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Lu C, Khan K, Khan F, Shah SU, Jamal M, Badshah N. Epidemiology of cutaneous leishmaniasis in children of Khyber Pakhtunkhwa, Pakistan. Trop Med Int Health 2024; 29:633-646. [PMID: 38740057 DOI: 10.1111/tmi.14005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
OBJECTIVES In Pakistan, cutaneous leishmaniasis is an emerging tropical disease and a very high number (>70%) of children are afflicted by this marring infection. This study aimed to scrutinise the prevalence, spatial distribution and socio-demographic and behavioural risk factors associated with cutaneous leishmaniasis in children aged <5-15 years in Khyber Pakhtunkhwa. METHODS A total of 1, 559 clinically confirmed records of children diagnosed with cutaneous leishmaniasis (January-December) from 2020 and 2022 were obtained from selected district hospitals. In addition, a risk factors-related questionnaire was administered to 1, 011 households (400 in 2020 and 611 in 2022) in nine districts during a household survey. RESULTS The maximum number of cutaneous leishmaniasis cases was recorded in 2022 (n = 877, 56.25%) as compared to 2020 (n = 682, 43.75%). The hospital records showed a greater number of male patients in the 2022 cohort (n = 603, 68.76%). The highest number of cases were observed in children aged 5-9 years in 2022 (n = 282, 32.16%) and 2020 (n = 255, 37.39%). In 2020 and 2022, cutaneous leishmaniasis cases showed peak aggregation in March (n = 118, 17.3%) and January (n = 322, 36.72%). From a spatial analysis, the maximum number of cutaneous leishmaniasis cases was recorded at 59-1700 m elevation in various land-use/land-cover and climatic regions with quaternary alluvium rock formations. A multivariate logistic regression model analysis of risk factors from the households survey suggested that age group, socio-economic status, construction materials of the house, use of insect repellents, Afghan refugee camps in the village/district, knowledge and biting times of sand flies, frequent use of mosquito bed nets, presence of domestic animals in the house, knowledge of the transmission period and peak month of leishmaniasis infection increased the risk of acquiring cutaneous leishmaniasis (p value < 0.05). CONCLUSION Our analysis demonstrated that cutaneous leishmaniasis in children is influenced by a variety of environmental, socio-demographic and behavioural risk factors in Khyber Pakhtunkhwa. The increase in recorded cases of cutaneous leishmaniasis in children in 2022 compared to 2020 suggests that the infection likely extended to new foci in the province.
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Affiliation(s)
- Chao Lu
- Hefei University of Technology, Hefei, Anhui, China
| | - Khurshaid Khan
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Fawad Khan
- District Integrated Vector Control Department, Lower Dir, Khyber Pakhtunkhwa, Pakistan
| | - Safeer Ullah Shah
- National Centre of Excellence in Geology, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Muhsin Jamal
- Department of Microbiology, Abdul Wali Khan University Mardan, Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Noor Badshah
- Department of Zoology, Abdul Wali Khan University Mardan, Mardan, Khyber Pakhtunkhwa, Pakistan
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Lu C, Ullah Z, Khan K, Shah SU, Jamal M, Khan NH. Environmental and socio-demographic factors associated with cutaneous leishmaniasis in district Khyber, Pakistan; alarming spread of the disease to new foci. Heliyon 2024; 10:e29571. [PMID: 38681643 PMCID: PMC11053183 DOI: 10.1016/j.heliyon.2024.e29571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 04/06/2024] [Accepted: 04/10/2024] [Indexed: 05/01/2024] Open
Abstract
Cutaneous leishmaniasis (CL) is a sand fly-borne infection of significant public health concern in Pakistan (endemic for CL). This study aimed to scrutinize the environmental and socio-economic risk factors for CL in district Khyber (located on Pak-Afghan border), Pakistan. Clinically confirmed 2881 CL case records for (January-December) 2017 and 2020 were obtained from district hospital. In addition, a questionnaire for CL risk factors assessment was administered to 525 households (175 in 2017 and 350 in 2020) in 40 villages throughout the district in a household survey. Higher number of CL cases were recorded in 2020 (N = 1824 belonging to 90 villages) compared to 2017 (N = 1057 from 42 villages). Highest number of CL patient cases were recorded in tehsil Jamrud (N = 2248, 39.01 %), followed by Landi Kotal (N = 398, 6.91 %) and Bara (N = 235, 4.08 %). Records showed higher number of CL cases in males (N = 1,659, 57.58 %) compared to females (N = 1,222, 42.41 %). In 2017 and 2020 the disease burden peaked in January. GIS-based spatial analyses of hospital records revealed that CL cases were abundant at 294-1,916 m elevation, in agriculture and range lands. Univariate logistic regression model analysis of risk factors suggested that higher education, family size >15, knowledge of CL, having family member/s that suffered from CL in the past, knowledge about biting time of sand flies, use of mosquito spray, presence of Afghan refugees in the village/s and living in mud-made houses increased the risk of acquiring CL. The multivariable logistic regression model showed none of the risk factors to be statistically significant. Findings of the study are crucial towards effective and targeted control of CL in district Khyber.
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Affiliation(s)
- Chao Lu
- Hefei University of Technology, Hefei, China
| | - Zerman Ullah
- Department of Zoology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Khurshaid Khan
- Department of Zoology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Safeer Ullah Shah
- National Centre of Excellence in Geology, University of Peshawar, Peshawar, Pakistan
| | - Muhsin Jamal
- Department of Microbiology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Nazma Habib Khan
- Department of Zoology, University of Peshawar, Khyber Pakhtunkhwa, Pakistan
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Perez-Guerra UH, Macedo R, Manrique YP, Condori EA, Gonzáles HI, Fernández E, Luque N, Pérez-Durand MG, García-Herreros M. Seasonal autoregressive integrated moving average (SARIMA) time-series model for milk production forecasting in pasture-based dairy cows in the Andean highlands. PLoS One 2023; 18:e0288849. [PMID: 37972120 PMCID: PMC10653396 DOI: 10.1371/journal.pone.0288849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/05/2023] [Indexed: 11/19/2023] Open
Abstract
Milk production in the Andean highlands is variable over space and time. This variability is related to fluctuating environmental factors such as rainfall season which directly influence the availability of livestock feeding resources. The main aim of this study was to develop a time-series model to forecast milk production in a mountainous geographical area by analysing the dynamics of milk records thorough the year. The study was carried out in the Andean highlands, using time-series models of monthly milk records collected routinely from dairy cows maintained in a controlled experimental farm over a 9-year period (2008-2016). Several statistical forecasting models were compared. The Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and Mean Absolute Percent Error (MAPE) were used as selection criteria to compare models. A relation between monthly milk records and the season of the year was modelled using seasonal autoregressive integrated moving average (SARIMA) methods to explore temporal redundancy (trends and periodicity). According to white noise residual test (Q = 13.951 and p = 0.052), Akaike Information Criterion and MAE, MAPE, and RMSE values, the SARIMA (1, 0, 0) x (2, 0, 0)12 time-series model resulted slightly better forecasting model compared to others. In conclusion, time-series models were promising, simple and useful tools for producing reasonably reliable forecasts of milk production thorough the year in the Andean highlands. The forecasting potential of the different models were similar and they could be used indistinctly to forecast the milk production seasonal fluctuations. However, the SARIMA model performed the best good predictive capacity minimizing the prediction interval error. Thus, a useful effective strategy has been developed by using time-series models to monitor milk production and alleviate production drops due to seasonal factors in the Andean highlands.
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Affiliation(s)
- Uri H. Perez-Guerra
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional del Altiplano, Puno, Peru
| | - Rassiel Macedo
- Facultad de Ciencias Agrarias, Universidad Nacional San Antonio Abad del Cusco, Cusco, Peru
| | - Yan P. Manrique
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional del Altiplano, Puno, Peru
| | - Eloy A. Condori
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional del Altiplano, Puno, Peru
| | - Henry I. Gonzáles
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional del Altiplano, Puno, Peru
| | - Eliseo Fernández
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional del Altiplano, Puno, Peru
| | - Natalio Luque
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional del Altiplano, Puno, Peru
| | - Manuel G. Pérez-Durand
- Facultad de Medicina Veterinaria y Zootecnia, Universidad Nacional del Altiplano, Puno, Peru
| | - Manuel García-Herreros
- Instituto Nacional de Investigação Agrária e Veterinária, I. P. (INIAV, I.P.), Santarém, Portugal
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Majidnia M, Ahmadabadi Z, Zolfaghari P, Khosravi A. Time series analysis of cutaneous leishmaniasis incidence in Shahroud based on ARIMA model. BMC Public Health 2023; 23:1190. [PMID: 37340451 DOI: 10.1186/s12889-023-16121-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/14/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Leishmaniasis is a zoonotic disease and Iran is one of the ten countries with has the highest estimated cases of leishmaniasis. This study aimed to determine the time trend of cutaneous leishmaniasis (CL) incidence using the ARIMA model in Shahroud County, Semnan, Iran. METHODS In this study, 725 patients with leishmaniasis were selected in the Health Centers of Shahroud during 2009-2020. Demographic characteristics including; history of traveling, history of leishmaniasis, co-morbidity of other family members, history of treatment, underlying disease, and diagnostic measures were collected using the patients' information listed in the Health Ministry portal. The Box-Jenkins approach was applied to fit the SARIMA model for CL incidence from 2009 to 2020. All statistical analyses were done by using Minitab software version 14. RESULTS The mean age of patients was 28.2 ± 21.3 years. The highest and lowest annual incidence of leishmaniasis were in 2018 and 2017, respectively. The average ten-year incidence was 132 per 100,000 population. The highest and lowest incidence of the disease were 592 and 195 for 100,000 population in the years 2011 and 2017, respectively. The best model was SARIMA (3,1,1) (0,1,2)4 (AIC: 324.3, BIC: 317.7 and RMSE: 0.167). CONCLUSIONS This study suggested that time series models would be useful tools for predicting cutaneous leishmaniasis incidence trends; therefore, the SARIMA model could be used in planning public health programs. It will predict the course of the disease in the coming years and run the solutions to reduce the cases of the disease.
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Affiliation(s)
- Mostafa Majidnia
- Student Research Committee, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
| | - Zahra Ahmadabadi
- Student Research Committee, School of Medicine, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Poneh Zolfaghari
- Vice-chanceller of Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ahmad Khosravi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
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OUP accepted manuscript. Trans R Soc Trop Med Hyg 2022; 116:832-844. [DOI: 10.1093/trstmh/trac025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 12/27/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
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Ihsanullah M, Yousuf MJ, Ahmad N, Masood Z, Majeed S, Hassan HU, Ibrahim M, Khooharo AR, Khooharo E, Mastoi AH, Zafar N, Shaikh FM. Prevalence of cutaneous leishmaniasis in the largest populated city Karachi, Pakistan. BRAZ J BIOL 2021; 83:e247583. [PMID: 34932616 DOI: 10.1590/1519-6984.247583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 06/04/2021] [Indexed: 11/22/2022] Open
Abstract
The study was undertaken from September 2018 to April 2019 to determine the prevalence of cutaneous leishmaniasis in human beings living in six districts of Karachi. Suspected persons were screened for the disease and positive cases were identified on the basis of skin lesions and blood samples. Samples were observed by mounting their smear. A total of 207 subjects of different ages and sex groups were investigated, however, only 192 (92%) of the suspected cases were found to have the disease 64% of cases were male which were significantly high (p 0.05), than female 36%. The lesion was more frequently detected among the youth ages of 21-30 years (31%) as compared to other groups. In both sexes, legs were found to be more infected (25% male + 20% female) followed by arms (20% male + 0% female) and face (15% male +11% female). The mixed body parts had shown the lowest infections such as (4% in males + 5%) in females. In conclusion, the highest and lowest leishmaniasis infections were observed in District West (23% male + 9% female) followed by District East (15% male + 7% female), District Malir (11% male+ 4% female), District Central (7% male + 5% female), District Korangi (4% male + 7% female) and District South (4% male + 4% female) respectively.
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Affiliation(s)
- M Ihsanullah
- University of Karachi, Department of Zoology, Karachi-75270, Pakistan
| | - M J Yousuf
- University of Karachi, Department of Zoology, Karachi-75270, Pakistan
| | - N Ahmad
- Aquatic Diagnostic e Research Center Bahria University, Karachi-75260, Pakistan
| | - Z Masood
- Department of Zoology, Sardar Bahadur Khan Women's University Quetta Balochistan, Pakistan
| | - S Majeed
- Aquatic Diagnostic e Research Center Bahria University, Karachi-75260, Pakistan
| | - H Ul Hassan
- University of Karachi, Department of Zoology, Karachi-75270, Pakistan
| | - M Ibrahim
- University of Karachi, Department of Zoology, Karachi-75270, Pakistan
| | - A R Khooharo
- Centre of Excellence in Marine Biology University of Karachi, Karachi-75270, Pakistan
| | - E Khooharo
- Regional Training Institute Karachi, Population Welfare Department Government of Sindh, Pakistan
| | - A H Mastoi
- Faculty of Agriculture, Lasbela University of Agriculture, Water and Marine Science, Uthal Balochistan, Pakistan
| | - N Zafar
- Institute of Skin Diseases, Sindh, Karachi, Pakistan
| | - F M Shaikh
- Institute of Skin Diseases, Sindh, Karachi, Pakistan
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Khan K, Khan NH, Anwar F, Ullah I, Badshah N, Irfan I, Iqbal K, Shah I, Aziz ST, Khan MSN, Shah SU. Characterization of sand fly breeding sites in district Malakand, Khyber Pakhtunkhwa, Pakistan, and evaluation of risk factors for cutaneous leishmaniasis in the region. Zoonoses Public Health 2021; 69:33-45. [PMID: 34510761 DOI: 10.1111/zph.12893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 11/29/2022]
Abstract
Present study was carried to determine the sand fly species composition, breeding sites ecology, seasonal abundance, and spatial distribution in district Malakand, Khyber Pakhtunkhwa, Pakistan. In addition, risk factors associated with cutaneous leishmaniasis (CL) were also evaluated. Survey of indoor and outdoor habitats was carried out using sticky traps in 31 villages of Dargai and Batkhela tehsils of Malakand. Soil from habitats of adult and immature sand flies was analysed. Questionnaire-based household survey was also performed in these villages to assess risk factors associated with CL. Soil samples from selected CL positive households were analysed for its contents. Additionally, clinicoepidemiological data from local health centres was examined for the year 2019. Total of 3,140 sand flies belonging to 18 species were collected. Phlebotomus sergenti was the most abundant species (38.16%). Its abundance had a strong positive correlation with mean monthly relative humidity and negative correlation with average temperature. Phlebotomus sergenti and Phlebotomus papatasi were abundant at an elevation ranging from 320 to 1,120 m above sea level and in agricultural lands near human settlements. Flight height preference apparatus collected maximum sand flies at 30 cm (1ft) above the ground and all species associated negatively with height. Soil analysis from habitats of adult and immature flies showed that highest mean number of adults and immatures were recorded from silt loam which carried highest concentrations of K2 O, Mg, Ca, and Zn. Number of immature sand flies correlated moderately (r = .7, p < .05) with K2 O soil concentrations. There was significant similarity between organic matter contents in soil samples from positive breeding sites and CL households (Wilcoxon rank-sum test, p = .1976). In multivariate analysis model for CL risk factors, age (26-35 and >35 years), knowledge of leishmaniasis, living in a middle and upper class, preachers visit to villages, and assumption that Afghan refugees are more prone to CL were significant. CL patient's archived data from health centres showed that majority of patients had lesions on face and hands. Patient's influx was highest in February and March.
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Affiliation(s)
- Khurshaid Khan
- Department of Zoology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Nazma Habib Khan
- Department of Zoology, University of Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Farhat Anwar
- Department of Zoology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Ihtisham Ullah
- Department of Zoology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Noor Badshah
- Department of Zoology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Irfan Irfan
- Department of Zoology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Khalid Iqbal
- Department of Zoology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Ibrar Shah
- Department of Zoology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Shah Tariq Aziz
- Department of Zoology, Abdul Wali Khan University Mardan, Khyber Pakhtunkhwa, Pakistan
| | | | - Safeer Ullah Shah
- National Centre of Excellence in Geology, University of Peshawar, Khyber Pakhtunkhwa, Pakistan
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Lehlewa AM, Khaleel HA, Lami F, Hasan SAF, Malick HA, Mohammed RH, Abdulmottaleb QA. Impact of Modifiable Risk Factors on the Occurrence of Cutaneous Leishmaniasis in Diyala, Iraq: Case-Control Study. JMIRX MED 2021; 2:e28255. [PMID: 37725543 PMCID: PMC10414455 DOI: 10.2196/28255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/25/2021] [Accepted: 05/16/2021] [Indexed: 09/21/2023]
Abstract
BACKGROUND In 2018, an outbreak of cutaneous leishmaniasis (CL) occurred in Diyala Province in Iraq. Several risk factors of CL were identified in a prior study; however, the impact of removing modifiable risk factors on the occurrence of the disease was not measured. OBJECTIVE The aim of this study is to measure the impact of removing modifiable risk factors of CL on the occurrence of the disease. METHODS We conducted a population-based unmatched case-control study in two conveniently selected districts in Diyala Province. All cases of CL were included. Controls were chosen preferentially according to the site where the cases occurred. A structured questionnaire was used to collect data. The unadjusted odds ratios (ORs) and 95% confidence intervals for each risk factor were calculated using binary logistic regression. We also calculated the attributable fractions and 95% confidence intervals of the modifiable risk factors. A P value <.05 was considered statistically significant. RESULTS Data from 844 persons (432 cases, 51.2%) were analyzed. Cases were more likely than controls to report a history of previous displacement (OR 5.18, 95% CI 3.84-6.98), electricity supply for less than 12 hours per day (OR 1.94, 95% CI 1.47-2.55), living in a rural area (OR 1.91, 95% CI 1.45-2.51), living in a clay house (OR 2.41, 95% CI 1.59-3.66), having an unpainted indoor living space (OR 2.14, 95% CI 1.51-3.02), having rodents inside the house (OR 5.15, 95% CI 3.56-7.47), having chickens, sheep, or both (OR 3.44, 95% CI 2.48-4.75), having a mixture of dogs and sheep or of dogs and chickens within a distance of less than 100 meters (OR 3.92, 95% CI 2.59-5.94), fogging (OR 2.11, 95% CI 1.40-3.19), bed net use (OR 1.72, 95% CI 1.08-2.72), and sleeping outside or a mixture of inside and outside (OR 4.01, 95% CI 1.32-12.19). The data show that the exposure of approximately 70% to 80% of cases was associated with displacement, the presence of rodents inside the house, the presence of animals within 100 meters of the house, the presence of animals (chickens/sheep/both or a mixture of dogs and sheep or of dogs and chickens), and sleeping outside. Approximately 40%-50% of the cases reported living in a clay house, living in a rural area, having an unpainted indoor space, having an electricity supply for less than 12 hours, and using a bed net. CONCLUSIONS Prevention and control of CL requires a multifaceted approach that relies on changing environmental conditions, housing conditions, and human behavior. Fogging and bed net use were not effective because the underlying housing characteristics and human behavior provided a good culture for the disease. We recommend conducting a study to identify the species, reservoirs, and vectors of CL in Iraq; studying vector behaviors before applying environmental control measures; and educating the public on how and when to use bed nets as well as how to accompany their use with behavioral changes.
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Affiliation(s)
| | - Hanan Abdulghafoor Khaleel
- Communicable Diseases Control Center, Public Health Directorate, Ministry of Health of Iraq, Baghdad, Iraq
| | - Faris Lami
- Department of Community and Family Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Saif Aldeen Falah Hasan
- Communicable Diseases Control Center, Public Health Directorate, Ministry of Health of Iraq, Baghdad, Iraq
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Kayani B, Sadiq S, Rashid HB, Ahmed N, Mahmood A, Khaliq MS, Maqsood R, Rashid H, Hasan S, Mushtaq MH, Zia UUR, Chaudhry M. Cutaneous Leishmaniasis in Pakistan: a neglected disease needing one health strategy. BMC Infect Dis 2021; 21:622. [PMID: 34193071 PMCID: PMC8243581 DOI: 10.1186/s12879-021-06327-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/16/2021] [Indexed: 11/21/2022] Open
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. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-021-06327-w.
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Affiliation(s)
- Behzad Kayani
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Shakera Sadiq
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Hamad Bin Rashid
- Department of Clinical Medicine and Surgery, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Naseer Ahmed
- District Health Development Center, Jhelum, Pakistan
| | - Altaf Mahmood
- Directorate of Animal Disease, Diagnostic, Reporting, and Surveillance, Livestock and Dairy Development Department, Government of Punjab, Lahore, Pakistan
| | - Muhammad Shakeel Khaliq
- Directorate of Animal Disease, Diagnostic, Reporting, and Surveillance, Livestock and Dairy Development Department, Government of Punjab, Lahore, Pakistan
| | - Rubab Maqsood
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Haroon Rashid
- Department of Microbiology, Faculty of Veterinary Sciences, Islamia University Bahawalpur, Bahawalpur, Pakistan
| | - Saima Hasan
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Muhammad Hassan Mushtaq
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Ubaid-Ur-Rehman Zia
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Mamoona Chaudhry
- Department of Epidemiology and Public Health, University of Veterinary and Animal Sciences, Lahore, Pakistan.
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Rassi Y, Ebrahimi S, Abai MR, Vatandoost H, Akhavan AA, Afshar AA. Comparative Testing of Susceptibility Levels of Phlebotomus sergenti, the Main Vector of Anthroponotic Cutaneous Leishmaniasis, to Conventional Insecticides Using Two Capture Methods in Kerman City, Southeastern Iran. J Arthropod Borne Dis 2021; 15:82-96. [PMID: 34277858 PMCID: PMC8271233 DOI: 10.18502/jad.v15i1.6488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 03/13/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Collecting live sand flies from indoor sites is a major challenge for researchers in large cities due to the reluctance of families to survey their homes. This study was conducted to assess the efficacy of two methods for collecting sand flies for use in susceptibility tests in the urban area of Kerman, southeastern Iran. Methods: Sandflies were mainly collected using both baited traps and hand catch methods from outdoor and indoor sites. Susceptibility tests were separately done according to the standard World Health Organization testing protocol on Phlebotomus sergenti, including 60-minute exposure to DDT 4.0%, propoxur 0.1%, deltamethrin 0.05%, and malathion 5.0%. Results: During this research, the natural habitats and suitable indoor sites were selected to predict the density of live sand fly with perfect accuracy. The number of live Ph. sergenti caught by hand catch and baited traps methods was 42 and 361 in indoor and outdoor sites, respectively. The mortality rate of Ph. sergenti exposed to DDT 4%, deltamethrin 0.05, malathion 5%, and propoxur was 100%. Conclusion The baited traps showed a significant efficiency compared to hand catch for collecting live Ph. sergenti for use in susceptibility tests in urban areas. The Ph. sergenti collected from both indoor and outdoor sites were susceptible to all insecticides.
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Affiliation(s)
- Yavar Rassi
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahla Ebrahimi
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Abai
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Environmental Chemical Pollutants and Pesticides, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Vatandoost
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Environmental Chemical Pollutants and Pesticides, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Ahmad Akhavan
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Department of Environmental Chemical Pollutants and Pesticides, Institute for Environmental Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Abass Aghaie Afshar
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
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11
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Wahid S, Khan K, Khan NH. Sand Fly (Diptera: Psychodidae) Species Diversity, Habitat Preferences, and Ecological Aspects of Distribution in Bajaur District, Khyber Pakhtunkhwa, Pakistan. JOURNAL OF MEDICAL ENTOMOLOGY 2020; 57:1432-1439. [PMID: 32221548 DOI: 10.1093/jme/tjaa050] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Indexed: 06/10/2023]
Abstract
The species composition, distribution, and bionomics of sand flies was investigated from January to December 2017 in four tehsils (20 villages) of district Bajaur (formally Bajaur agency), Khyber Pakhtunkhwa, Pakistan. In total, 4,173 adult specimens comprising of seven species of Phlebotomus (Diptera: Psychodidae) and three species of Sergentomyia (Diptera: Psychodidae) were collected by oral aspirator, insecticide spray, and sticky traps from June to October. Highest numbers of flies were collected indoors in July and August when relative humidity and temperature were highest. Phlebotomus sergenti Parrot (Diptera: Psychodidae) was the most abundant species from all the collection sites, making approximately 70% of the total capture. Combined dwellings and chicken cages harbored the highest number of adult and immature flies (unrotated external genitalia). Abundance of P. sergenti had a significant (P ≤ 0.05) positive correlation with monthly average temperature, relative humidity, and average rainfall in indoor collections. On the other hand, P. papatasi Scopoli displayed similar correlation in the indoor and nighttime collections. Both the species were apparently abundant in the elevation range ≤ 419 m above sea level and on rangelands. Phlebotomus papatasi, however, also occurred on agricultural lands. The number of cutaneous leishmaniasis (CL) cases did not significantly correlate with the abundance of sand fly vectors across the villages surveyed. The results reported herein can serve as a baseline for an all-extensive future work in Bajaur. Our investigations will benefit the public health experts and medical entomologists for improved control and surveillance vectors of leishmaniasis.
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Affiliation(s)
- Shah Wahid
- Department of Zoology, Abdul Wali Khan University, Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Khurshaid Khan
- Department of Zoology, Abdul Wali Khan University, Mardan, Khyber Pakhtunkhwa, Pakistan
| | - Nazma Habib Khan
- Department of Zoology, University of Peshawar, Peshawar, Khyber Pakhtunkhwa, Pakistan
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12
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Environmental and socioeconomic risk factors associated with visceral and cutaneous leishmaniasis: a systematic review. Parasitol Res 2020; 119:365-384. [PMID: 31897789 DOI: 10.1007/s00436-019-06575-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/10/2019] [Indexed: 12/11/2022]
Abstract
We performed a systematic review of the literature published since 1900 about leishmaniasis a neglected vector-borne disease, focused on environmental and social risk factors for visceral (VL) and cutaneous leishmaniasis (CL) to better understand their impact on the incidence of disease. The search terms were "leishmaniasis" AND "risk factors" using Google Scholar, PudMed, and Scielo. We reviewed 177 articles, 95 studies for VL, 75 for CL, and 7 on both forms. We identified 14 categories of risk factors which were divided into three groups: socioeconomic (7), environmental (5), and climate (2) variables. Socioeconomic factors were also associated with disease incidence in vulnerable human populations of arid and tropical developing regions. Environmental and climate factors showed significant associations with the incidence of VL and CL in all the studies that considered them. Proximity to natural vegetation remnants increased disease risk in both the New and Old World while the climate conditions favorable for disease transmission differed among regions. We propose a common conceptual framework for both clinical forms that highlights networks of interaction among risk factors. In both clinical forms, the interplay of these factors played a major role in disease incidence. Although there are similarities in environmental and socioeconomic conditions that mediate the transmission cycle of tropical, arid, and Mediterranean regions, the behavior of vector and reservoirs in each region is different. Special attention should be given to the possibility of vector adaptation to urban environments in developing countries where populations with low socioeconomic status are particularly vulnerable to the disease.
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13
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Aflatoonian MR, Sharifi I, Aflatoonian B, Bamorovat M, Heshmatkhah A, Babaei Z, Ghasemi Nejad Almani P, Mohammadi MA, Salarkia E, Aghaei Afshar A, Sharifi H, Sharifi F, Khosravi A, Khatami M, Arefinia N, Fekri A, Farajzadeh S, Khamesipour A, Mohebali M, Gouya MM, Shirzadi MR, Varma RS. Associated-risk determinants for anthroponotic cutaneous leishmaniasis treated with meglumine antimoniate: A cohort study in Iran. PLoS Negl Trop Dis 2019; 13:e0007423. [PMID: 31188834 PMCID: PMC6590833 DOI: 10.1371/journal.pntd.0007423] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 06/24/2019] [Accepted: 04/29/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The control of cutaneous leishmaniasis (CL) is facilitated by knowledge of factors associated with the treatment failures in endemic countries. The aim of this evaluation was to identify the potential risk determinants which might affect the significance of demographic and clinical characteristics for the patients with anthroponotic CL (ACL) and the outcome of meglumine antimoniate (MA) (Glucantime) treatment. METHODOLOGY/PRINCIPAL FINDINGS This current was executed as a cohort spanning over a period of 5 years which centered in southeastern part of Iran. Altogether, 2,422 participants were evaluated and 1,391 eligible volunteer patients with ACL caused by Leishmania tropica were included. Overall, 1,116 (80.2%) patients received MA intraleisionally (IL), once a week for 12 weeks along with biweekly cryotherapy, while 275 (19.8%) patients received MA alone (20 mg/kg/day for 3 weeks) (intramuscular, IM). The treatment failure rate in ACL patients was 11% using IL combined with cryotherapy plus IM alone, whilst 9% and 18.5% by IL along with cryotherapy or IM alone, respectively. Multivariate logistic regression model predicted 5 major associated-risk determinants including male (odds ratio (OR) = 1.54, confidence interval (CI) = 1.079-2.22, p = 0.018), lesion on face (OR = 1.574, CI = 1.075-2.303, p = 0.02), multiple lesions (OR = 1.446, CI = 1.008-2.075, p = 0.045), poor treatment adherence (OR = 2.041, CI = 1.204-3.46, p = 0.008) and disease duration > 4 months (OR = 2.739, CI = 1.906-3.936, p≤0.001). CONCLUSIONS/SIGNIFICANCE The present study is the original and largest cohort of ACL patients who treated with MA. A comprehensive intervention and coordinated action by the health authorities and policy-makers are crucial to make sure that patients strictly follow medical instructions. Early detection and effective therapy < 4 months following the onset of the lesion is critical for successful treatment of the patients. Since a significant number of patients are still refractory to MA, reducing man-vector exposure and development of new effective alternative drugs are essential measures against ACL due to L. tropica.
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Affiliation(s)
- Mohammad Reza Aflatoonian
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | - Iraj Sharifi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Behnaz Aflatoonian
- Research Center of Tropical and Infectious Diseases, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Bamorovat
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Amireh Heshmatkhah
- Shahid Dadbin Clinic, Kerman University of Medical Sciences, Kerman, Iran
| | - Zahra Babaei
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Mohammad Ali Mohammadi
- Research Center for Hydatid Disease in Iran, Kerman University of Medical Sciences٫ Kerman, Iran
| | - Ehsan Salarkia
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Aghaei Afshar
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Fatemeh Sharifi
- Pharmaceutics Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Ahmad Khosravi
- Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehrdad Khatami
- School of Medicine, Bam University of Medical Sciences, Bam, Iran
| | - Nasir Arefinia
- Shahid Dadbin Clinic, Kerman University of Medical Sciences, Kerman, Iran
| | - Alireza Fekri
- Department of Dermatology, Afzalipour Hospital, Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Saeideh Farajzadeh
- Department of Dermatology, Afzalipour Hospital, Leishmaniasis Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Rajender S. Varma
- Regional Centre of Advanced Technologies and Materials, Faculty of Science, Palacký University in Olomouc, Šlechtitelů 27, Czech Republic
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Khan K, Wahid S, Khan NH, Ali N. Potential Resting and Breeding Sites of Sand Flies (Diptera: Psychodidae) and Their Habitat Characteristics in Leishmaniasis Foci of Dir Districts, Khyber Pakhtunkhwa, Pakistan. JOURNAL OF MEDICAL ENTOMOLOGY 2017; 54:1390-1396. [PMID: 28874012 DOI: 10.1093/jme/tjx098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Indexed: 06/07/2023]
Abstract
Despite their medical importance, natural breeding sites of sand flies have been poorly explored. Detecting such sites is imperative in vector control strategies. This study aimed to identify potential breeding and resting microhabitats of sand flies and household risk factors associated with cutaneous leishmaniasis transmission in Dir districts, Khyber Pakhtunkhwa, Pakistan. Survey of indoor and outdoor habitats in four tehsils (subdistricts) of upper and lower Dir districts was carried out using sticky traps, flit method, and aspirator. To assess risk factors associated with cutaneous leishmaniasis (CL), questionnaires were administered to household heads. Mud houses and plants belonging to Cucurbitaceae family sheltered highest number of sand flies. Excessive number of flies were collected from indoor sites (common rooms used for both people and animals) compared to outdoor habitats (cattle dungs). Phlebotomus salangensis Artemiev, 1978 and Phlebotomus sergenti were the most widely distributed species, while Sergentomyia bailyi peaked in caves with high organic content in soil. Roof material and ownership of fans were associated with significant risk of CL. Findings of this study present a list of potential breeding sites for sand flies and CL risk factors that can be targeted and implemented in control programs for CL. Further studies are required to elucidate the breeding behavior and preferences of these medically important vectors.
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Affiliation(s)
- Khurshaid Khan
- Department of Zoology, University of Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Sobia Wahid
- Department of Zoology, University of Peshawar, Khyber Pakhtunkhwa, Pakistan
| | - Nazma Habib Khan
- Department of Zoology, University of Peshawar, Khyber Pakhtunkhwa, Pakistan
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