Cutaneous Leishmaniasis in Bam: A Comparative Evaluation of Pre- and Post- Earthquake Years (1999-2008)

Background: the recent devastating earthquake of december 26 in bam, 2003 created various risk factors; caused asharp increase in incidence of anthroponotic cutaneous leishmaniasis (acl) cases and reached to an epidemic proportion.the objective of this study was to evaluate the status of acl cases five years before the earthquake compared to thecases occurred five years after the earthquake (1999-2008).methods: status of disease was assessed retrospectively for the five years before the earthquake and prospectively for thefive years after the earthquake. identification was confirmed by smear and polymerase chain reaction (pcr).results: the mean annual incidence of acl for the period from 1999 to 2003 was 1.9 per 1000 comparing to postearthquake period, which was 7.6 per 1000. most of the infection was in individuals of <20 years, more frequently infemales before the earthquake, whilst in contrast, there was a progressive rise in the number of cases, significantly inmale individuals of >20 years (p< 0.0001) in post earthquake era. the anatomical distribution of lesions considerablychanged during the two periods. most of the cases were limited to three zones within the city prior to the earthquake,whereas it was spread throughout different zones after the earthquake. pcr indicated that the cl was due to leishmaniatropica in the city.conclusion: the results strongly suggest that in natural disasters such as earthquakes various precipitating factors infavor of disease will be created, which in turn provide a suitable condition for propagation of the vector and the transmissionof the parasite.