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Situational Analysis of Cutaneous Leishmaniasis in an Endemic Focus of the Disease, Southeastern Iran.

J Arthropod Borne Dis · 2018 · PMC6046105 · PMID 30018995

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a decreasing trendno p-value reported
From 2006 to 2009, the disease erupted into an epidemic condition in some areas of the county, however, this situation was brought under control which led to a decreasing trend in the incidence of the disease after the year 2009.

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an increasing trendno p-value reported
There has been an increasing trend of the prevalence of leishmaniasis in Iran, and provinces including Yazd, Bushehr, Khorassan-e-Razavi, Fars, Ilam, Khuzestan, and Esfahan have recorded the highest prevalence of the disease with many endemic foci ( 5 ).

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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.