Dr. Murai Éva - Gubányi András szerk.: Parasitologia Hungarica 31. (Budapest, 1998)

Lupoid form XI In Afghanistan, cutaneous leishmaniosis (CL) is caused by L. tropica (urban form, dry ulcer) and L. major (rural form, wet ulcer). In Northern Afghanistan L. major prevails, with Rhombomys opimus as a reservoir host. The natural foci of the diseases were detected in Northern Afghanistan between the provinces of Badaghshan and Herat (Elisejev and Kellina 1963; Omar et al. 1969; Sery et al. 1971), mainly at the altitude of 400-1000 m. That area is situated partly in the Bakhterian Lowland across the Amu Darya river (which forms the border with the north of the lowland). These are arid regions characterised as steppe and semi-desert. The large gerbil (Rhombomys opimus) is the most important natural reservoir for this disease in this region. The permanent vectors of the disease are sand flies from the genus Phlebotomus (mostly Phlebotomus papatasi and P. sergentï) that occur in the rodents' burrows. Southward of the Hindukush the dominant form of leishmaniosis is caused by L. tropica, which occurs mainly in towns and in agglomerations with a higher population density. Due to increased migration of the population in recent years, the anthroponotic form is spreading to the north and the zoonotic form to the south. The main aim of this research was to review the occurrence of cutaneous leishmaniosis in the region of Northern Afghanistan, namely in the province of Balkh, in spite of the civil war. Fig. 1. Occurrence of cutaneous leishmaniosis (CL) according to the causative species MATERIALS AND METHODS The analysed set contained 8410 samples, taken from the periphery of the patients' ulcer, in and around the town of Mazar-e-Sharif in Balkh province, Northern Afghanistan. We also acquired additional data from the immigration camps of the provinces of Faryab (330 cases), Jawzjan (289 cases), Samangan (175 cases) and Sarepul (161 cases), which are located in Northern Afghanistan. Unfortunately, those data were incomplete and thus we did not include them in the analysed set. Patients were referred to us from general physicians or came direct. On reporting to the treatment centre in Mazar-e-Sharif, each patient completed a form, which indicated his/her age, sex and place of residence. The information on the forms was tabulated monthly and annually. In addition, the collected material was stained by the Giemsa method. In the majority of cases the disease was treated with Glucantime (mainly locally). In patients with secondary infection antibiotics, antiseptics and vitamins were applied.