Spatial Epidemiology and Clinical Characteristics of Cutaneous Leishmaniasis in District Lakki Marwat, Pakistan: A Comprehensive Study Utilizing GIS and Entomological Surveys

Javeria Rafiq; Farrah Zaidi; Salahuddin Khan; Syeda Hira Fatima

doi:10.53941/ecdd.2026.100007

Abstract

Objective: The study investigates the Phlebotominae species, epidemiological patterns, and spatial distribution of cutaneous leishmaniasis (CL) in district Lakki Marwat, Pakistan. Method: An entomological survey was conducted in the main city and surrounding union councils (UCs) of Lakki Marwat to characterize Phlebotominae species. Epidemiological data for microscopically confirmed CL cases reported between March 2016 and May 2023 were obtained from the District Health Office, Lakki Marwat. Temporal trends in annual reported case counts were assessed using simple linear regression for the complete reporting years 2017–2022. Annual and cumulative UC-level reported incidence were calculated as cases per 1000 population using the 2023 census population as the denominator, and choropleth maps were generated in R (version 4.4.2) to examine spatial patterns. Results: Among 834 collected Phlebotominae specimens, Sergentomyia babu (29.37%) and Sergentomyia baghdadis (22.78%) were the most abundant species. A total of 2393 confirmed CL cases were reported during the epidemiological study period. Annual case numbers showed an overall upward pattern across the complete reporting years 2017–2022, with an estimated increase of 61.5 cases per year; however, the temporal trend was not statistically significant (p = 0.104, R² = 0.524). Spatial mapping showed variation in reported CL incidence across UCs, with relatively high incidence observed in some eastern and northern areas of the district, particularly in 2022. Conclusions: This study’s findings offer useful insights into the clinical characteristics of the affected population, as well as the epidemiology and spatial distribution of CL in the study area. This information may support targeted epidemiological surveillance, prevention, and control measures.

References

1.
Abadías-Granado, I.; Diago, A.; Cerro, P.A.; et al. Cutaneous and Mucocutaneous Leishmaniasis. Actas Dermo-Sifiliogr. 2021, 112, 601–618. https://doi.org/10.1016/j.adengl.2021.05.011.
2.
Wamai, R.G.; Kahn, J.; McGloin, J.; et al. Visceral leishmaniasis: A global overview. J. Glob. Health Sci. 2020, 2, e3. https://doi.org/10.35500/jghs.2020.2.e3.
3.
George, J.E. Isolation of Phlebotomus fever virus from Phlebotomus papatasi and determination of the host ranges of sandflies (Diptera: Psychodidae) in West Pakistan. J. Med. Entomol. 1970, 7, 670–676. https://doi.org/10.1093/jmedent/7.6.670.
4.
Rasheed, S.B.; Shah, M.Z. Molecular detection of Leishmania tropica in field-caught Phlebotomus sand flies (Diptera: Psychodidae) from cutaneous leishmaniasis endemic focus of Pakistan. J. Asia-Pac. Entomol. 2023, 26, 102129. https://doi.org/10.1016/j.aspen.2023.102129.
5.
World Health Organization. Leishmaniasis Fact Sheet. Available online: https://www.who.int/news-room/fact-sheets/detail/leishmaniasis (accessed on 10 February 2024).
6.
Ullah, W.; Yen, T.Y.; Niaz, S.; et al. Distribution and Risk of Cutaneous Leishmaniasis in Khyber Pakhtunkhwa, Pakistan. Trop. Med. Infect. Dis. 2023, 8, 128. https://doi.org/10.3390/TROPICALMED8020128.
7.
Khan, K.; Wahid, S.; Khan, N.H.; et al. Geospatial and climatic patterns associated with the distribution of sand fly (Diptera: Psychodidae) vectors of leishmaniasis in Pakistan. J. Med. Entomol. 2018, 55, 626–633. https://doi.org/10.1093/jme/tjx246.
8.
Trajer, A.J.; Grmasha, R.A. The potential effects of climate change on the climatic suitability patterns of the Western Asian vectors and parasites of cutaneous leishmaniasis in the mid- and late twenty-first century. Theor. Appl. Climatol. 2024, 155, 1897–1914. https://doi.org/10.1007/s00704-023-04726-4.
9.
Mansoor, A.; Afshan, K.; Nargis, G.; et al. Epidemiology and future risk estimates of cutaneous leishmaniasis in district Dera Ismail Khan, Pakistan: Analysis of data from 2019–2022. Afr. Health Sci. 2024, 24, 51–64. https://doi.org/10.4314/ahs.v24i4.8.
10.
Khan, M.; Ghayyur, S. Distribution, clinical features, and cutaneous leishmaniasis epidemiology: A District Haripur, KPK, Pakistan case study. Med. Rep. 2023, 2, 100025. https://doi.org/10.1016/J.HMEDIC.2023.100025.
11.
Khan, N.H.; Bari, A.U.; Hashim, R.; et al. Cutaneous leishmaniasis in Khyber Pakhtunkhwa province of Pakistan: Clinical diversity and species-level diagnosis. Am. J. Trop. Med. Hyg. 2016, 95, 1106–1114. https://doi.org/10.4269/ajtmh.16-0343.
12.
Zeb, I.; Qureshi, N.A.; Shaheen, N.; et al. Spatiotemporal patterns of cutaneous leishmaniasis in the district Upper and Lower Dir, Khyber Pakhtunkhwa, Pakistan: A GIS-based spatial approach. Acta Trop. 2021, 217, 105861. https://doi.org/10.1016/j.actatropica.2021.105861.
13.
Pakistan Bureau of Statistics. 7th Population and Housing Census 2023: Khyber Pakhtunkhwa, Table 1—Households, Population, Household Size and Annual Growth Rate; Government of Pakistan: Islamabad, Pakistan, 2023.
14.
Sales, K.G.D.S.; Miranda, D.E.D.O.; da Silva, F.J.; et al. Evaluation of different storage times and preservation methods on phlebotomine sand fly DNA concentration and purity. Parasit. Vectors 2020, 13, 399.
15.
Phuphisut, O.; Nitatsukprasert, C.; Pathawong, N.; et al. Sandfly identification and screening for Leishmania spp. in six provinces of Thailand. Parasit. Vectors 2021, 14, 352. https://doi.org/10.1186/S13071-021-04856-6.
16.
Wijerathna, T.; Gunathilaka, N. Morphological identification keys for adults of sand flies (Diptera: Psychodidae) in Sri Lanka. Parasit. Vectors 2020, 13, 450. https://doi.org/10.1186/S13071-020-04305-W.
17.
Pakistan Meteorological Department. Outlook for March–April–May (MAM), 2026; Government of Pakistan: Islamabad, Pakistan, 2026.
18.
Zaidi, F.; Fatima, S.H.; Jan, T.; et al. Environmental risk modeling and potential sand fly vectors of cutaneous leishmaniasis in Chitral district: A leishmanial focal point of Mount Tirich Mir, Pakistan. Trop. Med. Int. Health 2017, 22, 1130–1140. https://doi.org/10.1111/tmi.12916.
19.
Kassiri, H.; Javadian, E. Composition of the sand fly fauna in Khash County, Southeast Iran. J. Insect Sci. 2012, 12, 132. https://doi.org/10.1673/031.012.13201.
20.
Solomon, M.; Fuchs, I.; Glazer, Y.; et al. Gender and Cutaneous Leishmaniasis in Israel. Trop. Med. Infect. Dis. 2022, 7, 179. https://doi.org/10.3390/TROPICALMED7080179.
21.
Calderón-Anyosa, R.; Galvez-Petzoldt, C.; Garcia, P.J.; et al. Housing Characteristics and Leishmaniasis: A Systematic Review. Am. J. Trop. Med. Hyg. 2018, 99, 1547–1554. https://doi.org/10.4269/ajtmh.18-0037.
22.
Bamorovat, M.; Sharifi, I.; Agha Kuchak Afshari, S.; et al. Mutual Role of Patients and the Healthcare System in the Control of Cutaneous Leishmaniasis. Transbound. Emerg. Dis. 2023, 2023, 7814940. https://doi.org/10.1155/2023/7814940.

Scilight Press

Author Information

Abstract

Keywords

References

About Scilight

Journals

Publishing Policies

Contact Us