Risk factors of Cutaneous Leishmaniasis (CL) caused by L. tropica: a case-control study in PalestineIkram Salah

Ikram Salah, N Davidovitch, B Kotler

Research output: Contribution to conferenceAbstract


Leishmaniasis is still considered as a neglected disease by the World Health Organization. This study applies an eco-health approach that integrates public health measures, epidemiology, and disease ecology to study CL caused by Leishmania tropica in the West Bank.
The study was conducted in Tubas district (northeast of the West Bank). The district was divided to three different sites according to their urbanization and socio-economic status. A matched Case-Control study was conducted in the endemic sites. Questionnaires were used to determine the epidemiological risk factors.

There was a significant difference in age distribution (p = 0.022) of cases between the three sites. The city and villages cases were males in majority, while Bedouin cases were mostly females. The peak temporal distribution of cases was in December-January months. In the urban setting controls tend to use insect repellents (p = 0.044), and spraying inside their houses (p = 0.022) more than cases. Houses of cases were significantly closer to the village’s edge than controls (p = 0.0001). Other risk factors include: living closer to farms (p = 0.0001), raising domestic animals (p = 0.017), seeing hyraxes in vicinity of houses (p = 0.0001), and the distance of hyrax colony from houses (p = 0.0001). In the rural setting risk factors include living closer to the village edge (p = 0.05). In the Bedouin area risk factor includes living closer to hyrax colonies (p = 0.037).
In more urbanized sites, the effect of living next to the site’s edges, facing the wadies and open green areas, increase the exposure to vector (sand-fly), and proximity to the reservoir (hyrax) colonies. In addition high density of reservoir, proximity to human houses, as well as high density of vector, with the absence of personal protection against the vector, increased the risk of disease transmission. These risk factors must be included in future interventions to reduce CL incidence.
Original languageEnglish
StatePublished - 2016


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