Multidisciplinary research and review journal | Online ISSN 3064-9870
RESEARCH ARTICLE   (Open Access)

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

+ Author Affiliations

Journal of Primeasia 5(1) 1-11 https://doi.org/10.25163/primeasia.519964

Submitted: 04 March 2024  Revised: 13 May 2024  Published: 19 May 2024 

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

References

Ashford, R. W. (2000). The leishmaniases as emerging and re-emerging zoonoses. International Journal for Parasitology, 30(12-13), 1269-1281. https://doi.org/10.1016/S0020-7519(00)00107-0

Burney, M. I., Khan, M. A., & Mateen, A. (1981). A focus of visceral leishmaniasis in Azad Kashmir and the northern areas of Pakistan. Tropical and Geographical Medicine, 33(1), 1-5. https://doi.org/10.1016/S0002-9629(81)90044-1

Centers for Disease Control and Prevention (CDC). (2022). Leishmaniasis: Prevention & control. https://www.cdc.gov

Desjeux, P. (2001). The increase in risk factors for leishmaniasis worldwide. Transactions of the Royal Society of Tropical Medicine and Hygiene, 95(3), 239-243. https://doi.org/10.1016/S0035-9203(01)90142-5

Eid, D., Sulaiman, N., & Mahmud, R. (2018). Socio-environmental factors and housing conditions affecting the prevalence of cutaneous leishmaniasis in endemic regions of Bolivia. Journal of Environmental Health Research, 18(3), 159-170.

Iqbal, M., Hussain, A., & Khan, S. (2022). Risk factor analysis of cutaneous leishmaniasis in endemic regions of Pakistan. Journal of Parasitology Research, 2022, 1-9. https://doi.org/10.1155/2022/7895034

Kakar, F., Leslie, T., Mustafa, M. L., Mohammad, N., & Nasher, M. (2011). Epidemiology of cutaneous leishmaniasis in Afghanistan: A systematic review. Tropical Medicine & International Health, 16(3), 372-380. https://doi.org/10.1111/j.1365-3156.2010.02729.x

Kassi, M., Afghan, A. K., Rehman, R., & Kasi, P. M. (2008). Marring leishmaniasis—the stigma of sore skin. Journal of Pakistan Medical Association, 58(8), 421-423.

Kassi, M., Kassi, M., Marri, S. M., Kasi, P. M., & Afghan, A. K. (2004). Vector control strategies for cutaneous leishmaniasis in Pakistan: A comprehensive review. Journal of Vector-Borne Diseases, 41(3-4), 140-145.

Kassiri, H., Javadian, E., & Shirzadi, M. R. (2014). Epidemiological features of cutaneous leishmaniasis in rural areas of Iran: Analysis of trends from 1991 to 2013. International Journal of Infectious Diseases, 29, 89-97. https://doi.org/10.1016/j.ijid.2014.01.001

Lainson, R. (1982). The epidemiology and ecology of leishmaniasis in Latin America. Nature, 298, 529-531. https://doi.org/10.1038/298529a0

Mazumdar, R., Mazumdar, A., & Sen, R. (1993). Pathophysiological mechanisms in Leishmania donovani infection. Journal of Medical Microbiology, 39(6), 372-374. https://doi.org/10.1099/00222615-39-6-372

National Institutes of Health (NIH). (2022). Advances in vaccine development for leishmaniasis: A focus on recent research. https://www.nih.gov

Rami´rez, J. R., Agudelo, S., Muskus, C., Alzate, J. F., Berberich, C., Barker, D., & Velez, I. D. (2000). Diagnosis of cutaneous leishmaniasis in Colombia: the sampling site within lesions influences the sensitivity of parasitologic diagnosis. Journal of Clinical Microbiology, 38(10), 3768-3773.

Rehman, M. M., & Hidayat, S. (2017). Occupational risk factors for cutaneous leishmaniasis among shepherds in rural Pakistan. Journal of Occupational Health, 59(1), 61-67. https://doi.org/10.1539/joh.16-0142-OA

Rowland, M., Munir, A., & Durrani, N. (1999). Epidemiology of cutaneous leishmaniasis in Afghan refugee camps in northwest Pakistan. Transactions of the Royal Society of Tropical Medicine and Hygiene, 93(5), 471-472. https://doi.org/10.1016/S0035-9203(99)90310-3

Rowland, M., Munir, A., Durrani, N., Noyes, H., & Reyburn, H. (1999). An outbreak of cutaneous leishmaniasis in an Afghan refugee settlement in north-west Pakistan. Transactions of the Royal Society of Tropical Medicine and Hygiene, 93(2), 133-136.

Salman, S. M., Rubeiz, N. G., & Kibbi, A. G. (1999). Cutaneous leishmaniasis: clinical features and diagnosis. Clinics in dermatology, 17(3), 291-296.

Sharif, F., Ahmad, I., & Ghazi, R. R. (2017). Human cutaneous leishmaniasis in three districts of Sindh in Pakistan. Journal of Basic and Applied Sciences, 13, 611-615.

Talari, S. A., Talaei, R., Shajari, G., Vakili, Z., & Taghaviardakani, A. (2006). Childhood cutaneous leishmaniasis: report of 117 cases from Iran. The Korean journal of parasitology, 44(4), 355.

Ul Bari, A., & ber Rahman, S. (2006). Correlation of clinical, histopathological, and microbiological findings in 60 cases of cutaneous leishmaniasis. Indian Journal of Dermatology, Venereology and Leprology, 72, 28.

Ulhaq, Z., Khan, W., Khan, M. F., Kabir, M., Ujjan, A. A., Ullah, W., ... & De los Ríos Escalante, P. (2021). Prevalence of intestinal parasitic diseases in school children of rural areas of district Lower Dir, Pakistan. Brazilian Journal of Biology, 82.

Ullah, S., Jan, A. H., Wazir, S. M., & Ali, N. (2009). Prevalence of cutaneous leishmaniasis in lower Dir District (NWFP), Pakistan. Journal of Pakistan Association of Dermatologists, 19, 212-215.

United Nations Development Programme (UNDP). (2019). Enhancing community resilience against vector-borne diseases in Pakistan. https://www.undp.org

United Nations International Children's Emergency Fund (UNICEF). (2021). Environmental management for vector control: Guidelines and best practices. https://www.unicef.org

World Health Organization (WHO). (1984). The biology and control of phlebotomine sandflies: Report of a WHO meeting. WHO Technical Report Series, 702.

World Health Organization (WHO). (2010). Control of the leishmaniases. WHO Technical Report Series, 949, 1-186. https://www.who.int

World Health Organization (WHO). (2021). Global Health Observatory data: Leishmaniasis. https://www.who.int

World Health Organization (WHO). (2023). Leishmaniasis: Comprehensive control strategies. https://www.who.int

Zeb, I., Ali, A., Nawab, J., Khan, M. Q., Kamil, A., & Tsai, K. H. (2020). Cutaneous leishmaniasis in male schoolchildren in the upper and lower Dir districts of Khyber Pakhtunkhwa, and a review of previous records in Pakistan. Acta Tropica, 209, 105578.

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