The Sociodemographic, Living and Environmental Characteristics of Patients with Cutaneous Leishmaniasis

Background: Cutaneous leishmaniasis is a parasitic skin disease caused by various leishmaniasis species. Material and Methods: In this study, the clinical, sociodemographic, living and environmental characteristics of 4048 cutaneous leshmaniasis patients are presented. A retrospective evaluation was made of 4048 cutaneous leishmaniasis patients in terms of gender, lesion diameter (mm), number of lesions, duration of lesions (weeks) and living conditions, then statistical analysis was applied. Results: The cutaneous leismaniasis patients comprised 52.47% female and 47.53% males with a mean age of 16.48±0.23 years. The mean duration of the disease was 9.62±0.33 weeks, lesion diameter was 12.197±0.10 mm and mean number of lesions was 1.75±0.02. The number of people in the patient’s family was generally 5-10 and the number of rooms in the house was 2-3 for 70.63% of patients. The vast majority of the cutaneous leishmaniasis patients, 96.96%, lived in a lowland plains area and no patient lived in wetlands. The types of houses were of concrete construction in 94.94% and stone in 1.61% and 1.41% lived in an apartment block. Animals were reported to be kept in the living area of 17.02% of patients and of those, 2.30% had a WC. Conclusion: The determination of an excessive number of Phlebotomus in areas of low socio-economic living conditions and the high incidence of cases in these areas has revealed a direct, positive relationship between cutaneous leishmaniasis disease and the socio-economic conditions of the patients. Page 1 of 6 (page number not for citation purposes) J Turk Acad Dermatol 2016; 11 (1): 17111a1. http://www.jtad. org/2017/1/jtad17111a1.pdf Page 2 of 6 (page number not for citation purposes) has been determined [5,6]. According to the Ministry of Health, approximately 45% of the cases of CL in Turkey in the last 20 years, in the province of Şanliurfa in particular, have been seen to originate in areas of highly unplanned residences without sufficient infrastructure [7]. Two types of sandfly species (Phlebotomus spp) are responsible for the spread of CL disease; the vector sandfly Lutzomyia for New World CL seen on the American continent and the vector sandfly Phlebotomus (Phlebotomus papatasi and Phlebotomus sergenti) for Old World CL seen in the Mediterranean region [8]. While Phlebotomus sergenti is accepted as the vector for Leishmania tropica, Phlebotomus papatasi is accepted as the vector for Leishmania major [9,10,11]. The agent often causing CL disease seen in the province of Şanliurfa has been shown to be Leishmania tropica [8,10,12,13,14,15]. The aim of this study was to make a retrospective examination of the clinical and socio-demographic characteristics and living environments of 4048 CL patients recorded in Turkey at Şanliurfa Public Health Centre and Harran University Medical Faculty Dermatology Clinic. Material and Methods A retrospective evaluation was made of the records of 4048 CL patients registered at Şanliurfa Public Health Centre and Harran University Medical Faculty Dermatology Clinic between 1998 and 2004. Approval for the study was granted by the Local Ethics Committee. An examination was made of the age (years) of the CL patients, gender, lesion diameter (mm), number of lesions, duration of lesions (months) and living conditions. The data were statistically evaluated. Diagnosis of CL disease was made from clinical appearance of the patient, and positive demonstration of Leishmania with laboratory tests (parasites-amastigotes-in skin smears). When there were difficulties in diagnosis, laboratory tests such as polymerase chain reaction and immune fluorescent antibody techniques were of benefit in the evaluation of the histopathological results. Statistical evaluation In the statistical evaluation of the data, the SAS 9.12 statistical software program was used. For examination of the variables in the study, firstly descriptive statistical calculations were made. Then, to establish differences between the characteristics of the groups such as age, gender, duration of the disease, lesion type, localization and diameter, the proportions test was used. A value of p<0.05 was accepted as statistically significant.