Cutaneous Leishmaniasis in Pakistan: a neglected disease needing one health strategy
- PMID: 34193071
- PMCID: PMC8243581
- DOI: 10.1186/s12879-021-06327-w
Cutaneous Leishmaniasis in Pakistan: a neglected disease needing one health strategy
Abstract
Background: Cutaneous Leishmaniasis (CL) is a neglected tropical disease, which mainly affects poor communities. It is one of the major vector-borne disease and endemic in Pakistan.
Methods: A case-control study to evaluate potential risk factors of human-CL was conducted in Khewra region, District Jhelum, Pakistan from January-April 2014. Case data about 90 cases registered during October 2012 to November 2013 was retrieved from Municipal Hospital. Controls were matched (1,1 ratio) on the date of registration with cases from same hospital. Both cases and controls were invited to participate and data was collected in a face-to-face interview. A prospective study of canine leishmaniasis (canine-CL) was also conducted at Civil Veterinary Hospital in the same area. Suspected dogs with skin ulceration signs were included in the study and blood samples were collected. Statistical analyses were conducted to determine association between various parameters and outcome of interest.
Results: The ages of cases ranged from 1 to 76 years (median = 15 years) and proved to be protective factor i.e. increase in each year in age reduced the likelihood of being infected with human-CL [Odds Ratio (OR) = 0.4, 95% Confidence Interval (CI) = 0.25-0.76]. People sleeping outsides in an open area were more likely to become a case (OR = 8.7, 95% CI = 2.90-26.37) than a control. Poor sanitary condition inside the house (OR = 3.3, 95% CI 1.03-10.56) and presence of other animals in house (livestock, poultry) (OR = 3.6, 95% CI = 1.07-12.12) also identified as risk factors of high significance. The proportion of positive dogs with canine-CL was 21.05% and was significantly associated with human-CL cases in the same area (p < 0.05).
Conclusions: We concluded that adopting self-protections measures against sand-fly, and maintaining good hygiene may lower the risk of human-CL. One-Health Strategy is suggested to control leishmaniasis in human and dog population.
Keywords: Case-control; Cutaneous; Leishmaniasis; Pakistan; Risk factors; Sand-fly; Vector-borne; Zoonosis.
Conflict of interest statement
All authors declare that they have no competing interest.
Figures





Similar articles
-
Cutaneous Leishmaniasis in the Metropolitan City of Multan, Pakistan, a Neglected Tropical Disease.J Med Entomol. 2018 Jun 28;55(4):1040-1042. doi: 10.1093/jme/tjy003. J Med Entomol. 2018. PMID: 29415246
-
Sand fly bionomics, geospatial investigation and risk factors associated with cutaneous leishmaniasis in district Mardan, Pakistan.Zoonoses Public Health. 2023 Nov;70(7):581-593. doi: 10.1111/zph.13066. Epub 2023 Jun 19. Zoonoses Public Health. 2023. PMID: 37337354
-
Cutaneous Leishmaniasis (CL): A Cross-Sectional Community Based Survey on Knowledge, Attitude and Practices in a Highly Endemic Area of Waziristan (KPK Province), Pakistan.Acta Trop. 2021 Jan;213:105746. doi: 10.1016/j.actatropica.2020.105746. Epub 2020 Nov 6. Acta Trop. 2021. PMID: 33160955
-
Vector control in cutaneous leishmaniasis of the old world: a review of literature.Dermatol Online J. 2008 Jun 15;14(6):1. Dermatol Online J. 2008. PMID: 18713582 Review.
-
SYSTEMATIC REVIEW OF LEISHMANIASIS IN PAKISTAN: EVALUATING SPATIAL DISTRIBUTION AND RISK FACTORS.J Parasitol. 2021 Jul 1;107(4):630-638. doi: 10.1645/19-191. J Parasitol. 2021. PMID: 34358311
Cited by
-
Comparing Dermatoscopic Features With Slit Skin Smear and Histopathology in Diagnosis of Cutaneous Leishmaniasis.Cureus. 2023 Feb 22;15(2):e35336. doi: 10.7759/cureus.35336. eCollection 2023 Feb. Cureus. 2023. PMID: 36974240 Free PMC article.
-
Cutaneous leishmaniasis in Afghanistan.Trans R Soc Trop Med Hyg. 2025 Aug 8;119(8):848-864. doi: 10.1093/trstmh/traf028. Trans R Soc Trop Med Hyg. 2025. PMID: 40331266 Free PMC article.
-
Characterizing cutaneous leishmaniasis in a conflict-affected region: a study from North Waziristan, Pakistan.Turk J Med Sci. 2023 Oct 10;53(6):1767-1775. doi: 10.55730/1300-0144.5746. eCollection 2023. Turk J Med Sci. 2023. PMID: 38813502 Free PMC article.
-
Epidemiology of cutaneous leishmaniasis in Karachi, Pakistan.JAAD Int. 2025 Apr 9;21:9-15. doi: 10.1016/j.jdin.2025.03.002. eCollection 2025 Aug. JAAD Int. 2025. PMID: 40453505 Free PMC article.
-
Canine leishmaniasis caused by Leishmania Tropica in southeastern Iran: a case series study.Sci Rep. 2024 Oct 27;14(1):25599. doi: 10.1038/s41598-024-76301-4. Sci Rep. 2024. PMID: 39465272 Free PMC article.
References
-
- Leishmania fact sheet number 375. 2016. [http://www.who.int/mediacentre/factsheets/fs375/en/]. Accessed 10 Dec 2016.
MeSH terms
LinkOut - more resources
Full Text Sources
Miscellaneous