The incidence of human visceral leishmaniasis (VL) caused by Leishmania infantum, which is endemic in several parts of Iran, has recently increased in the Nourabad-Mamassani district of Fars province, in the south of the country. Between 2003 and 2005, 12,688 sandflies were caught in this focus, using CDC miniature light traps, sticky traps and aspirators, in an attempt to identify the main vector of L. infantum. When 120 of the parous, female Phlebotomus (Paraphlebotomus) alexandri caught were individually checked for Leishmania infection, in an assay based on PCR and kinetoplast minicircle primers (LINR4 and LIN17), five (4.2%) of the flies were found to be infected with L. infantum. Thirty-nine (32.5%) of the 120 blood-fed Ph. alexandri checked in an ELISA were found positive for human blood. Since Ph. alexandri was the third-most common species caught (representing over 17% of the total catch), was clearly anthropophilic, and was not infrequently infected with L. infantum, it is probably an important vector in the Nourabad-Mamassani focus. Although other sandfly species have been found naturally infected with promastigotes in Iran, Ph. alexandri is the first that has been proven to harbour L. infantum in the country.

Visceral leishmaniasis is caused by Leishmania infantum, which is transmitted to humans by bites of phlebotomine sand flies and is one of the most important public health problems in Iran. To identify the vector(s), an investigation was carried out in Germi district, an important focus of the disease in Ardebil province in northwestern Iran, during July–September 2004 and 2005. Using sticky papers, CDC light traps and aspirators, 3,560 sand flies were collected and identified to species. Host bloodmeal preference and Leishmania infections in female specimens were evaluated using enzyme-linked immunosorbent assay (ELISA) for the former and microscopic examination followed by polymerase chain reaction (PCR) assay using species-specific kinetoplast minicircle primers for the latter. Nine sand fly species are present in the district, including Phlebotomus kandelakii Shchurenkova, Phlebotomus perfiliewi transcaucasicus Perfil’ev, Phlebotomus major Annandale, Phlebotomus balcanicus Theodor, Phlebotomus halepensis Theodor, Phlebotomus brevis Theodor & Meshghali, Phlebotomus papatasi Scopoli, Sergentomyia dentata Sinton, and Sergentomyia sintoni Pringle, with P. p. transcaucasicus being the most prevalent representative of the genus Phlebotomus at 45%. The anthropophilic index for P. p. transcaucasicus was 36.3%, indicating a strong preference for humans. Of 905 female P. p. transcuacasicus dissected, 10 (1.1%) were found naturally infected with promastigotes. Species-specific amplification of promastigotes eluted from Giemsa-stained slides revealed specific PCR products of L. infantum DNA. Based on its high anthropophily and natural infections with L. infantum, and the fact that it was the only species found infected with L. infantum, we conclude that P. p. transcaucasicus is the principal vector of L. infantum in northwestern Iran.

Human cutaneous leishmaniasis (CL) is of increasing public-health importance in Iran. On 10 July 2003, two mild earthquakes struck the rural town of Zarindasht in the southern Iranian province of Fars. The results of passive detection of CL cases in this town (in which patients with any skin lesions were evaluated) from April 2002 to April 2004 indicated that the earthquakes may have led to an outbreak of the disease; annual incidence increased from 58·6 detected cases/100,000 in the 12 months before the earthquakes to (an outbreak peak of) 864 detected cases/100,000 in the following 12 months. In addition, the incidence of detected CL in the town that was struck by the earthquakes in 2003 was significantly higher in the 12 months after the earthquakes than that recorded, over the same 12 months, for Fars province as a whole (P<0·05). Most (70%) of the cases detected in the town were aged ≤10 years, about half (50·4%) of the detected skin lesions were on the face, and most (89·7%) of the skin lesions were caused by Leishmania major. Incidence over the study period showed marked seasonality, with most (79·5%) of the detected cases occurring between November and February. In areas where the disease is endemic, CL may need to be considered among the health threats posed by natural disasters such as earthquakes, and increased surveillance for CL after future earthquakes may be justified.

Ghir-Karzin district is one of the most important endemic foci of visceral leishmaniaisis (VL) in Fars province of southern Iran. To identify the vector(s) of Leishmania in this focus, a total of 2,539 sand flies were collected during June to September 2005. Eleven species (six Phlebotomus and five Sergentomyia) were identified, of which Phlebotomus papatasi Scopoli and Phlebotomus major Annandale were the first (37.4%) and third (11.2%) most common species, respectively. Natural leptomonad infections were observed in two P. papatasi (4.25%) and three P. major (6.65%) specimens on dissection and microscopic examination. Using a Leishmania genus-specific standard polymerase chain reaction (PCR; primers RV1-RV2) and a species-specific nested-PCR (primers LINR4, LIN17, and LIN 19), Leishmania infantum and Leishmania major kinetoplast minicircle DNA was detected in 6 of 72 P. major (8.3%) and 4 of 65 P. papatasi (6.1%), respectively. This is the first detection of L. infantum in P. major, implicating this sand fly as a probable vector of VL in Iran.

The Ministry of Health, Treatment and Medical Education in Iran has tried integrating the primary science curriculum with the clinical program. This means educational reform has been implemented in most medical schools in Iran. In the study of the medical entomology Discipline, prioritization of educational needs, and determination of appropriate solutions to improve the status of the entomology Discipline in the Faculty of Medicine and Health, the basis of experts’ opinions were examined and analyzed. Objetivo: Insert the subject of medical entomology into the Medicine Discipline at the Faculty of Medicine and Health. The Nominal Group Technique (NGT), which was the papers for recording the opinions of the professors, was done after the focus group. In the focus group, the professors discussed the results obtained from the NGT. This method used the Delphi technique to exchange opinions (disagreement and consensus of experts). According to the findings of this study, after two technical sessions of the Nominal group, the weak and strong points and required subjects for revision of the chapters of the medical entomology curriculum were determined. Medical entomology in Iranian universities of medical sciences is one of the important topics of medical parasitology Disciplines for general medical students because it provides information about Disease-vector insects and ways to control them (Results two rounds of Delphi). The educational program of the entomology Discipline needs to be revised and evaluated after the implementation of the revised program.

Background: Head lice infestation (Pediculosis) is one of the most important health challenges particularly in primary school-aged children. It is often present among 6–11-year-old students in various tropical and temperate regions of the world. The aim of this study was to examine epidemiologic indices and comparative analysis of two pyrethroid-based and one non-chemical pediculicide products on head lice treatment of primary school girls in a rural setting of Fars province, south Iran, as part of a randomized controlled assessor blind trial. Methods: Before treatment, infested students were screened using plastic detection combs to find live head lice. Three independent parallel groups, each with about 25 participants (#77) were eventually twice with a week apart treated with either 1% permethrin, 0.2% parasidose (d-phenothrin) or 4% dimeticone lotion preparations. In each case, a questionnaire form was completed on epidemiologic factors. Data were registered after a fortnight from primary scalp treatment and re-inspection on days 2, 6, 9 and 14. Data analyses were performed using Chi-square test with a P-value < 0.05 being taken as statistically significant. Results: From 3728 inspected students, 87 (2.33%) girls were infested with head lice, Pediculus humanus capitis De Geer, 1778. Ten students dropped out pertaining to exclusion criteria. No significant correlation was found between head lice infestation level and hair length, hair style, itching, nationality, age, settlement site and baths; but there was a significant relationship between age and hair style (P = 0.027). The efficacy values on each of the above re-inspection days from each of the three treatments were 81, 74, 70 and 63% for permethrin; 83, 92, 100 and 100% for dimeticone; and 96, 88, 96 and 92% for d-phenothrin; respectively. A quartile difference in efficacy of permethrin relative to dimeticone on day 14 represented the scale of head lice resistance to permethrin treatment. There were significant statistical differences in case re-inspection days 9 (P = 0.008) and 14 (P = 0.003) post treatment. Only two dropout cases, one non-compliant and the other lost before the second-week treatment, from permethrin trial were observed following two applications a week apart. Conclusions: Dimeticone lotion had the fullest efficacy (100%) among all treatments. This high cure rate was attributed to the low level of infestation and the extent of patients’ involvement. Parasidose swiftly ameliorated the infested cases by the second day since initial treatment. Female third grade students were the most infested cohort. Trial registration: Current Controlled Trials- IRCT2016041627408N1, Dated: 21-08-2017.