Faculty of Biological Sciences, Department of Zoology, Kohat University of Science and Technology, Khyber Pakhtunkhwa, Pakistan.
Department of Zoology, Abdul Wali Khan University Garden Campus Mardan, Khyber Pakhtunkhwa, Pakistan.
PLoS One. 2022 May 26;17(5):e0268801. doi: 10.1371/journal.pone.0268801. eCollection 2022.
BACKGROUND: Cutaneous leishmaniasis is a neglected tropical disease caused by Leishmania spp. and transmitted by female sandflies. Terrorism and counter-insurgency military operations in Federally Administered Tribal Areas (FATA) lead to a large-scale migration of internally displaced persons (IDPs) in Khyber Pakhtunkhwa and thus, new outbreaks of several infectious diseases such as cutaneous leishmaniasis occurred. This study intended to find the prevalence of cutaneous leishmaniasis in people with cutaneous lesions suspected of having cutaneous leishmaniasis in four remote districts of Khyber Pakhtunkhwa and to assess the participant's knowledge, attitude, and practices about the infection and its control. METHODS: A cross-sectional study was carried out in four remote districts of Khyber Pakhtunkhwa including Karak, Lakki Marwat, Tank, and Dera Ismail Khan (D. I. Khan) and a total of 1,674 participants were recruited using a convenience sampling technique. RESULTS: The prevalence of cutaneous leishmaniasis among the participants with cutaneous lesions was 50.4% and the infection was comparatively more prevalent in district Karak. Among participants, 56.8% were male and mostly, 53.8% were under the age of 16 years with 52.8% living in kutcha houses and were from rural areas. Multiple skin lesions were more common, and the face was frequently affected body part. The ratio of participants with lesions older than a month was higher and the majority confronted infections with blood protozoan parasites for the first time. Most participants were unaware of the signs/symptoms of the disease, basic knowledge of the vectors, anthroponotic spread, preventive measures, secondary infections, and reservoir hosts. The use of wood/animal dung as fuel, closeness with reservoir animals, and no use of insect repellents were some of the notable risk factors. CONCLUSION: Cutaneous leishmaniasis is highly prevalent in the study area and a very low level of awareness was reported among the participants. This study necessitates the planning and execution of regulations and preventive programs, public health education, awareness campaigns, and disease management practices to overcome future incidence of cutaneous leishmaniasis.
背景：皮肤利什曼病是一种由利什曼原虫引起的被忽视的热带病，通过雌性沙蝇传播。联邦部落地区（FATA）的恐怖主义和反叛乱军事行动导致俾路支省境内流离失所者（IDP）大规模迁移，因此，出现了几种新的传染病爆发，如皮肤利什曼病。本研究旨在调查俾路支省四个偏远地区疑似患有皮肤利什曼病的皮肤损伤患者中皮肤利什曼病的患病率，并评估参与者对感染及其控制的知识、态度和实践。
方法：在俾路支省的四个偏远地区（包括卡拉奇、拉基马尔瓦特、坦克和德拉伊斯梅尔汗（D.I.汗））进行了横断面研究，共使用便利抽样技术招募了 1674 名参与者。
结果：有皮肤损伤的参与者中皮肤利什曼病的患病率为 50.4%，卡拉奇地区的感染更为普遍。参与者中 56.8%为男性，其中 53.8%年龄在 16 岁以下，52.8%居住在土坯房中，来自农村地区。多发性皮肤损伤更为常见，面部是经常受影响的身体部位。一个月以上的损伤参与者比例较高，大多数人第一次遇到血液原生动物寄生虫感染。大多数参与者不知道疾病的体征/症状、病媒、人源传播、预防措施、继发感染和储存宿主的基本知识。使用木材/动物粪便作为燃料、与储存动物接近以及不使用驱虫剂是一些值得注意的危险因素。
结论：皮肤利什曼病在研究地区高度流行，参与者的意识水平极低。本研究需要制定和执行法规和预防计划、开展公共卫生教育、宣传活动和疾病管理实践，以克服未来皮肤利什曼病的发病率。
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