THE FREQUENCY OF OLD WORLD CUTANEOUS LEISHMANIASIS IN SKIN ULCERS IN PESHAWAR
AbstractBackground: Old World Cutaneous Leishmaniasis (OWCL) is a preventable skin infection that leadsto morbidity and social isolation. It is spreading rapidly. The sore of OWCL may be a non-ulcerativered papule, nodule or a large mutilating ulcer. The ulcer is typically painless and can leave a disfiguringscar. Methods: This was a descriptive study. The diagnosis of OWCL was established by finding LDbodies in skin smear preparation. Results: This study identified 1680 cutaneous leishmaniasis in 1767skin ulcers. Children (n=924) were infected more than other age groups (n=756). There were typicalskin sore of OWCL in 1512 cases while 168 patients had atypical presentation. The ulcers werepainless in 1603 patients. History of insect bite was present in 1366 cases, thorn prick in 156 patients,religious visit to endemic areas in 256 patients, and 4 patients had post surgical non healing wound.Lesions with 4 to 6 months of age had a maximum yield of LD bodies. There were 498 patients fromdifferent areas of Peshawar; 688 cases from leishmania endemic belt of FATA while 89 patients camefrom other urban and rural areas of NWFP. Conclusions: There is a tremendous increase in cases ofOWCL and the disease became endemic in many regions of Pakistan. The bordering areas alongAfghanistan have constituted an endemic belt that had invaded the neighboring urban and rural areas.Several chronic non healing ulcers had been diagnosed as OWCL. Many cases have been detected inPeshawar. People need education about the nature of the diseases and the efficacy of personalprotective measures. Spray with suitable insecticides is required in all residential areas.Keywords: Leishmaniasis, sand flies, amastigote, non-healing ulcers, disfiguring scar
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