Cutaneous leishmaniasis in Dir Lower District, North-West Pakistan: epidemiology and treatment response

Hidayat Ur Rahman, Atta Ur Rehman

Abstract


Objective To assess the epidemiological and chemotherapeutic aspects of cutaneous leishmaniasis.

 

Methods This study was carried out during September, 2011 to December, 2011 and encompassed a total of 1000 patients of both gender. All patients enrolled in this study were selected at random from four sub-divisions of Dir Lower district. Data regarding different variables were obtained on a designed questionnaire through face-to-face interviews with the patients after approval of their informed consent. Standard protocols were used for confirmation of Leishman-Donovan bodies using slit-skin smears.

 

Results The overall incidence of CL was found to be 21.1%. The prevalence was observed to be significantly higher among Afghans than the local population (32.5% vs. 20.3%, OR: 1.6, p<0.05). The distribution of CL showed significant difference with respect to all studied demographic parameters, except subject’s age and tehsil. More than half of the infected patients (56.8%) had wet lesions and majority of the infected patients (42.3%) had only one lesion. Moreover, face and arms were the most frequently inflicted body parts. It was further observed that among various antimonials used by the patients, sodium stibogluconate demonstrated the highest efficacy followed by glucantime® and stibotim® whereas thermotherapy showed no efficacy. Collectively, the efficacy significantly varied across different antimonials used in this study (p<0.05).

 

Conclusion This study provides detailed information regarding descriptive epidemiological aspects of cutaneous leishmaniasis in Dir Lower District.

 


Keywords


Cutaneous leishmaniasis, antimonial drugs, chemotherapy, thermotherapy

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