A clinical study of cutaneous leishmaniasis in a new focus in the Kurdistan region, Iraq

Leishmaniasis is caused by protozoan parasites of the genus Leishmania and is a major health problem in various parts of the world. Cutaneous leishmaniasis (CL) occurs, among others, in unpredictable outbreaks after wars and disasters. After the last war in Iraq, the collapse of the health system led to the spread of infectious diseases, including CL. Between September 2016 and November 2017, all patients with confirmed CL having one or more skin lesion(s) were referred to a regional health center in Musol City within the Rabeea District. During this period, 1539 patients visited the clinic. A total of 190 patients were excluded from the study because of poor follow-up. The treatment success rate was 97.7% (1319/1349). Statistically significant associations were found between number of lesions and treatment failure (p = 0.0018; OR = 1.4430; CI = 1.1466-1.8161), number of doses and number of lesions (Pearson's correlation coefficient = 0.095; p = 0.001), and the lack of municipality services and number of doses used for the treatment (p = 0.008; OR = 1.0629; CI = 1.0158-1.1122). To conclude, the highest number of patients with CL in the city of Musol was recorded after the war in Iraq. The treatment success rate was high, which reflected the strict treatment and follow-up program. An urgent plan is needed to stop the spread of infection.