Spatial and Temporal Modeling of Cutaneous Leishmaniasis in Yazd Province, Iran: Based on the Geographic Information System (GIS)

Background: Cutaneous Leishmaniasis (CL) remains a significant health concern in Iran, particularly in specific areas of Yazd province in central Iran. This investigation was conducted with the aim of presenting the spatial and temporal modeling of CL in Yazd province. Methods: This was an ecological study, using data from the health department of Yazd province. The data for the cases of CL during 2004-2013 were extracted and merged into Arc Geographic Information System (GIS) 9.3 software. Cochran-Armitage test, Choropleth Map, Hot-Spot Analysis, and High/Low Clustering analysis were used to determine time trend, distribution of disease, hot-spots, and possible abnormal clustering, respectively. Results: The results indicated a decreasing trend of incidence of CL from 199 to 29.2 cases (per 100,000 populations) during 2004-2013. The findings of the choropleth map showed that cities of Khatam and Abarkuh had a high incidence of CL. The results of the analysis of hot spots showed that during 2004-2008, cities of Yazd and Saduq were classified as cold spots of disease and the difference with neighboring cities was statistically significant (p = 0.031). No hot spots were obtained. In the cluster analysis, no results were obtained to separate high or low level. Conclusion: Maps of spatial distribution of CL were generated to facilitate the decision-making capacity at provincial health department. These results showed that in regions of Yazd province neighboring Fars, Isfahan and Kerman provinces, there was a high risk of disease. Hence, in these areas, preventive strategies can be focused and pursued more purposefully.