Occurrence Analysis of Cutaneous Leishmaniasis particularly in Pakistan

Cutaneous leishmaniasis is the known form of leishmaniasis affecting humans. It is a skin infection caused by protozoan parasite Leishmania from animals to human by the bite of a vector phlebotomine sand fly. About 21 species causing leishmaniasis depending on geographical distribution and host immunity. Population of northern areas of Pakistan are commonly affected by the disease. DNA microscopic

females with a ratio of 1.88. Face was most commonly affected site and most (65.21%) cases presented with single lesion. Nodules (40.87%), plaques (24.35%) and papules (7.39%) were commonly observed morphologies although mixed patterns and atypical forms were also found. Most (62.60%) cases presented within 1-3 months of lesion onset. All cases responded well to treatment with antimonials. Lesional pain, swelling, bleeding, pigmentation and scarring were minor post treatment side effects. Pancham K et al. [12]. Leishmaniasis in Yemen is still not fully investigated nor well studied. Outbreaks of CL in western highland declared. However, there are no reports concerning the disease and the circulating species in the region.
The aim of this study was to determine the prevalence of CL in Utmah district located in Western Highlands in Yemen. A crosssectional survey was carried out at those highlands. For the survey, 1165 participants were subjected to Leishmanin Skin Test (LST) accompanied with direct interviews and physical examination.
The overall prevalence of CL in the district was 18.5% and the CL was more frequent in the escarpments with a prevalence of 37%, including 5.5% for active lesion and 31.5% for scar of healed lesions. Children under the age of 16 years old comprised most of the CL cases (76.3%). According to this investigation the escarpments of western highlands in Yemen were hyper endemic areas for CL and the infection was more prevalent in children.
Mohammed MA et al. [3]. CL is endemic in Pakistan and is widely spreading day by day. Leishmaniasis is endemic in Jacobabad, Dadu and Larkana districts of Sindh Province. It was pointed out that the disease is dramatically spreading in the country and warned that if the preventive measures were not taken at right time there would be a serious public health problem in the country.
One study was conducted in the Department of Dermatology, Larkana. All the patients were aged between 3 months and 60 years. Seven hundred eighty were males and 860 were females.
Duration of the disease ranged from1 to 12 months. Most of the patients had single lesions but multiple lesions were also seen on the exposed (mainly) and unexposed parts of the body. Clinically, the lesions were classified as dry ulcerative, wet ulcerative, dry In Pakistan, an endemic country for CL, the possibility of CL should be kept in mind while diagnosing common dermatological diseases like erysipelas, chronic eczema, herpes zoster, paronychia; and uncommon disorders like lupus vulgaris, squamous cell carcinoma, sporotrichosis, mycetoma and other deep mycoses.
CL is the disease of a public health concern in Punjab, Pakistan.
The knowledge of how the population perceives the disease and its vector is essential in order to design an effective management strategy, but such studies are rare in Pakistan. The present study was based on a cross-sectional self-administered survey Some believed that summer was the main peak incidence of the disease and it could be transmitted from man to man via contact.
However, most of the respondents believed that the disease could be cured. Admission to hospitals, cleanliness and use of bed Atypical lesions were not significantly associated with the infecting Leishmania species, nor with "dry" or "wet" appearance of lesions.
Findings from this study provide a platform for species typing of CL patients in Pakistan, utilizing a combination of in vitro culture and molecular diagnostics. Moreover, the clinical diversity described herein can benefit clinicians in devising differential diagnosis of the disease. Nazma HK et al. [16].
One study in 2017 in Dir Lower District showed the overall incidence of CL was 21.1%. The prevalence was observed to be significantly higher among Afghans than the local population Writers concluded that there is a substantial gap between the burden of disease for NTDs in children and research devoted to this population. Most medications lack adequate pediatric prescribing information, highlighting the urgency to increase pediatric research activity for NTDs with high burden of disease and limited treatment options Chris AR et al. [21].