Epidemiology and clinical features of cutaneous leishmaniasis in Khyber Pakhtunkhwa, Pakistan

Abstract

Current cross-sectional study was carried out between September 2019 to January 2020 at the Department of Pathology, Mardan Medical Complex (MMC), Mardan, and District Headquarter Hospital North Waziristan, Khyber Pakhtunkhwa (KP), Pakistan. The objectives of the current study were to determine the prevalence of leishmaniasis and its associated risk factors in selected districts of KP province, Pakistan. Altogether, three hundred and seventy-four (n=374) leishmaniosis patients were included in the current study. Skin specimen from the ulcer border were collected. The slides were stained by Giemsa stain and examined for the presence of amastigote. The prevalence of leishmania infected patients in different region of KP were as follows: North Waziristan region 53.7 (n=201) District Mardan 34.7% (n=130); District Nowshera 6.7% (n=25), District Swabi 1.1% (n=4) and other Districts i.e. Dir, Malakand, Buner and Bajawarr were 3.7% (n=14). The frequency of leishmaniasis were more in male and majority of the infected patients were in the age group of <10 years. Among n=374 patients 95.7% (n= 358) had cutaneous leishmaniasis while 3% (n= 11) had mucocutaneous type of infection and 1.3% (n= 5) patients had both cutaneous and mucocutaneous infection. Upon treatment by Sodium stibogluconate (SSG) 97% (n=362) showed clinical signs of complete or partial recovery of their skin lesions. Conclusively, highest incidence of leishmania infection occurred during short study period and majority of the cases showed positive response to treatment.

Evaluation of intralesional treatment in american tegumentary leishmaniasis in the amazon region: results and perspectives

“…Conceptually, cutaneous leishmaniasis can manifest as localized, disseminated, or diffuse and presents as papules that evolve into ulcers with granular bases and borders, either as single or multiple lesions. The localized form is usually ulcerated with one to twenty lesions (Machado, Prates, Machado, 2019) The characteristics of cutaneous lesions observed in the patients of this study corroborate with the literature, where the cutaneous form of ATL is the most common in Brazil, representing more than 90% of cases (Iqbal et al, 2024). The occurrence of ulcers with granular bases and borders, mainly in the lower limbs, reinforces the typical pattern of the disease in the region (Tirone et al, 2021).…”

Characterizing cutaneous leishmaniasis in a conflict-affected region: a study from North Waziristan, Pakistan

“…According to the current research findings, males were affected by cutaneous leishmaniasis more than females. This finding is supported by the opinions of some national and international experts [ 15 – 20 ]. A higher proportion of males were diagnosed with cutaneous leishmaniasis than females, which may be due to a combination of factors, such as greater exposure to the disease because men tend to work outdoors and are less likely to wear protective clothing, leading to a higher incidence of infected sand fly bites, or less frequent medical attention because women may have less access to health-care facilities.…”

“…Similarly, a study conducted including local and Afghan refugees in the Lower Dir district of KPK revealed 51% positivity [ 14 ], while there was 50.6% positivity in Baluchistan [ 6 ]. Another study in North Waziristan reported 53.7% positivity for cutaneous leishmaniasis [ 15 ]. Over the last several decades, this region has been politically unstable due to ongoing military operations against terrorists.…”