took the registered records of all lepra cases from Isfahan Medical Health Center, between 1975 and 2002, in whom leprosy as a diagnosis was suggested and confirmed through a skin smear and skin biopsy.
We studied the documents and searched for items such as sex, age, nationality, type of the disease, residential area, and the mode of treatment. We found 25 registered patients from the above period.
RESULTS
From the 25 Lepra patients who had been registered bewteen 1975 and 2002 in Isfahan, the youngest patient was 14 and the oldest was 67 (mean age = 40 years). Twenty of them were in the lepromatous spectrum, and 5 were in the tuberculoid spectrum of leprosy.
In respect to the nationality, 19 were Afghani, 4 were Iranian who had migrated to Isfahan after being infected in other provinces, and 2 were Iraqi. According to the patients' residential area, the highest numbers belonged to Isfahan city and Khomeinishahr city, respectively (Graph 1). The sex distribution of the patients showed 80% males and 20% females.
Graph 1. The comparative evaluation of the prevalence of leprosy patients in different parts of Isfahan province.
Finally, we did not find any lepra patients originally from Isfahan.
DISCUSSION
Leprosy is a worldwide disease, particularly prevalent in tropical underdeveloped countries. Leprosy is endemic in 24 countries (2, 3).
Mycobacterium leprae bacilli live in colder areas of the body such as skin, mucous membranes, nerves, or scrotum (4, 5).
At the beginning of 2004, the number of leprosy patients undergoing treatment in the world was around 460,000. About 515,000 new cases were detected during 2003. Among them, 43% were multibacillary (MB) cases, 12% were children, and 3% were diagnosed with severe disabilities. During the past two years, the global number of new cases detected continued to decrease dramatically (a reduction of about 20% per year) (6, 7).
New cases are reported annually from many provinces in north east, north west, west, and south of the country. It was estimated that the total number of lepric patients in Iran until 1982 was 16,500. According to the World Health Organization there are approximately 30,000 to 45,000 lepra patients in Iran (1, 7). Iran is not considered as an endemic area for leprosy (1).
CONCLUSION
There was an idea that there were not any cases of leprosy among the native population of Isfahan province in Iran, and the results of the study confirmed this. In Iran, no study has been carried out to determine the predominant clinical forms, and further studies and research in this area are required.
Acknowledgment. We are very grateful to health workers in the Leprosy Registration Center in Isfahan who helped us a lot.
—A. Asilian, Professor, Dermatology
—G. Faghihi, Assistant Professor Dermatology
—A. Momeni, M.D. Dermatology
—M. R. Radan, M.D., General Practitioner
—M. Meghdadi, Professor Dermatology
—F. Shariati, Assistant Professor Dermatology
Reprint requests to:
A. Asilian
Department of Dermatology, Alzahra Hospital
Isfahan University School of Medicine
Mail Box 897
Isfahan, Iran
E-mail 1: g_faghihi@med.mui.ac.ir
E-mail 2: yaldarad22@yahoo.com