Background: The leishmania is an obligatory intracellular parasite that may occur sporadically, endemic or sometimes in epithemic focuses, in the whole world, and it remained a public health problem of the developing countries. In Iran, visceral leishmaniasis caused by leishmania infantum in mediteranean basin, which are epidemiological aspects of visceral leishmaniasis (Kala- Azar), is of great importance.Many regions in Iran are endemic for Kala-Azar especially in villages and every year affect some people. It will progress rapidly in young children with malnutrition.Because of leukopenia, severe decrease of polymorphonoclear (PMN) and T cell suppression, patients are susceptible to opportunistic infections and if there is a delay in diagnosis and treatment, the mortality will be increased.Methods: A retroactive cross-sectional study done to investigate case series. A total of 43 patients, 9 months to 14 years old with Kala-Azar, admitted during 8 year period (1996-2004) in infectious section of pediatrics department of Imam Khomeini Hospital were enrolled in the study.Findings: 60% were rural and under 4 years old that 28% were girls. Signs and symptoms were as following: fever 79%, pollar and cechexia and weakness 30%, abdominal distention 49%, weight lost 9.3%, hepatosplenomegaly 100% and all have BCG scar and their PPD test were negative.50% had pancytopenia, 80% had microcytic hypochronic anemia, and ESR were higher than 30 in 90%.Blood culture was positive in 11.5%, 7% had bacterial pneumonia and 93% had a positive IFA titer of 1/1280.Leishman body was positive in 79% of the first Bone marrow examinations. All these diagnosed patients treated with glocantim for 3 weeks duration. In 7% recurrence was happened.Conclusion: Any child with hepatosplenomegaly has to work up for Kala-Asar. Constantly epithemiologic assessment in endemic region can help diagnosis. Patient should start treatment with glucantim sooner. Using prevention methods (saunplies and affected dogs) can prohibit prevalence and incidence in villages.

Introduction: Visceral leishmaniosis, kala-azar, or black fever is a fatal disease caused by protozoan parasites of the genus Leishmania. Serological testing is more frequently used in endemic areas. The recombinant kinesin antigen (rK39) is a useful antigen in enzyme-linked immunosorbent assay (ELISA), also available in strip format as a rapid test, but the best way for the diagnosis of visceral leishmaniosis is histopathologic demonstration of the parasite by aspiration or biopsy of affected organs (usually, bone marrow or spleen aspirations). Case Presentation: Here, wepresent the case of a 5-year-old girl with fever, weight loss, weakness and massive hepatosplenomegaly. In lab data, pancytopenia was observed. ELISA rapid test was negative for leishmaniosis. Bone marrow aspiration showed amastigotes within macrophages and outside cells. Conclusions: The aim of this report was to emphasize that bone marrow aspiration is an accurate method for the diagnosis of visceral leishmaniosis.

Cutaneous leishmaniasis is a neglected and parasitic vector borne diseases that is endemic in tropical and subtropical countries, including Iran. The aim of this study was to explain the present status of CL in Iran. This report is based on data that recorded by cutaneous leishmaniasis surveillance system in 2019, and evaluated in Center for Communicable Diseases Management in Ministry of Health in Iran. Iran has been considered an endemic area for cutaneous leishmani-asis in the world. Dependent to activities for cutaneous leishmaniasis control the number of cases decreased from 23202 in 2008 (Incidence rate 32 per 100000) to 13124 in 2019 (Incidence rate 15. 8 per 100000), more cases reported from September to December, in 2019, 46% of cases had one lesion and 21% had 2 lesions, 85% of cases diagnosed when the diameter of lesions had 3 centimeters and bellows. Although the Leishmania control program began in 1977, the incidence of the disease has dropped dramatically since 2008 when the new cutaneous leishmaniasis control program have been implemented. Although in some areas the inci-dence of the disease increased, but the implementation of the new program has reduced the number of cases, in order to continue reducing the disease, permanent support for the control programs is needed.

Visceral leishmaniosis as a zoonotic disease is one of the important infectious disease due to severe side effects and mortality in children and because of at least two endemic foci in Iran (Firooz Abad and Djahrom in Fars State, Meshkin Shar and Moghan in Ardabil State). Despite all preventive procedures, the incidence of the disease has commonly increased which indicates the possible existence of other vertebrate’s reservoirs in addition to carnivoirs (main reservoirs of the Mediterranean visceral Leishmaniasis); therefore, rodents were examined during this research (1995-1997) in the endemic region of Meshkin Shahr. Comprehensive parasitological studies were conducted. Serological tests (Direct Agglutination Test) and cultivation protozoa were done in 120 sample rodents, which were captured alive. The prepared blood smears were undergone microscopic studies. Rodents that showed positive titers in DAT were also undergone necropsy .The prepared impression smears from Reticulo endothelial tissues (Liver and Spleen) were cultivated in NNN media. The observed livers and spleens of many rodents showed very low titers in many cases but showed significant pathological signs (Hepatomegally and splenomegally) even compared to higher titer rodents. The research procedure was changed by just considering the pathological signs of livers and spleens of sample rodents and ignoring the results of DAT .All the suspicious organs were cultivated in NNN. The captured rodents were Meriones persicus (116), Mus musculus (3) Cricetulus migratorius (1) and for the first time in Iran Leishmania donovani was isolated from M.persicus. In isoenzyme studies, zymodeme of isolated L.donvani , LON 50, was identified. Among 116 M.persicus 10.3% showed positive parasitological results and 52.6% had sero titers between 1:10 to 1:200 in DAT.    

Background: Chemotherapy still relies on the use of pentavalent antimonials, amphotericin B, paromomycin, miltefosin, and allopurinol. In this study, we explained about the native plant that grows in different regions of Iran and used as antileishmanial in Iran and even many other countries. Methods: This narrative review covers all information about local herbal medicine in Iran that used in treatment of cutaneous leishmaniasis in all the worlds, published in local and international journals from 1996 to 2015 using various databases including PubMed, SID, Google Scholar, Scopus, and Science Direct. Results: Overall, 150 articles in databases were identified. Many local plants grown in some places of Iran were used to treat this endemic disease. Conclusion: The cutaneous leishmaniasis is also a major health problem in Iran, especially in Mashhad (Northeast of Iran). Therefore, many patients seek for herbal therapy that is cheaper and readily available. This review provides information regarding plant that exists in Iran and exhibiting effects on anti-Leishmania activity. Among the anti-leishmanial mentioned in this review, most have never been tested for cytotoxicity and very few have been tested for in vivo activity.