An Epidemiological Study of Cutaneous Leishmaniasis in Al-Jabal Al-Gharbi, Libya

Abstract

Cutaneous leishmaniasis (CL) is an endemic parasitic infection in the Mediterranean region, including Libya and its Al-jabal Al-gharbi province. We aimed at studying the occupational relevance as well as other epidemiological aspects of CL. We investigated 140 CL cases who attended at Gharyan outpatient polyclinic during a period of 6 months in 2009. CL infection was clinically diagnosed and confirmed by demonstration of Leishmania parasites on smears from lesions. Our findings showed that males were more affected than females (P=0.04), and people above 10-years were more affected than younger ones (P=0.0001). A significant percent of CL cases belonged to Al-Kawasem subprovince (P=0.0001). Farm-related activities were the most frequent occupations among CL cases (P=0.04). In addition to farm workers, housewives and students are at risk groups since they are engaged at farm activities. Moreover, those who have occupations that require staying outdoors for a part of night, e.g., policemen, are also at risk. Compared to children, adult CL patients had multiple lesions (P=0.001) that were more prevalent in their upper and lower extremities than the face (P=0.0001). We conclude that CL is a major health problem in Al-jabal Al-gharbi province of Libya. The presence of rodents and sandflies makes it a suitable environment for Leishmania to spread in an endemic epidemiological pattern. Being engaged in farming activities or outdoor occupations increases the risk of infection. Various clinical patterns of CL suggest the presence of more than 1 species of Leishmania at Al-jabal Al-gharbi province. We propose that the 2 species responsible for CL in this area are L. major and L. tropica. Further investigations to identify the leishmanial species responsible for CL at Al-jabal Al-gharbi together with adoption of preventive and control programs are needed.

A Comparison of Demographic and Clinical Characteristics of Syrian and Turkish Patients with Cutaneous Leishmaniasis

“…20 Other studies indicate sizes of CL lesions to range between 5 and 200 mm. 11 However, our analysis of lesion numbers between Syrian and Turkish patients in this study revealed significantly greater numbers of CL lesions in Syrian patients. The number of lesions in Turkish CL patients was determined as 1.93 ± 1.47, whereas in the Syrian patient group, the mean number was determined as 2.46 ± 2.43.…”

“…11 In conclusion, we demonstrated variations in the clinicoepidemiological features of CL between Turkish and Syrian patients within the Sanliurfa province. Specifically, we showed that the disease duration is significantly higher for Turkish patients, whereas the number of lesions is greater in the Syrian patient group.…”

“…This age-based incidence of CL is similar to previous studies on this subject in both Syria and Turkey. 7,9,[11][12][13][14][15] Interestingly, in contrast to Syrian patients, a higher female (58.5%) to male (41.5%) ratio was observed in Turkish patients. Similar reports of higher female incidence were observed in a recent study in Nizip, southern Turkey (61% female, 39% male), which is geographically close to Sanliurfa and is also endemic for CL.…”

“…A study in Turkey by Gurel and others 9 reported the location of CL lesions as 57.5% in the head and neck region, 32.2% in the upper extremities, 10.2% in the lower extremities, 0.8% in oral mucosa, 0.2% on the trunk, and no mucosal involvement. Abdellatif and others 11 reported on lesion locations in Syrian CL patients as 45.8% in the head and neck region, 26.5% in the upper extremities, 24.1% in the lower extremities, and 3.6% on the trunk. With respect to lesion types, results from this study also agree with previous findings.…”

Risk Factors Associated With American Cutaneous Leishmaniasis in an Endemic Area of Brazil

“…In a study in Libya 16 , it was found that being engaged in farm activities was a risk factor, increasing the exposure to ACL infection, as was an occupational requirement to stay outdoors during part of the night.…”