Epidemiological Features of Cutaneous Leishmaniasis in Zliten (North West of Libya)

Abstract

Cutaneous Leishmaniasis is endemic in north-west of Libya for long time and it’s spread to other new foci continues to involve new areas like Taurgha, Sirt and recently, Zliten. Most of the patients in north-west of Libya were infected with zoonotic Cutaneous Leishmaniasis, which caused by leishmania major, although some cases of anthroponotic cutaneous leishmaniasis caused by leishmania tropica were also reported. Zliten is a coastal city in the north west of Libya; with more than 289000 people; and now is known to be a new focus since 2016 when the sudden increase of the number of patients with Cutaneous Leishmaniasis had occurred. Aims: This study was performed to observe epidemiological changes about incidence, age of patients, geographical distribution in Zliten city over a period of last 2 year (2017 and 2018(. Study Design: Cross-sectional study as retrospective study over time of two years, involving all patients, who were presented or referred, to get management of Cutaneous Leishmaniasis,  in three accredited outpatient departments for cutaneous leishmania (in Zliten). The data were collected and analyzed in Zliten Teching Hospital. Place and Duration of Study: Outpatient Department of Dermatology and Venereology of Zliten Teaching Hospital between 1st January 2017 and 31st December 2018. Methodology: The study included all patients (different gender and from all age groups) with Cutaneous Leishmaniasis, who sought medical advice in dermatology reference clinics in Zliten, over the period of 2 years (2017 and 2018). The main collected data were age, sex, number of lesions, and affected sites in the body, residency of the patients, year and month of presentation. The analysis of data was made with the use of Statistical Package for the Social Sciences (SPSS 25). Results: Eight hundred thirty nine patients were included in this study. The majority of patients came from Zliten and these represented 95.6%, while the most of them came from Majer (south eastern part of Zliten City with more than 25000 people living in it) and represented 45.5% of total patients with CL included in this study, followed by Al-juma (south western part of Zliten with around 52000 people), represented (28%) of total patients with CL. Males were found to be more affected, with male to female ratio, 2.4:1. The most affected age group were these less than forty with peak incidence at age group (20 yrs to 30 yrs). The registered patients in 2017 were 397, this number had increased slightly to be 440 in the following year (2018). The distribution of patients had shown seasonal variations, with steep increase in the number of cases in December, November and January. Conclusion: Cutaneous Leishmaniasis is remained to be a major health problem in Zliten, affecting a large number of population every year and need further study to determine molecular identification of parasites, and more efforts are needed to control the vector and reservoir.