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Original Article
Bionomics of Phlebotomine Sand Flies in Different Climates of Leishmaniasis in
Fars Province, Southern Iran
Kourosh Azizi1, Zahra Soltani2, Mohsen Aliakbarpour2, Hassan Rezanezhad3, 4, *Mohsen
Kalantari1
1Research Center for Health Sciences, Institute of Health, Department of Medical Entomology and Vector
Control, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
2Control Disease Center, Shiraz University of Medical Sciences, Shiraz, Iran
3Department of Parasitology, Jahrom University of Medical Sciences, Jahrom, Iran
4Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
*Corresponding author: Dr Mohsen Kalantari, E-mail: kalantari_m@sums.ac.ir
(Received 30 June 2020; accepted 11 June 2022)
Abstract
Background: Phlebotomus and Sergentomya are distributed in the old-world regions and transmit leishmaniases through
mammalian and reptile hosts. Cutaneous leishmaniasis (CL) is one of the most important diseases in Iran. Iranian sand
flies belong to three Oriental, Palearctic, and Afrotropical Regions. Fars Province is located in Palearctic, but southern
parts are affected Oriental region situations on phglebotomine population variety. Therefore, a comprehensive study
was required on the vectors of the disease in this Province.
Methods: Regarding the approved role of the environmental factors in creating the fauna and distribution of living crea-
tures, the “de martonne climate method” was used, and the climate was noticed as an important environmental factor for
the determination of vector distribution. Accordingly, 14 sampling sites were selected from 10 foci in different climates
of Fars Province. 19648 sand flies were collected from the studied areas in this Province during 2016.
Results: Phlebotomus papatasi and Se. antennata were the most frequent species, which were caught from in/outdoor
areas. Phlebotomus sergenti and Ph. alexandri were caught from both Palearctic and Oriental zones but were more
prevalent in the cold semi-arid climate of the Palearctic zone. Moreover, they were not caught from the hot desert and
summer Mediterranean climates of the Oriental zone.
Conclusions: It seems that Ph. papatasi as the main vector of CL could be well distributed in different climates in Fars.
Moreover, some species like Ph. sergenti preferred especial climates in the Palearctic zone. Therefore, these data could
be helpful to control leishmaniases more efficiently.
Keywords: Cutaneous leishmaniasis; Sand flies; Phlebotomus papatasi; Geographic Information System; Iran
Introduction
Leishmaniases, as one of the most common
group of vector-borne diseases, are transmit-
ted to humans through female sand flies’ bites
infected with Leishmania parasites in the world
(1). There are more than 3,000 described Psy-
chodid species distributed among six subfam-
ilies of Phlebotominae, Bruchomyiinae, Sycorac-
inae, Trichomyiinae, Psychodinae, and Horaiel-
linae in the world (2). The last one, with its sole
genus Horaiella and its four species, is restricted
to the Himalayas, China, and Thailand (1). In
addition, there are about 1000 species of
phlebotominae sand flies in the world, of
which 98 species are identified as the proven
or suspected vectors of human leishmaniases
(4). Sand flies have different breeding places
in tropical and subtropical areas and their var-
iations directly affect the prevalence, incidence,
and transmission rates of the disease in differ-
ent areas (5).
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Phlebotomus and Sergentomya (Diptera:
Psychodidae) are distributed in the Old-World
regions and transmit the parasite through hu-
mans, different mammalian, and reptile hosts
(6). They have a wide range of mammalian hosts,
such as canines, rodents, cats, hyrax, and hu-
mans. Consequently, human leishmaniases have
different zoonotic and anthroponotic transmis-
sion patterns (7). Phlebotomine sand flies usu-
ally have different ecological habits and may
tend to rest in or outdoors of residential plac-
es. Some sand fly species prefer to live within
active rodents’ burrows across plain or moun-
tainous regions (8).
Cutaneous leishmaniasis (CL) is endemic
in Iran and reported from different regions of
the country (9). The study of Iranian sand flies
began in the early years of this century, main-
ly by researchers such as Adler, Theodore, and
Laurie. The first comprehensive study was car-
ried out by Mesghali in 1961, which reported
12 species of Phlebotomus and 11 species of
Sergentomyia from Iran (10). In continue, Ja-
vadian and Mesghali reported a total of 42
species in the country during 1975. Thereaf-
ter, 54 species of sand flies were reported from
different regions of the country. Accordingly,
48 species were finally confirmed from two
genera of Phlebotomus and Sergentomyia based
on the studies carried out since 1930 (11). Spe-
cies, such as Ph. caucasicus, Ph. mongolensis,
Ph. kazeruni, Ph. brevis, Ph. adlerius, Ph. pa-
patasi, Ph. sergenti, Ph. alexandri, Se. sogdiana,
Se. hodegson, Se. grekovi, Se. hodgsoni, Se. ti-
beriadis, Se. sintoni, Se. clydei, Se. dentata, and
Se. antennata have been usually reported from
the northern zones of Iran. On the other hand,
some species, such as Ph. ansarii, Ph. lon-
giductus, Ph. papatasi, Ph. sergenti, Ph. alex-
andri, Ph. bergeroti, Ph. major, Ph. mongolen-
sis, Se. sintoni, Se. baghdadis, Se. theodori, Se.
antennata, Se. clydei, Se. squamipleuris, Se. den-
tata, and Se. mervynae have been more report-
ed from the southern zones of the country in-
cluding Fars Province. In this regard, Ph. pa-
patasi and Se. sintoni species were reported as
the dominant sand flies’ species (9). Phleboto-
mus papatasi and Ph. sergenti have been re-
ported as the suspected or proven vectors of
CL. Moreover, Ph. kandelakii, Ph. perfiliewi, Ph.
sergenti, Ph. papatasi, Ph. ansarii, Ph. salehi,
and Ph. caucasicus have been reported as the
suspected or proven vectors of visceral leish-
maniasis (VL) in Iran (12, 13). Additionally,
Ph. papatasi, Ph. keshishiani, Ph. alexandri, and
Ph. major have been reported as the vectors
of CL and VL in southern Provinces of the
country including Fars and Bushehr (14).
The Palearctic zone covers Eurasia, includ-
ing Europe, Asia north of the Oriental Region,
and northern Africa, and. The Oriental Re-
gion includes eastern Iran, China south of the
Yangtze River, India and Sri Lanka, Southeast
of Asia, the Philippines, the East Indies and
Indo-Malayan Archipelago, and the large island
regions of Taiwan (15). Iranian sand flies be-
long to three Oriental, Palearctic, and Afrotrop-
ical Regions (16). Environmental factors, such
as the mean temperature of the wettest quar-
ters, play an important role in sand flies’ dis-
tribution (especially Ph. papatasi) in Iran and
can be reported in the regions where biologi-
cal situations are suitable (17). In fact, such
factors as appropriate temperature and relative
humidity are very important for their survival
in different areas of the country (18). Moreo-
ver, rainfall, altitude from the sea level, land
cover type, annual mean or minimum temper-
ature in the coldest months, and mean temper-
ature of the driest or wettest quarters have been
reported to be effective in the distribution of
different sand flies’ species (19). Changes in the
environment cause variations in the transmis-
sion pattern of communicable diseases. The con-
sciousness of the relations between the envi-
ronment changes and the incidence of vector-
borne diseases can be helpful in planning ef-
fective control strategies (20, 21).
Due to the high incidence of leishmaniasis
in Fars Province, a comprehensive study was
required on the vectors of the disease in this
Province. The precise control of cutaneous and/
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or visceral leishmaniasis helps to identify en-
demic vectors as well as reservoir hosts of the
disease. The present study was designed to ex-
plore the fauna and the bio-ecology of sand flies
in Fars Province, southern Iran, during 2016.
Materials and Methods
Study area
Fars Province includes 23 counties with an
area of 122400km² in south of Iran (22). Shi-
raz as the capital city of the province is situ-
ated at 29° 59' 18" North, 52° 58' 37" East and
about 1200m above the sea level. Recently, Fars
has been the most important foci of CL in south-
ern Iran. This Province has many different cli-
mates, but the most prevalent ones are cold semi-
arid climate (in Shiraz, Kharameh, Marvdasht,
Darian, and Sarvestan), hot desert climate (in
Larestan, Zarin-Dasht, Hajiabad, Qir, Banarui-
yeh, and Shahr-e Pir), hot semi-arid climate (in
Farashband, Zahedshahr, Now Bandegan, Duzeh,
Sheshdeh, and Sahrarud), hot-summer Medi-
terranean climate (in khan-e-Zenyan and Kaze-
run), cold desert climate (in Mehrdasht), and hot
humid continental climate in southern parts. Shi-
raz has been considered to have a local steppe
climate. The average annual temperature is 16.8
°C and there is little annual rainfall (the aver-
age rainfall is equal to 316mm) in Shiraz. Re-
cently, Shiraz, Marvdasht, and Kharameh have
been the most important foci of CL in Fars
Province, southern Iran (Fig. 1).
Selection of Villages
Considering the approved role of the envi-
ronmental factors in creating the fauna and dis-
tribution of living creatures, the “de martonne
climate method” was used (23, 24), and cli-
mate was noticed as a key factor for determi-
nation of vector distribution affected by atmos-
pheric precipitation, elevation, and vegetation.
Accordingly, 14 sampling sites were selected
from 10 foci in plain and mountainous areas
regarding the contribution of different climates.
Among these foci, eight were in endemic are-
as of ZCL and six belonged to non-endemic
foci (Table 1).
Sampling
Phlebotomine sand flies were caught using
sticky paper traps and aspirating tube from
Zafar-Abad, Mahmood-Abad, Ahmad-Abad,
Koh-Sabz, Tole-Mahtabi, Bahman, Deh-Dagh,
and Khsoyeh villages from the Palearctic zones
and Eslam-Abad, Bid-Karz, Baba-Monir, Hos-
sein-Abad, Deh-Mian, and Ali-Abad from the
climate zone of Oriental in Fars Province eve-
ry month during 2016. Sand flies were sam-
pled from indoors, such as bedrooms and bath-
rooms, and outdoors, such as rocks, rodent bur-
rows, agricultural lands, and wall gaps. In each
sampling round, 60 sticky paper traps (30 in-
doors and 30 outdoors) were fixed in the sun-
set and collected in the next morning before
sunrise. Phlebotomine sand flies were collected,
kept in ethanol (70%), mounted in the Puri’s
media, and taxonomically identified accord-
ing to valid taxonomic criteria studies (25).
Pearson’s correlation coefficient was used
to find the relationship between the disease in-
cidence rate which was reported from the Ira-
nian Control Disease Center and the number
of collected P. papatasi as the main vector of
ZCL from different studied villages in 2016. The
data were analyzed using the Arc Explorer soft-
ware. This application is included three exten-
sions of 3D Analyst, Spatial Analyst, and Ge-
oStatistical Analyst. At first, topology data will
be added to the geodatabase part, which is a
feature originally available only with ArcInfo
coverages. Then, these three extensions facili-
tate the ability to access data online, directly
from the Geography Network site or other Ar-
cIMS map services (26).
Results
In this study, a total of 19648 sand flies
were collected from different villages of the
studied areas in Fars Province during 2016.
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Among the collected sand flies, 11778 speci-
mens (59.95%) were male and 7870 (40.05%)
were female. In addition, 14030 (71.41%) and
5618 (28.59%) specimens were identified as
the various species of Phlebotomus and Ser-
gentomyia, respectively.
Phlebotomus species included 10654 Ph.
papatasi (54.22%), 2052 Ph. sergenti (10.44%),
672 Ph. alexandri (3.42%), 548 Ph. bergeroti
(2.79%), 80 Ph. major (0.41%), 10 Ph.
keshishiani (0.05%), 8 Ph. tobbi (0.04%), and
6 Ph. salehi (0.03%). The most dominant spe-
cies was Ph. papatasi caught from both in-
door and outdoor places of all studied foci.
On the other hand, among the 5618 collected
specimens of Sergentomyia, 2250 were Se. an-
tennata (11.45%), 1071 were Se. sintoni (5.45%),
884 were Se. baghdadis (4.5%), 662 were Se.
clydei (3.37%), 473 were Se. theodori (2.41%),
118 were Se. squamipleuris (0.60%), 106 were
Se. mervynae (0.54%), 47 were Se. dentata
(0.24%), and 7 were Se. palestinensis (0.04).
Besides, Se. antennata was the most frequent
species caught from in/outdoors (Table 2).
In the Palearctic zone, all above-mentioned
Phlebotomus species were caught, except for
Ph. keshishiani that was only collected from
Bid-Karz village in Mamasani focus in the Ori-
ental zone (Fig. 2). Besides, among the collected
Sergentmyia species, Se. palestinensis was not
caught from the Palearctic zone and was only
recorded from Eslam-Abad village of Kazerun
in the Oriental climate region. In the current
study, no Ph. major, Ph. tobbi, and Ph. salehi
species were caught in the studied villages of
the Oriental zone (Fig. 2). Indeed, the first two
species were merely recorded from Koh-Sabz
from Marvdasht focus and the last one was
only collected from Tole-Mahtabi from Ney-
riz in the Palearctic zone (Table 2).
The results revealed significant variation
(p< 0.001) between the incidence rates of CL
reported from the Iranian Control Disease Cen-
ter and the number of caught Ph. papatasi in
different endemic and non-endemic foci of Fars
Province during 2016. But it does not indicate
a positive or negative relationship between CL
cases and the number of Ph. papatasi sand flies
caught in different foci. For example, in Niriz,
where the number of CL cases was higher, the
number of Ph. papatasi sand flies caught was
less than in Shiraz with fewer CL cases (Ta-
ble 3).
Table 1. The geographic coordinates of the studied sites
Climate Zone Climate type Topographical type Foci Village X_long
altitude
Y_lat
altitude
ZCL
cases
Palearctic Cold semi-arid Plain Shiraz Zafar-Abad 653501.1 3254461 864
Mountainous Shiraz Mahmood-Abad 659075.2 3249343
Plain Kharameh Ahmad-Abad 708846.3 3259576 224
Mountainous Marvdasht Koh-Sabz 664812.1 3310268 901
Mountainous Neyriz Tole-Mahtabi 823232.7 3237904 95
Plain Abadeh Bahman 641681.6 3450615 29
Plain Abadeh Deh-Dagh 662026 3445878
Hot desert Plain Zarin-Dasht Khosoyeh 831592.2 3161876 135
Oriental Hot desert Mountainous Larestan Deh-Mian 803992.9 3048333 240
Plain Larestan Ali-Abad 864440.2 3067707
Hot semi-arid Plain Farashband Hossein-Abad 612280.1 3186581 69
Hot-summer
Mediterranean
Plain Kazerun Eslam-Abad 596084.8 3244258 44
Mountainous Mamasani Bid-Karz 501180.5 3311488 11
Plain Mamasani Baba-Monir 519969 3326872
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Table 2. Sand fly species collected from different zone and climate regions of Fars Province during 2016
No. of collected Phlebotomine sand flies Z
o
n
e
s
C
lim
a
te
s
F
o
c
i
V
illa
g
e
s
P
h
le
b
o
to
m
u
s p
a
p
a
ta
si
P
h
le
b
o
to
m
u
s se
rg
e
n
ti
P
h
le
b
o
to
m
u
s a
le
x
a
n
d
ri
P
h
le
b
o
to
m
u
s b
e
rg
e
ro
ti
P
h
le
b
o
to
m
u
s m
a
jo
r
P
h
le
b
o
to
m
u
s k
e
sh
ish
ia
n
i
P
h
le
b
o
to
m
u
s to
b
b
i
P
h
le
b
o
to
m
u
s sa
le
h
i
S
e
rg
e
n
to
m
y
ia
a
n
te
n
a
ta
S
e
rg
e
n
to
m
y
ia
sin
to
n
i
S
e
rg
e
n
to
m
y
ia
c
ly
d
e
i
S
e
rg
e
n
to
m
y
ia
d
e
n
ta
ta
S
e
rg
e
n
to
m
y
ia
m
e
rv
y
n
a
e
S
e
rg
e
n
to
m
y
ia
th
e
o
d
o
ri
S
e
rg
e
n
to
m
y
ia
b
a
g
h
d
a
d
is
S
e
rg
e
n
to
m
y
ia
sq
u
a
m
ip
le
u
ris
S
e
rg
e
n
to
m
y
ia
p
a
le
stin
e
n
sis
T
o
ta
l
P
a
le
a
r
c
tic
C
o
ld
se
m
i-a
rid
A
a
1473 654 480 0 0 0 0 0 0 88 0 9 9 213 492 0 0 3418
b
652 321 0 0 0 0 0 0 0 53 0 7 8 92 161 0 0 1294
B
c
828 99 29 164 0 0 0 0 320 24 25 0 0 21 0 19 0 1529
C
d
1839 217 0 112 80 0 8 0 78 0 0 0 60 8 0 0 0 2402
D
e
1818 0 0 102 0 0 0 6 492 85 0 0 0 6 0 0 0 2509
E
f 19 78 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 97
g
9 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 11 *
H
D
F
h
1038 106 0 24 0 0 0 0 536 364 344 0 7 64 0 0 0 2483
Subtotal 13743
T
h
e
O
r
ie
n
ta
l
O
r
ie
n
ta
l
H
D
G
i 428 0 0 51 0 0 0 0 337 369 144 0 0 49 0 0 0 1341
j 763 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 800
*
*
H
S
A
H
k
275 0 57 0 0 0 0 0 60 0 36 31 0 7 91 51 0 608
*
*
*
H
S
M
I l 864 0 0 92 0 0 0 0 95 0 27 0 0 0 140 44 7 1269
J
m
2 249 106 3 0 10 0 0 332 76 81 0 22 13 0 4 0 898 n
646 326 0 0 0 0 0 0 0 12 5 0 0 0 0 0 0 989
Subtotal 5905 T
o
ta
l %
1
0
6
5
4
2
0
5
2
6
7
2
5
4
8
8
0
1
0
8
6
2
2
5
0
1
0
7
1
6
6
2
4
7
1
0
6
4
7
3
8
8
4
1
1
8
7
1
9
6
4
8
5
4
.2
2
1
0
.4
4
3
.4
2
2
.7
9
0
.4
1
0
.0
5
0
.0
4
0
.0
3
1
1
.4
5
5
.4
5
3
.3
7
0
.2
4
0
.5
4
2
.4
1
4
.5
0
.6
0
.0
4
1
0
0
A, Shiraz; B, Kharameh; C, Marvdasht; D, Neyriz; E, Abadeh; F, Zarin-Dasht; G, Larestan; H, Farashband; I, Kazerun; J,
Mamasani
a, Zafar-Abad; b, Mahmood-Abad; c, Ahmad-Abad; d, Koh-Sabz; e, Tole-Mahtabi; f, Bahman; g, Deh-Dagh; h, Kho-
soyeh; i, Deh-Mian; j, Ali-Abad; k, Hossein-Abad; l, Eslam-Abad; m, Bid-Karz; n, Baba-Monir. *Hot desert; ** Hot
semi-arid; ***Hot summer Mediterranean
Table 3. Comparison of the number of collected sand flies and incidence rates of CL in different endemic and non-
endemic foci of CL in Fars Province during 2016
Foci CL cases Incidence per 100000 No. of caught Phlebotomus papatasi P value
Marvdasht 901 150.1 1839
<0.001
Shiraz 864 57.6 2125
Kharameh 224 373.3 828
Neyriz 95 135.7 1818
Zarin-Dasht 135 184.4 1038
Abadeh 29 49.1 28
Mamasani 11 9.4 648
Larestan 240 386.8 1191
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Kazerun 44 45.5 864
Farashband 69 339.6 275
Total 2612 94.9 10654
Fig. 1. Map of Iran showing the sample sites in different locations of Fars Province, southern Iran during 2016; Abadeh
(Nos. 1 and 2), Marvdasht (No. 3), Shiraz (Nos. 4 and 5), Kharameh (No. 6), Neyriz (No. 7), Farashband (No. 8), Ma-
masani (Nos. 9 and 10), Kazerun (Nos. 11 and 12), and Larestan (Nos. 13 and 14)
Fig. 2. Map of the geographic distribution of Phlebotomus species in the Palearctic and influenced Oriental zones of
Fars Province during 2016
Table 3. Continued ...
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Discussion
In this study, phlebotomines were caught
from various climates in the Palearctic and af-
fected zones of Oriental in Fars Province.
Among the 19648 sand flies caught, 14030
(71.41%) and 5618 (28.59%) specimens were
identified as various species of Phlebotomus
and Sergentomyia, respectively. Phlebotomus
papatasi was the most frequent species and was
collected from all in/outdoors of people’s re-
sidual places in both Palearctic and affected
zones of Oriental in Fars Province. Indeed, wall
gaps of old rooms and agricultural lands were
the most frequent breeding places of these spe-
cies. Resting sites of this species is naturally in-
fected with L. major and reported from differ-
ent parts of Iran, including Fars Province (27).
The high biodiversity of the Iranian fauna
is the result of its area and the influences of four
ecozones from Palaearctic and old periodical
connections with the Nearctic by Bering Strait
in north, Afrotropical from the Arabian Penin-
sula in south, and Oriental in southeast in-
cludes Fars (28, 29). Fars Province includes a
wide variety of sand fly fauna. Species such as
Ph. papatasi, Ph. alexandri, Ph. keshishiani, and
Ph. major were formerly reported as the vec-
tors of ZCL and VL in this province. But Ph.
papatasi has been noticed as the main proven
vector of ZCL in all endemic foci of Fars. Al-
so, this species was the main frequent species
(54.22%) in the current study in both geograph-
ical zones. In a similar study conducted in south-
ern foci of this Province in Palearctic zone, it
seems that relative humidity was the main en-
vironmental factor affecting phlebotomine ac-
tivity and spatial distribution. Accordingly, their
activity increased significantly when the aver-
age humidity was induced to more than 10%
and reduced rapidly when the average humid-
ity average was over 50% (30). These findings
are in contract with those who believe that low
humidity which followed by low wind speed and
high temperature were the main factors affect-
ing phlebotomine activities (31). However, some
other studies indicated that low wind velocity,
light intensity, temperature, and low relative hu-
midity (Maximum wind speed of 3m/s, humid-
ity of 10%, and minimum temperature of 11
°C) were the main factors affecting their ac-
tivity and distribution (32).
Softwares such as Geographic Information
System (GIS) and Ecological Niche Models
(ENMs) have been used to generate the distri-
bution map for Phlebotomine sand flies to find
effective environmental factors on these vec-
tors on the prevalence of Leishmaniasis (21).
Therefore, more research are needed about the
seasonal variations and abiotic situations (cloud
cover, lunar cycle, wind speed and so forth) in
order to improve our knowledge of these epi-
demiologically important subjects.
However, species such as Ph. sergenti were
formerly recorded as the sole proven vector of
Leishmania tropica in Iran (33). Also, Ph. ser-
genti has been found positive with Leishmania
parasite in Shiraz and some other important cit-
ies in the country (34). In addition, Ph. alexan-
dri was previously recorded as the probable vec-
tor of Leishmania infantum in southern regions
(35-37). In the current study, Ph. sergenti and
Ph. alexandri were caught from both Palearc-
tic and affected zones of Oriental in the Prov-
ince, but were more prevalent in the cold semi-
arid climate of the Palearctic zone. Moreover,
they were not caught from the selected sites
of Larestan and Kazerun in hot desert and hot
summer Mediterranean climates of the zones
influenced by Oriental zone.
Phlebotomus major has been reported from
northern and southern regions of Iran and has
been naturally infected with L. infantum in Fars
(38). However, in the current study, this spe-
cies was only collected from Koh-Sabz village
from Marvdasht in the Palearctic zone. The in-
cidence and distribution of leishmaniasis are both
influenced by environmental variables affect-
ing the Phlebotomine sand flies (as vectors) and
reservoirs populations and human behaviors
(37). Due to the high incidence of leishmania-
sis in Fars Province (39, 40), a comprehensive
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study was required on the vectors of the dis-
ease in this Province. The precise control of
cutaneous and/or visceral leishmaniasis helps
identify the endemic vectors as well as the res-
ervoir hosts of the disease (40). Moreover, care-
ful monitoring of environmental variables in
relation to biology of vector and leishmaniasis
is important for designing and implementation
of control plans.
Conclusion
Phlebotomus papatasi as the main vector of
CL could be well distributed in different cli-
mates in Fars. Moreover, some species like Ph.
sergenti prefered especial climates in the Pa-
learctic zone. It seems that environmental fac-
tors play an important role in distribution of
phlebotomine sand flies and can be reported
in the regions where biological situations are
suitable. Therefore, the obtained data could be
helpful to control leishmaniases more efficiently.
Acknowledgements
This investigation was extracted from an
approved MSc thesis (proposal No. 92-6823)
written by Zahra Soltani and financially support-
ed by the Research Vice-chancellor of Shiraz
University of Medical Sciences. Hereby, the au-
thors would like to thank Ms A Keivanshekouh
at the Research Improvement Center of Shiraz
University of Medical Sciences for improving
the use of English in the manuscript.
Ethical considerations
Ethical approval for this study was obtained
from the Ethics Committee at Shiraz Univer-
sity of Medical Sciences (Iran).
Conflict of interest statement
Authors declare that there is no conflict of
interest.
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