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Abstract Background and Objectives: one of the endemic foci for Cutaneous Leishmaniasis in Iran is Mashhad in which limited outbreak have recently been reported. The commonly used method for diagnosis is the clinical features confirmed by direct microspic examination and culture or biopsy. We compared these two tests to determine the level of their sensitivity, specificity and positive predictive value. Material and Methods: we performed this comparative-analytic study on 73 patients suspected of having ulcers Leishmaniasis in Mashhad, Iran. Giemsa was staining the smears and the samples cultivated on Di-phasic N.N.N. culture media . Analysis was performed by SPSS version 11.5 and Chi square test. A P- value less than 0.05 were considered as a significant. Results: In 43 cases (58.9%), both the smear and culture are Positive. In 13 cases (17.8%), the smear is negative but the culture Positive. In 17 cases (23.2%), both smear and culture are negative. The two methods are positively correlated (82%). Sensitivity, Specifity, Positive predictive Value and negative predictive value are 76.7%, 100%, 100% and 56.7%., respectively. Conclusion: when the smear is positive, there is no need for culture. However, the opposite is not true. Key words: Cutaneous Leishmaniasis, Laboratory Diagnostic, Direct Microspic Examination, Culture.

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Background: Cutaneous leishmaniasis (CL) is a protozoan infection caused by a flagellated parasite complex known as Leishmania spp. Iran is an endemic area for CL. The present study aimed to investigate the epidemiological factors and geographical distribution of CL in Southwestern Khuzestan using the GIS method.
Methods: In this cross-sectional study, epidemiological and demographic data from 787 individuals affected by CL in Behbahan County between 2002 and 2021 were collected. Patient locations were plotted on a point shapefile of villages, towns, and cities in Behbahan County, and geographic data were analyzed using ArcGIS version 10.
Results: Among the 787 studied cases, 512 (65%) were male. The disease was most prevalent among individuals aged 21-30 years. Lesions appeared in various regions of the body, with 41% of cases involving the hands. The highest annual incidence rate was recorded in 2009, at approximately 40 cases per 100,000 population, whereas the lowest incidence rate occurred in 2002, at 5.8 per 100,000 population. Noticeable variations in disease prevalence were identified among non-Iranian individuals, rural populations (Including pastoral and peri-urban areas), males, and younger individuals. Geographic Information System (GIS) analysis indicated that the most affected areas were located in the central region (Behbahan or Markazi area) and the southern region (Zeydoon) of the mapped topography.
Conclusion: The findings highlight the need to implement effective prevention and control measures to reduce the burden of CL in Behbahan County. These measures should include targeted health education campaigns and vector control strategies, with particular focus on regions identified as high-prevalence areas through GIS topographic analysis.