Epidemiology and future risk estimates of cutaneous leishmaniasis in district Dera Ismail Khan, Pakistan: analysis of data from 2019-2022.

Abstract

Background: Cutaneous leishmaniasis (CL), despite not being a life-threatening condition, has a devastating impact on the public health. CL is widely distributed, exhibiting a distinct epidemiological pattern all over the world. The aim of this study was to investigate CL in District Dera Ismail Khan, Khyber Pakhtunkhwa, Pakistan, and to estimate the risk of epidemics.

Objectives:

Materials and methods: From 2019 to 2022, 1135 CL patients' epidemiological data were collected from district health facilities. For epidemiological characterization, descriptive statistics were used. The spatial analysis was done using ArcGIS V.10.3. The relationship between CL occurrence and climatic variables was investigated using liner regression analysis.

Results: Between 2019 and 2022, there was a decline in the annual CL incidence trend. Males and people under the age of 20 were particularly susceptible. A total of 1204 lesions were identified, with 76.1% of individuals having a single lesion and 23.9% having multiple lesions. Most of the lesions were nodular and ulcerative in nature and were found on exposed body parts such as the lower extremity (34.2%) and the face (30.7%). A choropleth map revealed an increased incidence of CL in Tehsil D.I.K (63%) and Paharpur (10%). According to a digital elevation model, high altitudes have a lower prevalence of CL. For focal transmission and high-risk zones, Inverse Density Weight (IDW) spatial interplation, focal statistics, cluster, and outlier analysis validated that CL cases were high in D.I.K, Kulachi, and Paharpur tehsils. Increased temperature, relative humidity, and precipitation were not significantly associated with CL infection.

Conclusions: The study provided essential details for public health sectors to develop intervention strategies for future CL outbreaks.