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. 2014 Feb 20;9(2):e89043.
doi: 10.1371/journal.pone.0089043. eCollection 2014.

A prospective cohort study of cutaneous leishmaniasis risk and opium addiction in south eastern Iran

Mohammad Reza Aflatoonian  1 , Iraj Sharifi  2 , Maryam Hakimi Parizi  2 , Ali Reza Fekri  2 , Behnaz Aflatoonian  3 , Maryam Sharifi  4 , Ahmad Khosravi  2 , Ali Khamesipour  5 , Hamid Sharifi  6
Affiliations

A prospective cohort study of cutaneous leishmaniasis risk and opium addiction in south eastern Iran

Mohammad Reza Aflatoonian et al. PLoS One. .

Abstract

Opium addiction and cutaneous leishmaniasis (CL) are endemic in different parts of Iran, particularly in Bam, where a massive earthquake occurred. This study was designed to compare the incidence rate and severity of CL cases among opium addicted and non-addicted individuals in south-eastern Iran. This study was carried out as a prospective cohort by active house-to-house visits of 1,481 habitants in Bam. CL cases were confirmed by smear and identification of Leishmania species was performed using nested-PCR. The data was analyzed by χ(2) and t-tests, using SPSS software and also Kaplan-Meier survival curve and long-rank test in Stata 11.2 and P<0.05 was considered as significant. A total of 904 individuals consisting of 226 opium addicted and 678 non-addicted individuals were followed-up for a period of seven years. The two cohorts were similar in terms of age, sex and place of residency. A similar pattern of incidence was observed among the two cohort groups. In contrast, the severity of CL in terms of the number, duration and the size of the lesions in opium addicted individuals was significantly (P<0.001) higher than non-opium addicted individuals. In conclusion, the present findings indicate that there is no relationship between the incidence of CL and opium addiction.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Study design.
Figure 2
Figure 2. Location of the cutaneous leishmaniasis lesions in opium addicted and opium non – addicted cohorts.
Figure 3
Figure 3. Kaplan-Meier survival estimates of cutaneous leishmaniasis in opium and opium non-addicted.
Figure 4
Figure 4. Agarose gel electrophoresis prepared for amplification of variable minicircle fragments of Leishmania kDNA by the nested PCR. Lane 1, DNA size marker, 100 bp; lane 2, negative control (distilled water); lane 3, L.major (positive control, 560 bp); lane 4, L.tropica (positive control,750 bp); lanes 5–7, L.tropica isolates obtained from the cutaneous leishmaniasis cases among opium addicted and opium non-addicted cohorts.
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