Impact of Environmental and Climate Factors on Spatial Distribution of Cutaneous Leishmaniasis in Northeastern Iran: Utilizing Remote Sensing
-
Mohammad Reza Shirzadi
,
Mohammad Javanbakht
,
Hassan Vatandoost
,
Nahid Jesri
,
Abedin Saghafipour
,
Reza Fouladi-Fard
,
Alireza Omidi-Oskouei
Abstract
Background: Cutaneous leishmaniasis (CL) is a dermal and parasitic disease.. The aim of this study was to determine the effect of environmental and climate factors on spatial distribution of CL in northeastern Iran by utilizing remote sensing from 20 March 2016 to 19 March 2017.
Methods: In this ecological study, the data were divided into two parts: The descriptive data on human CL cases were gathered from Communicable Diseases center of Iran. The remote sensing techniques and satellite imagery data (TRMM, MODIS-Aqua, MODIS-Terra and AMSR-2 with spatial resolution 0.25°, 0.05°, 5600m and 10km) of environmental and climate factors were used to determine the spatial pattern changes of cutaneous leishmaniasis incidence.
Results: The incidence of CL in North Khorasan, Razavi Khorasan, and South Khorasan was 35.80 per 100,000 people (309/863092), 34.14 per 100,000 people (2197/6,434,501) and 7.67 per 100,000 people (59/768,898), respectively. The incidence of CL had the highest correlation with soil moisture and evapotranspiration. Moreover, the incidence of disease was significantly correlated with Normalized Difference Vegetation Index (NDVI) and air humidity while it had the lowest correlation with rainfall. Furthermore, the CL incidence had an indirect correlation relation with the air temperature meaning that with an increase in the temperature, the incidence of disease decreased.
Conclusion: As such, the incidence of disease was also higher in the northern regions; most areas of North Khorasan and northern regions of Razavi Khorasan; where the rainfall, vegetation, specific humidity, evapotranspiration, and soil moisture was higher than the southern areas.
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2. Salam N, Al-Shaqha WM, Azzi A (2014) Leishmaniasis in the middle East: Inci-dence and epidemiology. PLoS Negl Trop Dis. 8: 1–8.
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7. Shirzadi MR, Gouya MM (2012) National guidelines for cutaneous leishmaniasis surveillance in Iran. Tehran: Ministry of Health and Medical Education, p. 1–78.
8. Karimi A, Hanafi-Bojd AA, Yaghoobi-Er-shadi MR, Akhavan AA, Ghezelbash Z (2014) Spatial and temporal distributions of phlebotomine sand flies (Diptera: Psy-chodidae), vectors of leishmaniasis, in Iran. Acta Trop. 132: 131–139.
9. Rabiee, MH, Mahmoudi A, Siahsarvie R, Kryštufek B, Mostafavi E (2018) Ro-dent-borne diseases and their public health importance in Iran. PLoS Negl Trop Dis. 12 (4): e0006256.
10. Salimi M, Jesri N, Javanbakht M, Farahani LZ, Shirzadi MR, Saghafipour A (2018) Spatio-temporal distribution analysis of zoonotic cutaneous leishmaniasis in Qom Province, Iran. J Parasit Dis. 42: 570–576.
11. Saghafipour A, Vatandoost H, Zahraei-Ram-azani AR, Yaghoobi-Ershadi MR, Kara-mi Jooshin M, Rassi Y (2017) Epidemi-ological study on cutaneous leishmaniasis in an endemic area, of Qom Province, cen-tral iran. J Arthropod Borne Dis. 11: 403–413.
12. Saghafipour A, Vatandoost H, Zahraei-Ra-mazani AR, Yaghoobi-Ershadi MR, Rassi Y, Shirzadi MR, Akhavan AA (2017) Spatial distribution of phlebotomine sand fly species (Diptera: Psychodidae) in Qom Province, central Iran. J Med Entomol. 54: 35–43.
13. Rafizadeh S, Saraei M, Abaei MR, Oshaghi MA, Mohebali M, Peymani A, Naserpour-Farivar T, Bakhshi H, Rassi Y (2016) Molecular detection of Leishmania major and L. turanica in Phlebotomus papatasi and first natural infection of P. salehi to L. major in North-East of Iran. J Arthro-pod Borne Dis. 10(2): 141–147.
14. Abdolmajid F, Ghodratollah SS, Hushang R, Mojtaba MB, Ali MM, Abdol-ghayoum M (2015) Identification of Leishmania species by kinetoplast DNA-polymerase chain reaction for the first time in Khaf District, Khorasan-e-Razavi Province, Iran. Trop Parasitol. 5: 50–54.
15. Mohajeri M, Shamsyan AA, Rezaei A, Has-sanpoor K, Shakeri M, Farnosh GH (2010) Molecular identification of species caus-ing cutaneous leishmaniasis in the city of Sabzevar. J Mashhad Univ Med Sci. 3: 138–144.
16. Campbell-Lendrum D, Manga L, Bagayoko M, Sommerfeld J (2015) Climate change and vector-borne diseases: what are the implications for public health research and policy? Philos Trans R Soc Lond B Biol Sci. 370: 20130552.
17. Salomon OD, Quintana MG, Mastrangelo AV, Fernandez MS (2012) Leishmania-sis and Climate Change-Case Study: Ar-gentina. J Trop Med. 2012: 601242.
18. Chamaillé L, Tran A, Meunier A, Bourdoiseau G, Ready P, Dedet JP (2010) Environmental risk mapping of canine leishmaniasis in France. Parasites and Vectors. 3(31): 18.
19. Gonzalez C, Wang O, Strutz SE, Gonzalez-Salazar C, Sanchez-Cordero V, Sarkar S (2010) Climate change and risk of leish-maniasis in North America: predictions from ecological niche models of vector and reservoir species. PLoS Neglected Trop Dis. 4: 1–16.
20. Toumi A, Chlif S, Bettaieb J, Ben Alaya N, Boukthir A, Ahmadi ZE, Ben Salah A (2012) Temporal dynamics and im-pact of climate factors on the incidence of zoonotic cutaneous leishmaniasis in cen-tral Tunisia. PLoS Negl Trop Dis. 6(5): e1633.
21. Ghatee MA, Haghdoost AA, Kooreshnia F, Kanannejad Z, Parisaie Z, Karamian M, Moshfe A (2018) Role of environ-mental, climatic risk factors and livestock animals on the occurrence of cutaneous leishmaniasis in newly emerging focus in Iran. J Infect Public Health. 11: 425–433.
22. Golpayegani AA, Moslem AR, Akhavan AA, Zeydabadi A, Mahvi AH, Allah-Abadi A (2018) Modeling of environ-mental factors affecting the prevalence of zoonotic and anthroponotic cutane-ous, and zoonotic visceral leishmaniasis in foci of Iran: A remote sensing and GIS based study. J Arthropod Borne Dis. 12: 41–66.
23. Ramezankhani R, Hosseini A, Sajjadi N, Khoshabi M, Ramezankhani A (2017) Environmental risk factors for the inci-dence of cutaneous leishmaniasis in an endemic area of Iran: A GIS-based ap-proach. Spat Spatiotemporal Epidemiol. 21: 57–66.
24. Hanafi Bojd AA, Vatandoust H, Soltani M, Charrahi ZA, Nasseh H (2013) Ap-plication of satellite remote sensing for tracking of arthropod vectors of diseases. J School Pub Health. 10: 45–64.
25. Rodell M, Houser PR, Jambor U, Gottschalck J, Mitchell K, Meng CJ (2004) The global land data assimilation system. B Am Meteorol Soc. 85(3): 381–394.
26. Wang F, Wang L, Koike T, Zhou H, Yang K, Wang A, Li W (2011) Evaluation and application of a fineresolution global data set in a semiarid mesoscale river basin with a distributed biosphere hydrological
model. J Geophys Res. 116(D21): 1–20.
27. Qi W, Zhang C, Fu G, Zhou H (2015) Glob-al land data assimilation system data as-sessment using a distributed biosphere hydrological model. J Hydrol. 528: 652–667.
28. Wang A, Zeng X (2012) Evaluation of mul-tireanalysis products with in situ obser-vations over the Tibetan Plateau. J Ge-ophys Res. 117(D5): 1–12.
29. Khazaei S, Mohammadian Hafshejani A, Saatchi M, Nematollahi S (2015) Epidemi-ological Aspects of Cutaneous Leishman-iasis in Iran. Arch Clin Infec Dis. 10: e28511
30. Norouzinezhad F, Ghaffari F, Norouzinejad A, Kaveh F, Gouya MM (2016) Cutane-ous leishmaniasis in Iran: Results from an epidemiological study in urban and ru-ral provinces. Asian Pac J Trop Biomed. 6(7): 614–619.
31. Entezari M, Eskandari F (2014) Relationship between climatic factors and the preva-lence of cutaneous leishmaniasis in Lar-estan City. J Mil Med. 16: 99–104.
32. Cabanillas MR, Castellón EG (1999) Dis-tribution of sandflies (Diptera: Psychodi-dae) on tree-trunks in a non-flooded area of the Ducke Forest Reserve, Manaus, AM, Brazil) Mem Inst Oswaldo Cruz. 94: 289–296.
33. Alencar RB, de Queiroz RG, Barrett TV (2011) Breeding sites of phlebotomine sand flies (Diptera: Psychodidae) and ef-ficiency of extraction techniques for im-mature stages in terra-firme forest in Amazonas State, Brazil. Acta Trop. 118: 204–208.
34. Singh R, Lal S, Saxena VK (2008) Breed-ing ecology of visceral leishmaniasis vec-tor sand fly in Bihar state of India. Acta Trop. 107(2): 117–120.
35. Roger A, Nacher M, Hanf M, Drogoul AS, Adenis A, Basurko C (2013) Climate and leishmaniasis in French Guiana. Am J Trop Med Hyg. 89: 564–569.
36. Viana GM, Nascimento Mdo D, Rabelo ÉM, Diniz Neto JA, Binda Júnior JR, Galvão Cde S (2011) Relationship between rain-fall and temperature: observations on the cases of visceral leishmaniasis in São Luis Island, State of Maranhão, Brazil. Rev Soc Bras Med Trop. 44: 722–724.
37. Rassi Y, Hanafi-Bojd AA (2008) Phlebotom-inae Sand flies, vector of leishmaniases. 1st ed. Tehran: Noavaran Elm Publica-tions. pp. 39–58.
38. Tsirigotakis N, Pavlou C, Christodoulou V, Dokianakis E, Kourouniotis C, Alten B, Antonio M (2018) Phlebotomine sand flies (Diptera: Psychodidae) in the Greek Aegean Islands: ecological approaches. Parasit Vectors. 11(97): 1–14.
39. Killick-Kendrick (1990) Phlebotomine vec-tors of the leishmaniases: A review. Med Vet Entomol. 4: 1–24.
40. Mozaffari GH, Bakhshizade Kloche F, Ghaybi M (2011) Analysis relationship between vegetation cover and Salak skin disease in Yazd-Ardakan plain. Geogr En-viron Plan J. 22: 47–50.
41. Ramezankhani R, Sajjadi N, Nezakati Esmaeilzadeh R, Jozi SA, Shirzadi MR (2018) Climate and environmental fac-tors affecting the incidence of cutaneous leishmaniasis in Isfahan, Iran. Environ Sci Pollut Res Int. 25: 11516–11526.
42. Bellali H, Talmoudi K, Ben Alaya N, Kouni Chahed M (2017) Effect of temperature, rainfall and specific density of rodent reservoir hosts on zoonotic cutaneous leishmaniasis incidence in Central Tunisia. Asian Pac J Trop Dis. 7: 88–96.
43. Claborn DM (2010) The biology and con-trol of leishmaniasis vectors. J Glob Infect Dis. 2: 127–134.
44. Alemayehu B, Alemayehu M (2017) Leish-maniasis: a review on parasite, vector and reservoir host. Health Sci J. 4(519): 1–6.
45. Vivero RJ, Torres-Gutierrez C, Bejarano EE, Peña HC, Estrada LG, Florez F (2015) Study on natural breeding sites of sand flies (Diptera: Phlebotominae) in areas of Leishmania transmission in Colombia. Parasit Vectors. 8: (116): 1–14.
46. Hesam-Mohammadi M, Rassi Y, Abai MR, Akhavan AA, Karimi F, Rafizadeh S, Sanei-Dehkordi A, Sharafkhah M (2014) Efficacy of different sampling methods of sand flies (Diptera: Psychodidae) in en-demic focus of cutaneous leishmaniasis in Kashan District, Isfahan Province, Iran. J Arthropod Borne Dis. 8: 156–162.
47. Subhakar S, Srinivas T (2006) Mapping of risk prone areas of kala-azar (Visceral leishmaniasis) in parts of Bihar state, In-dia: an RS and GIS approach. J Vector Borne Dis. 43: 115–122.
2. Salam N, Al-Shaqha WM, Azzi A (2014) Leishmaniasis in the middle East: Inci-dence and epidemiology. PLoS Negl Trop Dis. 8: 1–8.
3. Yaghoobi-Ershadi MR (2012) Phlebotomine Sand flies (Diptera: Psychodidae) in Iran and their role on Leishmania transmission.J Arthropod Borne Dis. 6: 1–17.
4. World Health Organization. Epidemiological Aspect, Control of the Leishmaniasis. WHO, Technical Report Series 2010: 793.
5. Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J (2012) Leishmaniasis Worldwide and Global Estimates of Its Incidence. Kirk M, ed. PLoS One. 7: e35671.
6. Shirzadi MR, Esfahani SB, Mohebali M, Yaghoobi-Ershadi MR, Gharachorlo F, Razavi MR, Postigo JA (2015) Epidemio-logical status of leishmaniasis in the Is-lamic Republic of Iran, 1983–2012. East Mediterr Health J. 21: 736–742.
7. Shirzadi MR, Gouya MM (2012) National guidelines for cutaneous leishmaniasis surveillance in Iran. Tehran: Ministry of Health and Medical Education, p. 1–78.
8. Karimi A, Hanafi-Bojd AA, Yaghoobi-Er-shadi MR, Akhavan AA, Ghezelbash Z (2014) Spatial and temporal distributions of phlebotomine sand flies (Diptera: Psy-chodidae), vectors of leishmaniasis, in Iran. Acta Trop. 132: 131–139.
9. Rabiee, MH, Mahmoudi A, Siahsarvie R, Kryštufek B, Mostafavi E (2018) Ro-dent-borne diseases and their public health importance in Iran. PLoS Negl Trop Dis. 12 (4): e0006256.
10. Salimi M, Jesri N, Javanbakht M, Farahani LZ, Shirzadi MR, Saghafipour A (2018) Spatio-temporal distribution analysis of zoonotic cutaneous leishmaniasis in Qom Province, Iran. J Parasit Dis. 42: 570–576.
11. Saghafipour A, Vatandoost H, Zahraei-Ram-azani AR, Yaghoobi-Ershadi MR, Kara-mi Jooshin M, Rassi Y (2017) Epidemi-ological study on cutaneous leishmaniasis in an endemic area, of Qom Province, cen-tral iran. J Arthropod Borne Dis. 11: 403–413.
12. Saghafipour A, Vatandoost H, Zahraei-Ra-mazani AR, Yaghoobi-Ershadi MR, Rassi Y, Shirzadi MR, Akhavan AA (2017) Spatial distribution of phlebotomine sand fly species (Diptera: Psychodidae) in Qom Province, central Iran. J Med Entomol. 54: 35–43.
13. Rafizadeh S, Saraei M, Abaei MR, Oshaghi MA, Mohebali M, Peymani A, Naserpour-Farivar T, Bakhshi H, Rassi Y (2016) Molecular detection of Leishmania major and L. turanica in Phlebotomus papatasi and first natural infection of P. salehi to L. major in North-East of Iran. J Arthro-pod Borne Dis. 10(2): 141–147.
14. Abdolmajid F, Ghodratollah SS, Hushang R, Mojtaba MB, Ali MM, Abdol-ghayoum M (2015) Identification of Leishmania species by kinetoplast DNA-polymerase chain reaction for the first time in Khaf District, Khorasan-e-Razavi Province, Iran. Trop Parasitol. 5: 50–54.
15. Mohajeri M, Shamsyan AA, Rezaei A, Has-sanpoor K, Shakeri M, Farnosh GH (2010) Molecular identification of species caus-ing cutaneous leishmaniasis in the city of Sabzevar. J Mashhad Univ Med Sci. 3: 138–144.
16. Campbell-Lendrum D, Manga L, Bagayoko M, Sommerfeld J (2015) Climate change and vector-borne diseases: what are the implications for public health research and policy? Philos Trans R Soc Lond B Biol Sci. 370: 20130552.
17. Salomon OD, Quintana MG, Mastrangelo AV, Fernandez MS (2012) Leishmania-sis and Climate Change-Case Study: Ar-gentina. J Trop Med. 2012: 601242.
18. Chamaillé L, Tran A, Meunier A, Bourdoiseau G, Ready P, Dedet JP (2010) Environmental risk mapping of canine leishmaniasis in France. Parasites and Vectors. 3(31): 18.
19. Gonzalez C, Wang O, Strutz SE, Gonzalez-Salazar C, Sanchez-Cordero V, Sarkar S (2010) Climate change and risk of leish-maniasis in North America: predictions from ecological niche models of vector and reservoir species. PLoS Neglected Trop Dis. 4: 1–16.
20. Toumi A, Chlif S, Bettaieb J, Ben Alaya N, Boukthir A, Ahmadi ZE, Ben Salah A (2012) Temporal dynamics and im-pact of climate factors on the incidence of zoonotic cutaneous leishmaniasis in cen-tral Tunisia. PLoS Negl Trop Dis. 6(5): e1633.
21. Ghatee MA, Haghdoost AA, Kooreshnia F, Kanannejad Z, Parisaie Z, Karamian M, Moshfe A (2018) Role of environ-mental, climatic risk factors and livestock animals on the occurrence of cutaneous leishmaniasis in newly emerging focus in Iran. J Infect Public Health. 11: 425–433.
22. Golpayegani AA, Moslem AR, Akhavan AA, Zeydabadi A, Mahvi AH, Allah-Abadi A (2018) Modeling of environ-mental factors affecting the prevalence of zoonotic and anthroponotic cutane-ous, and zoonotic visceral leishmaniasis in foci of Iran: A remote sensing and GIS based study. J Arthropod Borne Dis. 12: 41–66.
23. Ramezankhani R, Hosseini A, Sajjadi N, Khoshabi M, Ramezankhani A (2017) Environmental risk factors for the inci-dence of cutaneous leishmaniasis in an endemic area of Iran: A GIS-based ap-proach. Spat Spatiotemporal Epidemiol. 21: 57–66.
24. Hanafi Bojd AA, Vatandoust H, Soltani M, Charrahi ZA, Nasseh H (2013) Ap-plication of satellite remote sensing for tracking of arthropod vectors of diseases. J School Pub Health. 10: 45–64.
25. Rodell M, Houser PR, Jambor U, Gottschalck J, Mitchell K, Meng CJ (2004) The global land data assimilation system. B Am Meteorol Soc. 85(3): 381–394.
26. Wang F, Wang L, Koike T, Zhou H, Yang K, Wang A, Li W (2011) Evaluation and application of a fineresolution global data set in a semiarid mesoscale river basin with a distributed biosphere hydrological
model. J Geophys Res. 116(D21): 1–20.
27. Qi W, Zhang C, Fu G, Zhou H (2015) Glob-al land data assimilation system data as-sessment using a distributed biosphere hydrological model. J Hydrol. 528: 652–667.
28. Wang A, Zeng X (2012) Evaluation of mul-tireanalysis products with in situ obser-vations over the Tibetan Plateau. J Ge-ophys Res. 117(D5): 1–12.
29. Khazaei S, Mohammadian Hafshejani A, Saatchi M, Nematollahi S (2015) Epidemi-ological Aspects of Cutaneous Leishman-iasis in Iran. Arch Clin Infec Dis. 10: e28511
30. Norouzinezhad F, Ghaffari F, Norouzinejad A, Kaveh F, Gouya MM (2016) Cutane-ous leishmaniasis in Iran: Results from an epidemiological study in urban and ru-ral provinces. Asian Pac J Trop Biomed. 6(7): 614–619.
31. Entezari M, Eskandari F (2014) Relationship between climatic factors and the preva-lence of cutaneous leishmaniasis in Lar-estan City. J Mil Med. 16: 99–104.
32. Cabanillas MR, Castellón EG (1999) Dis-tribution of sandflies (Diptera: Psychodi-dae) on tree-trunks in a non-flooded area of the Ducke Forest Reserve, Manaus, AM, Brazil) Mem Inst Oswaldo Cruz. 94: 289–296.
33. Alencar RB, de Queiroz RG, Barrett TV (2011) Breeding sites of phlebotomine sand flies (Diptera: Psychodidae) and ef-ficiency of extraction techniques for im-mature stages in terra-firme forest in Amazonas State, Brazil. Acta Trop. 118: 204–208.
34. Singh R, Lal S, Saxena VK (2008) Breed-ing ecology of visceral leishmaniasis vec-tor sand fly in Bihar state of India. Acta Trop. 107(2): 117–120.
35. Roger A, Nacher M, Hanf M, Drogoul AS, Adenis A, Basurko C (2013) Climate and leishmaniasis in French Guiana. Am J Trop Med Hyg. 89: 564–569.
36. Viana GM, Nascimento Mdo D, Rabelo ÉM, Diniz Neto JA, Binda Júnior JR, Galvão Cde S (2011) Relationship between rain-fall and temperature: observations on the cases of visceral leishmaniasis in São Luis Island, State of Maranhão, Brazil. Rev Soc Bras Med Trop. 44: 722–724.
37. Rassi Y, Hanafi-Bojd AA (2008) Phlebotom-inae Sand flies, vector of leishmaniases. 1st ed. Tehran: Noavaran Elm Publica-tions. pp. 39–58.
38. Tsirigotakis N, Pavlou C, Christodoulou V, Dokianakis E, Kourouniotis C, Alten B, Antonio M (2018) Phlebotomine sand flies (Diptera: Psychodidae) in the Greek Aegean Islands: ecological approaches. Parasit Vectors. 11(97): 1–14.
39. Killick-Kendrick (1990) Phlebotomine vec-tors of the leishmaniases: A review. Med Vet Entomol. 4: 1–24.
40. Mozaffari GH, Bakhshizade Kloche F, Ghaybi M (2011) Analysis relationship between vegetation cover and Salak skin disease in Yazd-Ardakan plain. Geogr En-viron Plan J. 22: 47–50.
41. Ramezankhani R, Sajjadi N, Nezakati Esmaeilzadeh R, Jozi SA, Shirzadi MR (2018) Climate and environmental fac-tors affecting the incidence of cutaneous leishmaniasis in Isfahan, Iran. Environ Sci Pollut Res Int. 25: 11516–11526.
42. Bellali H, Talmoudi K, Ben Alaya N, Kouni Chahed M (2017) Effect of temperature, rainfall and specific density of rodent reservoir hosts on zoonotic cutaneous leishmaniasis incidence in Central Tunisia. Asian Pac J Trop Dis. 7: 88–96.
43. Claborn DM (2010) The biology and con-trol of leishmaniasis vectors. J Glob Infect Dis. 2: 127–134.
44. Alemayehu B, Alemayehu M (2017) Leish-maniasis: a review on parasite, vector and reservoir host. Health Sci J. 4(519): 1–6.
45. Vivero RJ, Torres-Gutierrez C, Bejarano EE, Peña HC, Estrada LG, Florez F (2015) Study on natural breeding sites of sand flies (Diptera: Phlebotominae) in areas of Leishmania transmission in Colombia. Parasit Vectors. 8: (116): 1–14.
46. Hesam-Mohammadi M, Rassi Y, Abai MR, Akhavan AA, Karimi F, Rafizadeh S, Sanei-Dehkordi A, Sharafkhah M (2014) Efficacy of different sampling methods of sand flies (Diptera: Psychodidae) in en-demic focus of cutaneous leishmaniasis in Kashan District, Isfahan Province, Iran. J Arthropod Borne Dis. 8: 156–162.
47. Subhakar S, Srinivas T (2006) Mapping of risk prone areas of kala-azar (Visceral leishmaniasis) in parts of Bihar state, In-dia: an RS and GIS approach. J Vector Borne Dis. 43: 115–122.
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| Issue | Vol 14 No 1 (2020) | |
| Section | Original Article | |
| DOI | https://doi.org/10.18502/jad.v14i1.2704 | |
| Keywords | ||
| Cutaneous leishmaniasis Remote sensing Climate Iran | ||
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How to Cite
1.
Shirzadi MR, Javanbakht M, Vatandoost H, Jesri N, Saghafipour A, Fouladi-Fard R, Omidi-Oskouei A. Impact of Environmental and Climate Factors on Spatial Distribution of Cutaneous Leishmaniasis in Northeastern Iran: Utilizing Remote Sensing. J Arthropod Borne Dis. 2019;14(1):56–67.
