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Situational Analysis of Visceral Leishmaniasis in the Most Important Endemic Area of the Disease in Iran.

J Arthropod Borne Dis · 2017 · PMC5775155 · PMID 29367925

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a positive trendno p-value reported
Considering altitude, the model we used found a positive trend to about 1250m above sea level, but higher altitudes demonstrated a negative presence probability for the disease.

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a decreasing trendno p-value reported
an increasing trendno p-value reported
Studies conducted in other countries showed a decreasing trend in the disease incidence and an increasing trend in the spatial distribution of the disease ( 41 – 44 ).

also in 47,180 other papers

Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.