Multi-systemic melioidosis in a patient with type 2 diabetes in nonendemic areas:A case report and review of literature

BACKGROUND Melioidosis,an infectious disease caused by Burkholderia pseudomallei(B.pseudomallei),occurs endemically in Southeast Asia and Northern Australia and is a serious opportunistic infection associated with a high mortality rate.CASE SUMMARY A 58-year-old woman presented with scattered erythema on the skin of her limbs,followed by fever and seizures.B.pseudomallei was isolated successively from the patient’s urine,blood,and pus.Magnetic resonance imaging showed abscess formation involving the right forehead and the right frontal region.Subsequently,abscess resection and drainage were performed.The patient showed no signs of relapse after 4 months of follow-up visits post-treatment.CONCLUSION We present here a unique case of multi-systemic melioidosis that occurs in nonendemic regions in a patient who had no recent travel history.Hence,it is critical to enhance awareness of melioidosis in non-endemic regions.

Development of endemicity and conservation importance indices for tropical forests and the floral diversity assessment of Mt.Natoo in Benguet,Philippines

The scientific community faces the challenge of measuring progress toward biodiversity targets and indices have been traditionally used.However,recent inventories in secondary tropical mountain forests using traditional biodiversity indices have yielded results that are indistinct with primary ones.This shows the need to develop complementary indices that goes beyond species count but integrates the distribution and conservation status of the species.This study developed endemicity and conservation importance index for tropical forest that incorporated the distribution and conservation status of the species.These indices were applied to Mt.Natoo,a remnant primary mossy forest in Buguias,Benguet,Philippines,that resulted to endemicity index of 81.07 and conservation importance index of 42.90.Comparing these with secondary forest sites with comparable Shannon-Wiener,Simpson,Evenness and Margalef’s indices,our endemicity and conservation indices clearly differentiates primary forest(our study site)with higher values from secondary forests with much lower values.Thus,we are proposing these indices for a direct but scientifically-informed identification of specific sites for conservation and protection in tropical forests.Additionally,our study documented a total of 168 vascular plant species(79 endemic and 12 locally threatened species)in Mt.Nato-o.Majority are of tropical elements for both generic and species levels with some temperate elements that could be attributed to the site's high elevation and semi-temperate climate.These are important baseline information for conservation plans and monitoring of tropical mossy forests.

Endemic medicinal plant distribution correlated with stable climate,precipitation,and cultural diversity

Medicinal plants provide crucial ecosystem services,especially in developing countries such as China,which harbors diverse endemic medicinal plant species with substantial cultural and economic value.Accordingly,understanding the patterns and drivers of medicinal plant distribution is critical.However,few studies have investigated the patterns and drivers of endemic medicinal plants distribution in China.Here,we linked endemic medicinal plants distribution with possible explanatory variables,i.e.,paleoclimate change,contemporary climate,altitudinal range and ethnic minority human population size at the prefecture city level in China.Our results show that endemic medicinal plants are concentrated in southern China,especially in southwestern China.Notably,both endemic medicinal plant species richness and the ratio of endemic medicinal plant species richness are negatively associated with glacialinterglacial anomaly in temperature,and positively associated with contemporary precipitation and altitudinal range.In addition,we found that endemic medicinal plant species richness is positively associated with ethnic minority population sizes as well as its ratio to the overall population size.These findings suggest that the distribution of endemic medicinal plants is determined by multiple drivers.Furthermore,our findings stress that dramatic future climate changes and massive anthropogenic activities in southern China pose great challenges to the conservation of China's endemic medicinal plants.

Risk estimation of chronic kidney disease in a leptospirosis endemic area: A case-control study from south Andaman Islands of India

Objective:To estimate the risk of chronic kidney disease in patients with leptospirosis.Methods:All reported(41890)and later confirmed leptospirosis(1990)cases from 2010-2020 were traced by universal sampling.386 Laboratory-confirmed leptospirosis cases were enrolled and 413 age,gender,area,and occupation matched healthy persons were included as controls.Variables including socio-demographic characteristics,medical history,and health-related behaviours were compared between the two groups and association between these variables and reduced estimated glomerular filtration rate(eGFR)was analyzed with multiple linear regression.Results:The median of eGFR was 49.0(27.0,75.0)mL/min/1.73 m^(2) in the cases and 96.0(72.0,121.0)mL/min/1.73 m^(2) in the controls,showing significant differences(P<0.001).Bivariate analysis showed that leptospirosis seropositivitiy,repeat leptospirosis infection,diabetes,male gender,working in field(sun exposure),COVID-19 infection and smoking had statistically significant association with reduced eGFR.Leptospirosis seropositivity had negative effects on eGFR.Multiple linear regression confirmed that leptospirosis seropositivity had negative effects on eGFR(unstandardised β coefficients=−30.86,95%CI−49.7 to−11.9,P<0.001).Conclusions:Chronic kidney disease is a complex disease with multiple risk factors involved.Exposure to leptospirosis is one of the essential factors in accelerating its progression.

Antibody seropositivity and endemicity of chikungunya and Zika viruses in Nigeria

Mosquito-borne infections are of global health concern because of their rapid spread and upsurge,which creates a risk for coinfections.chikungunya virus(CHIKV),an arbovirus disease transmitted by Aedes aegypti or A.albopictus,and malaria,a parasitic disease transmitted by Anopheles gambiae,are prevalent in Nigeria and neighbouring countries,but their burden and possible coinfections are poorly understood.In this study,we investigated the antibody seropositivity and endemicity of chikungunya and Zika viruses(ZIKV)in three regions of Nigeria.A cross-sectional serosurvey was conducted on 871 participants.Samples were collected from outpatients by simple random sampling.Analyses of the samples were performed using recomLine Tropical Fever for the presence of antibody serological marker IgG immunoblot with CHIKV VLP(virus like particle),ZIKV NS1 and ZIKV Equad according to manufacturers’instructions and malaria RDT for malaria parasite.There was a significantly higher antibody seropositivity against CHIKV in the central region than in the northern and southern regions(69.5%,291/419),while ZIKV-seropositivity(22.4%,34/152)and CHIKV-ZIKV co-circulating antibody seropositivity(17.8%,27/152)were notably higher in the southern region than in the central and northern regions.This investigation revealed an unexpectedly high antibody seropositivity and concealed endemicity of CHIKV and ZIKV in three Nigerian regions.The seropositivity of detectable antibodies differed among the three geographical locations.

Hiding on jagged karst pinnacles:A new microendemic genus and species of a limestone-dwelling agamid lizard(Squamata:Agamidae:Draconinae)from Khammouan Province,Laos

We describe a unique new species and genus of agamid lizard from the karstic massifs of Khammouan Province,central Laos.Laodracon carsticola Gen.et sp.nov.is an elusive medium-sized lizard(maximum snout-vent length101 mm)specifically adapted to life on limestone rocks and pinnacles.To assess the phylogenetic position of the new genus amongst other agamids,we generated DNA sequences from two mitochondrial gene fragments(16S rRNA and ND2)and three nuclear loci(BDNF,RAG1 and c-mos),with a final alignment comprising 7418 base pairs for 64 agamid species.Phylogenetic analyses unambiguously place the new genus in the mainland Asia subfamily Draconinae,where it forms a clade sister to the genus Diploderma from East Asia and the northern part of Southeast Asia.Morphologically,the new genus is distinguished from all other genera in Draconinae by possessing a notably swollen tail base with enlarged scales on its dorsal and ventral surfaces.Our work provides further evidence that limestone regions of Indochina represent unique“arks of biodiversity”and harbor numerous relict lineages.To date,Laodracon carsticola Gen.et sp.nov.is known from only two adult male specimens and its distribution seems to be restricted to a narrow limestone massif on the border of Khammouan and Bolikhamxai provinces of Laos.Additional studies are required to understand its life history,distribution,and conservation status.

More endemic birds occur in regions with stable climate, more plant species and high altitudinal range in China

Background:Geographical distribution of endemic species and its multiple scale drivers are an important topic in biodiversity conservation,because these species are especially vulnerable to climate change and habitat degradation,and therefore have high conservation priority.Here,for the first time,we simultaneously linked glacial-interglacial climate change,contemporary climate,plant species richness and altitudinal range with endemic bird distribution in China.Methods:Ordinary least squares models and simultaneous autoregressive models were used to assess the associations between endemic bird richness,endemic bird ratio and each explanatory variable.Structural Equation Models were also performed to test the direct and indirect effects of these variables on endemic bird richness and endemic bird ratio.Results:Higher endemic bird richness and endemic bird ratio occurred in regions with stable glacial-interglacial temperature,i.e.,southwest China.Plant species richness and altitudinal range were also positively correlated with endemic bird richness and endemic bird ratio.Glacial-interglacial temperature change,contemporary precipitation,plant species richness and altitudinal range were all included in the best combination of variables for endemic bird richness.Importantly,glacial-interglacial temperature change had strong direct effects on both endemic bird richness and endemic bird ratio,while plant species richness only had a direct effect on endemic bird richness.Conclusions:Our results indicate that endemic birds in China concentrate in southwest regions where there are stable glacial-interglacial temperature,more plant species and larger altitudinal range.Notably,while stable climate has strong direct effects on both endemic bird richness and endemic bird ratio,plant species may affect endemic bird richness through its effect on overall bird species richness.Importantly,the recent anthropogenic activities have also significantly intensified in this region,which would pose huge challenge for biodiversity conservation in China.

Eastern Asian endemic seed plant genera and their paleogeographic history throughout the Northern Hemisphere

We review the fossil history of seed plant genera that are now endemic to eastern Asia. Although the majority of eastern Asian endemic genera have no known fossil record at all, 54 genera, or about 9%, are reliably known from the fossil record. Most of these are woody （with two exceptions）, and most are today either broadly East Asian, or more specifically confined to Sino-Japanese subcategory rather than being endemic to the Sino-Himalayan area. Of the ＂eastern Asian endemic＂ genera so far known from the fossil record, the majority formerly occurred in Europe and/or North America, indicating that eastern Asia served as a late Tertiary or Quaternary refugium for taxa. Hence, many of these genera may have originated in other parts of the Northern Hemisphere and expanded their ranges across continents and former sea barriers when tectonic and climatic conditions allowed, leading to their arrival in eastern Asia. Although clear evidence for paleoendemism is provided by the gymnosperms Amentotaxus, Cathaya, Cephalotaxus, Cunninghamia, Cryptomeria, Glyptostrobus, Ginkgo, Keteleeria, Metasequoia, Nothotsuga, Pseudolarix, Sciadopitys, and Taiwania, and the angiosperms Cercidiphyllum, Choerospondias, Corylopsis, Craigia, Cyclocarya, Davidia, Dipelta, Decaisnea, Diplopanax, Dipteronia, Emmenopterys, Eucommia, Euscaphis, Hemiptelea, Hovenia, Koelreuteria, Paulownia, Phellodendron, Platycarya, Pteroceltis, Rehderodendron, Sargentodoxa, Schizophragma, Sinomenium, Tapiscia, Tetracentron, Toricellia, Trapella, and Trochodendron, we cannot rule out the possibility that neoendemism plays an important role especially for herbaceous taxa in the present-day flora of Asia, particularly in the Sino-Himalayan region. In addition to reviewing paleobotanical occurrences from the literature, we document newly recognized fossil occurrences that expand the geographic and stratigraphic ranges previously known for Dipelta, Pteroceltis, and Toricellia.

Endemic Amphibians and Their Distribution in China

Amphibians are good indicators of ecosystem health. Updating the information of endemic species in time and understanding their spatial distributions are necessary for the development of integrative conservation strategies and the elucidation of geographic patterns of amphibians. We analyzed the diversity and distributions of the endemic amphibians in China based on a database of specimen records, recently published literature, and field surveys. Two hundred and sixty two endemic species of amphibians, belonging to 59 genera in 12 families and two orders, are recognized. They account for 67% of the total number of amphibian species in China, with the family Megophryidae possessing the largest number of endemics. There are also 17 genera endemic to China. Across provinces, the species richness of endemics shows five levels with a hierarchical diversification. Sichuan has the largest number of endemics, while Heilongjiang and Jilin have no endemic species. Alternatively, whether on the level of endemic genus or species, the highest diversity occurs in the Western Mountains and Plateau Subregion. The distribution ranges of most endemic species cover ≤ 4 provinces or zoogeographic subregions. Additionally, the species richness of endemics along an elevational gradient shows a bell-shaped pattern with the peak around 800 m. Most endemic species are distributed in areas of low to mid elevation(c. 700–1 500 m), while 36 species are distributed up to 3 000 m. Endemic species richness decreases with increasing of elevation range. Species at mid elevations display large range sizes, while species at lower and higher elevations exhibit smaller ranges. Our results are to be beneficial for further exploration of the underlying mechanisms of distributional patterns of amphibians in China. This study highlights a need to promote conservation programs for Chinese endemic amphibians due to their narrow distribution ranges and potential threats.

Breaking seed dormancy in Cupressus atlantica Gaussen,an endemicand threatened coniferous tree in Morocco

Cupressus atlantica Gaussen （Cupressaceae） is an endemic and endangered coniferous tree geographically restricted to the N＇Fis valley in South-Western Morocco. Like many forest species, C. atlantica exhibits dormancy which delays and reduces germination. To improve seed germination, different pre-treatments were conducted on C. atlantica seeds after storage for different periods （one, two and five years） including： scarification with sandy paper; soaking seeds in hot distilled water at 60℃ and 80℃ for 15 min and soaking seeds for 48 h in a gibberellic acid （GA3） at 1,000 and 2,000 mg·L-1. Results showed that scarification with sandy paper increased the germination rate of Atlas cypress by up to 67%, indicating that the species possess essentially an exogenous dormancy （physical dormancy） due to the hard seed coat （hardseededness）. Exogenous application of gibberellic acid （GA3） at 1,000 mg.L-1 was also effective in breaking seed dormancy and germination induction. These two treatments induced faster speed germination expressed by low number of days to first germination （8-10 days） and low values of mean germination times （MGT）. However, germination rate, under any treatment, is greatly dependent on the year of seed collection. Seeds collected in year 2004 gave the highest value, suggesting that even after five years of storage, the germination capacity of C. atlantica seeds could remain high. This observation is very interesting in the ex-situ conservation of such endemic and endangered species where the production of seeds is irregular over the years.

Correlates of extinction risk in Chinese endemic birds

Background: China has a relative high degree of endemism of birds due to its large area, diversified topography, and varied climates and habitats. Among the 77 Chinese endemic birds, 29 species are classified as threatened according to the officially released China Biodiversity Red List in 2015. Chinese endemic birds should be the focus of conservation because their local extinction in China means complete global extinction. However, to date, no study has explicitly examined the patterns and processes of extinction and threat in Chinese endemic birds. Methods: We obtained eleven biological traits and four extrinsic factors that are commonly hypothesized to influence extinction risk. After phylogenetic correction, these factors were used separately and in combination to assess their associations with extinction risk. Results: We found that 37.7% of Chinese endemic birds were listed as threatened (Vulnerable, Endangered and Critically Endangered). Small range size, high hunting vulnerability, and high human population density were important predictors of high extinction risk in Chinese endemic birds. Conclusions: Our study is the first to systematically investigate the patterns and processes of extinction risk in Chinese endemic birds. We suggest that endemic species with small range size and living in area with high human densities require conservation priorities. Conservation efforts should also focus on the reduction of human threats, such as human hunting and habitat degradation, for the effective preservation of Chinese endemic birds.

Chemical endemic diseases and their impact on population in china

This paper deals with some endemic diseases related to selenium, iodine and fluoride in eco-environment. Keshan disease and Kaschin-Beck disease are associated with low selenium, they mainly occur in a belt zone across China ranging from North-East to South-West. Selenium contents in food grains and human hair from the disease affected areas are usually below 0.020ppm and 0.20ppm respectively. The endemic goitre caused by iodine deficiency distributes extensively in China, mainly in mountainous and hilly districts, swamp and peat areas, some sand soil and limestone areas. Also there is another kind of endemic goitre which caused by iodine excess in interior and coast areas. Endemic cretinism usually occurs in the endemic goitre seriously affected areas. Endemic fluorosis is also widely distributed in China, but mainly occurs in dry or semi-dry areas of north China. The fluoride sources for causing endemic fluorisis are drinking water and food grains polluted by coal smoke in the backing process of maize and chilli.

Notes on the key role of stenochoric endemic plants in the floristic regionalization of Yunnan

With the accumulation and accessibility of information about plant species,it is time to re-evaluate and further divide a global biodiversity hotspot region,Yunnan,located in southwestern China.In this study,we combined data on the distribution of 1010 stenochoric endemic seed plants,vegetation constitution,geological history and climate change,and used these to propose a new system of floristic regions.We identified 11 distinct floristic subregions and 84 floristic provinces within Yunnan.Our work confirmed some views emphasized by Wu Zhengyi that the stenochoric endemic species play a key role in defining floristic provinces;that stenochoric endemic plants with long collection and publication histories are more valuable;that greater attention should be paid to woody plants;and that for Yunnan,a border region,some trans-border distributed elements should be treated cautiously.

Studies on Human Dietary Requirements and Safe Range of Dietary Intakes of Selenium in China and Their Application in the Prevention of Related Endemic Diseases

The human dietary selenium requirement in China has been estimated by various methods. The minimum dietary selenium requircment for the prevention of Keshan disease (KD) was found to be around 17 μg/d. On the other hand, an intake of 40 μg/d is required to maintain the plasma glutathione peroxidase (GPx) activity at plateau. Hence 40 μg/d is considered as the adequate dietary selenium requirement. Studies conducted in a chronic selenosis area indicate thai the toxic dietary selenlum inlake (adverse effect level), which would maintain the characteristic fingernail changes, was approximately 1600 μg/d. The mean value of dietary selenium intakes, which enabled the five patients to recover from fingernail lesions, was found to be 819 ±126μg/d. At a 95% confidence limit, the lower limit is around 600μg/d. Therefore, 600 and 400μg/d were suggested as the individual daily maximum safe selenium intake and the safe dietary selenium intake, respectively,The results were used in the prevention of Se-related endemic KD and Kashin-Beck disease (KBD)

Value of routine dengue diagnosis in endemic countries

Dengue is one of the most common arthropod-borne viral diseases in humans and it is a leading cause of illness and death in the tropical and subtropical regions of the world. It is thought to account for 400 million cases annually among approximately 3.97 billion people at risk of infection in 128 endemic countries. Despite the global prevalence of the disease, the availability of a vaccine is limited in most countries in the endemic areas. Most endemic countries in South America, South East Asia and Africa serve as attractive touristic sites for people from non-endemic countries who become infected and export the virus to dengue-free regions. Dengue fever typically resembles malaria and in endemic countries most cases of dengue are treated as presumptive malaria. Consequently, routine dengue diagnosis among persons with fever will offer early treatment and reduce the burden of the disease. Also, routine testing among travellers from endemic countries will reduce importation and prevent the geographical expansion of dengue. In this essay, we seek to highlight the usefulness of routine dengue testing in endemic countries.

Predictors of complicated dengue infections in endemic region of Pakistan

Objective:To predict the factors associated with progression to severe dengue infection to prevent potentially fatal complications and to identify the determinants of severe complicated dengue.Methods:The study was conducted in a tertiary care hospitaldengue ward from September to November 2021 including confirmed dengue infected patients(positive NS1 antigen or antidengue-antibodies IgM).Secondary dengue infection was labelled by positive anti-dengue-antibodies IgG in active dengue infected patients.Detailed history,physical examination,laboratory and radiological parameters,hospital stay(days)and mortality percentages were noted.Patients were classified into three groups according to disease severity:dengue fever(DF),dengue hemorrhagic fever(DHF)and dengue shock syndrome(DSS).The predictors of complicated dengue infection were determined by regression analysis.Results:The most common symptom was fever(96.9%).Among 129 patients,62.8%had DF,31.0%had DHF and only 6.2%developed DSS.History of previous symptomatic dengue and positive anti-dengue-antibodies IgG were present in 100%DSS patients and nearly 75.0%DHF patients(P<0.05).The moratlity rate in patients with DSS,DHF and DF was 50.0%,2.5%and none respectively(P<0.05).Clinical parameters(body aches,bleeding,conjunctival hemorrhage,maculopapular rash,right hypochondrial tenderness,ascites,pleural effusion)and laboratory parameters(thrombocytopenia,raised alanine aminotransferase and secondary dengue infection)were determinants that complicate the dengue infection.Conclusions:Thrombocytopenia,raised alanine aminotransferase and secondary dengue infection are important laboratory parameters to complicate the disease process of dengue infection.

Phylogenetic relationship,biogeography,and conservation genetics of endangered Fraxinus chiisanensis(Oleaceae),endemic to South Korea

Endemic plants are important for understanding phylogenetic relationships,biogeographical history,and genetic variation because of their restricted distribution and their role in conserving biodiversity.Here,we investigated the phylogenetic relationships of the Korean endemic Fraxinus chiisanensis by reconstructing the molecular phylogeny of Fraxinus based on two nuclear DNA(nrITS and phantastica)and two chloroplast DNA(psbA-trnH and rp132-trnL)regions.Within our fossil-calibrated phylogenetic framework,we also inferred the biogeographical history of F.chiisanensis.To provide a scientific basis for the conservation of F.chiisanensis,we determined the levels of genetic diversity and genetic differentiation in this species.Combining information from nuclear and chloroplast DNA sequence data,our molecular phylogenetic analyses identified F.chiisanensis as a genetically distinct unit from its sister group,Fraxinus platypoda from Japan.Our molecular dating analyses using nuclear and chloroplast DNA data sets show F.chiisanensis diverged from its sister F.platypoda in the Early or Middle Miocene and differentiated in the Late Miocene on the Korean Peninsula.Our results suggest that the divergence of F.chiisanensis was associated with the submergence of the East China Sea land bridge and enhanced monsoons in East Asia.When compared to F.platypoda,F.chiisanensis exhibits low genetic diversity within populations and high genetic differentiation among populations.These results help us to understand the evolutionary history of F.chiisanensis and to develop a conservation strategy for this species.

Iodization of Village Water Supply in the Control of Endemic Iodine Deficiency in Rural Sarawak, Malaysia

A simple water iodizing system, which incorporates the Venturi principle in combination with the controlled release mechanism of a silicone-sodium iodide elastomer, for the iodization of rural piped-water supply in the control of endemic iodine deficiency has been developed and its effectiveness evaluated in three Iban longhouse villages in the iodinedeficient district of Lubok Antu, Sarawak. Urines were collected for iodine assays from women aged 15-40 years before and at 6 and 12 months after the connection of the iodinating device; goiter assessment was performed on the women at the start and end of the 1-year study. Water samples were collected for iodine assays at 2-weekly intervals. In all three villages, significant and sustained increases in median urinary iodine excretions,reaching levels recommended for an iodine-suffcient population, were observed; goitre prevalences were reduced in all the villages (by 22.6% to 35.8%). The iodine levels in the water ranged from 34 μg/l to 212 μg/L. In the control village, median urinary iodine excretions remained essentially unchanged but a small increase in goiter prevalence was observed. The iodized water was well received by the villagers and no adverse effects of water iodization were observed. The system functioned unattended throughout the one year period. The cost of providing supplemental iodine via the iodizing device is approximately 60 cents (U.S.) per family per year which is affordable by either the Government or the villagers. It is concluded that the iodizing system offers a new cost-effective strategy for the control of endemic iodine deficiency in Sarawak and may have applications in other areas with similar water sources

Bioclimatic Modeling of the Potential Distribution of the Western Tien-Shan Endemic <i>Tulipa kaufmanniana</i>Regel (Uzbekistan, Kazakhstan)

The article analyzes the natural distribution area of the species Tulipa kaufmanniana Regel using the programs of type MaxEnt and ArcGis, the endemic of Central Asia (past, current, future). According to the results of the study, it is proved that the main distribution of the species coincides with the boundaries of the areali Tien-Shan mountain system (Uzbekistan, Kazakhstan). It is noted that the climatic factors that are optimal for the species are sufficient temperature and annual precipitation.

Determining endemic values of cutaneous leishmaniasis in Iranian Fars province by retrospectively detected clusters and receiver operating characteristic curve analysis

Objective: To determine the endemic values of cutaneous leishmaniasis in different cities of Fars province, Iran. Methods: Totally, 29 201 cases registered from 2010 to 2015 in Iranian Fars province were selected, and the endemic values of cutaneous leishmaniasis were determined by retrospective clusters derived from spatiotemporal permutation modeling on a time-series design. The accuracy of the values was assessed using receiver operating characteristic(ROC) curve. SPSS version 22, Arc GIS, and ITSM 2002 software tools were used for analysis. Results: Nine statistically significant retrospective clusters(P<0.05) resulted in finding seven significant and accurate endemic values(P<0.1). These valid endemic scores were generalized to the other 18 cities based on 6 different climates in the province. Conclusions: Retrospectively detected clusters with the help of ROC curve analysis could help determine cutaneous leishmaniasis endemic values which are essential for future prediction and prevention policies in the area.