A Comparison of Demographic and Clinical Characteristics of Syrian and Turkish Patients with Cutaneous Leishmaniasis

Abstract

Abstract. Cutaneous leishmaniasis (CL) is a significant public health problem with increasing incidence, especially in extreme circumstances. In this study, we compared the sociodemographic and clinical characteristics of 685 Syrian CL patients afflicted by the Syrian conflict and 685 Turkish CL patients in 2012. Patient age, gender, duration of disease, lesion size, type, and localization were evaluated. The duration of CL disease in Syrian CL patients (4.5 ± 4.3 weeks) was shorter than that of Turkish CL patients (11.9 ± 9.7 weeks). The number of lesions was greater in Syrian patients (2.46 ± 2.43) than in Turkish patients (1.93 ± 1.47). Lesion sizes were comparable between both groups (Syrian, 11.2 ± 8.7 mm; Turkish, 10.7 ± 7.7 mm). In Syrian CL patients, nodular type lesions were the most common (325 patients, 49.1%), whereas, in Turkish CL patients, ulcer type lesions were the most common (352 patients, 51.5%). Our results indicate variations in the clinicoepidemiological features of CL between Turkish and Syrian patients within Sanliurfa province. This highlights the impact of social unrest and environmental conditions on the epidemiology of CL within this region. Approaches to prevention, control, and treatment of CL in these areas should take into consideration the emerging changes in clinicoepidemiological parameters of the disease.

Cutaneous Leishmaniasis: Evaluation of 117 Syrian Immigrants

“…The head and neck region and also the upper extremities were determined to be the most frequent areas of the lesions in the previous studies. [3][4][5][6][7][8] Consistent with these findings, the majority of the lesions were located on the face and extremities in our patients. This finding was not a surprise, as the sandfly could easily bite the uncovered areas of the body at nighttime.…”

“…In the studies conducted in Turkey after the beginning of the civil war, it was found out that more than 50 % of the patients were younger than 20 years. [4][5][6]8 Consistent with the literature, most of the patients in this study were children and young adults. This finding suggests inadequate hygiene practices among these age groups especially due to the war conditions, higher exposure to the sandfly bites due to their higher stay in rural areas and spending more time outdoors and low immunity due to lack of exposure with the cause of the disease.…”

“…Similar with recent studies, the ratio of the female patients were higher than the male patients in this study. [4][5][6]8 The reason for this result might be the relatively higher loss of the males under the war conditions, and the remaining staying of the males in their home country as fighters.…”

“…They suggested that the higher number of lesions in Syrian patients depends on multiple bites by sandfly vector due to unprotected tent camps. 8 In the studies focused on a large number of CL patients from Syria and the world before the start of the war, one or two lesions per patients were usually reported. [11][12][13] In the present study, the reasons for the high number of the patients with multiple lesions might be the unfavorable living conditions of the immigrants and difficulties to access to essential therapy.…”

“…After this intensive wave of immigration, in several studies, it is reported that CL cases were increased in both endemic and non-endemic regions of Turkey. [3][4][5][6][7][8] An outpatient department specific for Syrian leishmaniasis patients was opened in our clinic in parallel with the increased number of immigrants in Ankara.…”