Cartography and Epidemiological Study of Leishmaniasis Disease in Sefrou Province (2007-2010), Central North of Morocco

Causal association between environmental variables and the excess cases of cutaneous leishmaniasis in Colombia: are we looking to the wrong side?

Our main aim was to estimate and compare the effects of six environmental variables (air temperature, soil temperature, rainfall, runoff, soil moisture, and the enhanced vegetation index) on excess cases of cutaneous leishmaniasis in Colombia. We used epidemiological data from the Colombian Public Health Surveillance System (January 2007 to December 2019). Environmental data were obtained from remote sensing sources including the National Oceanic and Atmospheric Administration, the Global Land Data Assimilation System (GLDAS), and the Moderate Resolution Imaging Spectroradiometer. Data on population were obtained from the TerriData dataset. We implemented a causal inference approach using a machine learning algorithm to estimate the causal association of the environmental variables on the monthly occurrence of excess cases of cutaneous leishmaniasis. The results showed that the largest causal association corresponded to soil moisture with a lag of 3 months, with an average increase of 8.0% (95% confidence interval [CI] 7.7-8.3%) in the occurrence of excess cases. The temperature-related variables (air temperature and soil temperature) had a positive causal effect on the excess cases of cutaneous leishmaniasis. It is noteworthy that rainfall did not have a statistically significant causal effect. This information could potentially help to monitor and control cutaneous leishmaniasis in Colombia, providing estimates of causal effects using remote sensor variables.

Cutaneous Leishmaniasis: Associated Risk Factors and Prevention in Hubuna, Najran, Saudi Arabia

Background

Many countries are currently affected by leishmaniasis, and cutaneous leishmaniasis is ranked among the ten most neglected diseases. The aim of this study was to determine the risk factors related to cutaneous leishmaniasis and preventive measures among people living in Hubuna, Najran, Saudi Arabia.

Methods

A community-based cross-sectional survey was conducted from January to October 2022. A convenience sampling technique was used, with 396 individuals invited to participate in the current study and 391 included. A self-administered questionnaire was utilized for collecting data. Descriptive analysis was used for risk factors and preventive measures, while χ² tests were used for determining associations with risk factors.

Results

Among participants, 38.1% (n=149) reported having cutaneous leishmaniasis clinically diagnosed and under treatment. Age 0-10 years was found to be associated significantly with cutaneous leishmaniasis infection (AOR 3.08, 95% CI 1.6-6.4; P=0.002) compared to other groups. A significant association was noted too for those residing in/around planted areas versus those who were not (AOR 1.18, 95% CI 0.13-2.24; P<0.001). In terms of occupation, farming was significantly associated with cutaneous leishmaniasis (AOR 2.54, 95% CI 1.15-3.76; P=0.010). No significant associations were observed in regard to sex (AOR 1.4, 95% CI 0.7-1.6; P=0.11), education (P=0.072), or preventive measures used (P>0.05).

Conclusion

The cutaneous leishmaniasis endemicity level in Hubuna was high. Several socioeconomic and environmental factors contribute enormously to the spread of the disease in the area. Further investigation of risk factors of cutaneous leishmaniasis all over the country and setting up appropriate interventions to prevent its spread are recommended.

The Cutaneous Leishmaniasis and the Sand Fly: Knowledge and Beliefs of the Population in Central Morocco (El Hajeb)

Background

Cutaneous leishmaniasis is a neglected parasitic dermal disease transmitted to humans through the bite of an infected female sand fly. Morocco hopes to eliminate all forms of leishmaniasis by 2030. These dermatoses pose a real public health problem in the country. Although the information is available on the disease, individual knowledge of cutaneous leishmaniasis and sand fly is not yet developed. Exploring people's beliefs and popular behaviours about cutaneous leishmaniasis and its vector allows health officials to know the sociocultural aspects of the disease and to improve prevention and control actions.

Objectives

To identify the knowledge of cutaneous leishmaniasis and its vector in the population in central Morocco.

Methods

Based on the epidemiological data of leishmaniases in the province of El Hajeb, we conducted a field survey and personal interviews in April and May 2019, among 281 persons belonging to the localities where leishmaniases were registered.

Results

Our results show that the participants use the concept of "Chniwla" (61.6%) for sand fly and the concept of "Hboub Chniwla" (50.8%) for cutaneous leishmaniasis; 24.6% of the respondents do not know how the disease is transmitted to humans and 43.7% use traditional treatments and home remedies to cure themselves. 44% of participants believe that sand fly does not transmit the disease to humans and only 6.4% were aware of their responsibility in vector control.

Conclusions

The study concluded that there is a need to simplify the scientific terminology in the health education of citizens regarding these dermatoses and their vector by integrating the popular concepts obtained in this study to raise public awareness and facilitate their involvement as active actors in the prevention of cutaneous leishmaniasis.

Knowledge and Experiences of Health Professionals in the Peripheral Management of Leishmaniasis in Morocco (ELHajeb)

Background

Morocco hopes to eliminate leishmaniases by 2030. These diseases exist in cutaneous and visceral forms and constitute a serious public health problem. The fight against these parasitoses is carried out within the framework of a national program to control leishmaniases, which offers free treatment. However, the screening rate in public health structures does not exceed 35%.

Objective

To determine the knowledge and experience of the social actors directly involved in the fight against leishmaniasis to contribute to analyse and understand the factors of this underreporting and to draw scientific recommendations to improve screening and control activities.

Methods

Using a self-administered questionnaire, we conducted an exploratory survey during April and May 2019 among all health professionals working in public health structures in the province of ELHajeb in central Morocco.

Results

We found that most of the health professionals had good knowledge about the clinical signs of each form of leishmaniasis, but they had erroneous information about the true vector of the disease, the reservoirs, and the mode of transmission. 76% recognized the national leishmaniases control program and only 17% received continuing education. 85% of these professionals focused on the curative aspects of the program. 47% stated that patients do not adhere to the antileishmaniasis treatment, and 25% stated that the population uses the concept of “Hboub of Chniwla” to refer to cutaneous leishmaniasis.

Conclusion

The study concluded that the operationalization of the activities of the leishmaniases control program recognizes some weaknesses which explain the underscreening of cases. Improvement of this situation requires the implementation of continuous training programs for caregivers and awareness-raising programs for citizens which should focus on the mode of transmission, preventive measures against reservoirs, sand flies bites, and recognition of lesions using the popular names of the disease as a starting point.

Thematic Maps of the Impact of Urbanization and Socioeconomic Factors on the Distribution of the Incidence of Cutaneous Leishmaniasis Cases in Sefrou Province, Central North of Morocco (2007-2011)

Background

Leishmaniases are vector-borne diseases with health risks. They cause a big health problem. These parasitic diseases are transmitted by the parasite of the genus Leishmania through sandflies.

Objective

The aim of this work is to study the distribution of the incidence of cutaneous leishmaniasis (CL) cases and the impact of urbanization and socioeconomic factors and their effects as leishmaniasis risk factors.

Methods

We conducted a retrospective study of CL cases collected at the level of Sefrou Province during the period from 2007 to 2011. The data was collected from registers of the Medical Delegation of Sefrou Province. The socioeconomic data, namely, the poverty rate, the popular density, and the type of environment (urban/rural) of Sefrou Province, were obtained from the High Commission for Planning. Statistical analysis was performed by SPSS software (version 20). The data were registered in a Microsoft Excel 2010 file. Statistical analysis was based on one-way analysis of variance (ANOVA), and then a correlation study was carried out (Pearson correlation). The results were considered significant when p was less than 0.05. The database was analyzed by QGIS 2.18, which is open source software.

Results

A total of 349 cases of CL were collected at Sefrou Province from 2007 to 2011. A percentage of 49% of the cases come from urban areas, while 51% of the cases come from rural areas. In the statistical analysis, the division of the incidence of CL cases was found to be significantly associated only with urbanization. For the other factors, the number of people or the poverty rate is not taken into account in the incidence dynamics.

Conclusion

This study may be useful for the implementation of future adequate measures and controls. Getting rid of leishmaniasis requires a comprehensive approach by acting on the sources of contamination through good continuous surveillance, appropriate management, effective vector control, and awareness-raising strategies.