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

DISCUSSION Previous studies from the whole of Afghanistan showed only the occurrence of cutaneous leishmaniosis caused byL. tropica andL. major (Sery 1974) and in the region covered by our research only the zoonotic form of cutaneous leishmaniosis (L. major) occurred. However, recently it seems that under the present conditions in Afghanistan, the occurrence of the anthroponotic form in the province of Balkh (mainly in the town of Mazar-e-Shari) is spreading due to the immigration of large numbers of people from other cities, mainly from Kabul. In our research, 19% of the cases represented the urban form (which we consider as a highly significant ratio) and 81% of the rural form. It would be very interesting to compare our data with the results of similar research, to reveal the trend of occurrence of the urban form in this region. Moreover, in the last decade scientists from the Institute for Malaria and Parasitic Diseases in Kabul isolated the causative agent of the visceral form (VL), probably L. infantum. Although several investigators have reported that L. tropica can give rise not only to cutaneous but also to visceral disease (Peters 1993). Hence, it is possible that these cases were not caused byL. infantum but byL. tropica. This form was isolated from several of the infected patients from the whole of Afghanistan. Fig. 4. Age distribution of cutaneous leishmaniosis (CL) in the province of Balkh between 1990 and 1994 Table 1. Record of cutaneous leishmaniosis cases in some provinces of Northern Afghanistan from January 1990 to December 1994 Year Balkh Faryab Jawzjan Samangan Sare Pool 1990 1504 123

d 1991 1199 23

c 38

c 1992 1479 77

a 71

f 53

s 1993 2350 86

b 57

h 175

8 108

j 1994 1878 144

d Total 8410 330 289 175 161 a - data from April, May and June are missing; b - data from October, November and December are missing; c - data only from August, October, November and December; d - data from January, February, March, June, July and August are missing; e - data only from January, February and March; f - data only from March and Aprl; g - data only from July, August and September; h - data only from September and October; i data from January, September, October, November and December are missing; j - positive cases from the district of Kholm