Risk Factors and Spatial Distribution of Cutaneous Leishmaniasis in District Chitral, Pakistan

Fawad Khan ¹*, Bahar Uddin ², Shahab Saqib ³, Sana shahid ⁴, Samina Yasmin ⁵, Muhamamd Usman ⁶

This study determines key risk factors for cutaneous leishmaniasis in Chitral, guiding targeted public health interventions to reduce disease transmission.

Abstract

Background: Cutaneous leishmaniasis (CL) is a parasitic disease endemic to many regions, including Pakistan's Khyber Pakhtunkhwa (KPK) province. Chitral District, with its unique environmental conditions, presents a significant hotspot for CL transmission, driven by various socio-economic and environmental factors. Methods: This study was conducted between June and October 2023 in four tehsils of Chitral District. A total of 3,748 confirmed CL patients were surveyed for demographic information (figure 14), risk factors, and clinical data. Factors such as housing conditions, proximity to livestock, travel history, and environmental attributes were analyzed. Data were processed using SPSS (version 25.0), with significance determined at p < 0.05. Results: Key findings revealed that 76.94% of patients had recent travel history to endemic areas. Rural residency (58.65%), close proximity to livestock (88.76%), and inadequate housing conditions contributed significantly to CL prevalence. Poor waste management (66.04%) and vegetation near homes (52.14%) were identified as environmental risk factors. A majority (68.45%) of individuals did not use protective measures like mosquito nets, further increasing exposure to vector habitats. Conclusion: The study highlights the multifactorial nature of CL transmission in Chitral District. Socio-economic challenges, environmental factors, and travel history are major contributors. Effective public health strategies should focus on improving housing infrastructure, enhancing healthcare access, and promoting personal protection measures to reduce the burden of CL in high-risk areas.

Keywords: Cutaneous Leishmaniasis, Khyber Pakhtunkhwa, Socio-economic factors, Environmental risk factors, public health strategies

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