Effect of the Syrian Civil War on Prevalence of Cutaneous Leishmaniasis in Southeastern Anatolia, Turkey

Abstract

BackgroundCutaneous leishmaniasis (CL) is a vector-mediated skin disease, characterized by chronic wounds on the skin and caused by macrophages in protozoan parasites. It is an endemic disease in the southern and southeastern Anatolia region and is still an important public health problem in Turkey. Because of the civil war in Syria, immigrants to this region in the last 3 years have begun to more frequently present with this disease. The aim of this study was to draw attention to the dramatic increase in new cases with CL after the beginning of the civil war in Syria.Material/MethodsIn this retrospective study, we evaluated demographic, epidemiological, and clinical features of 110 patients diagnosed with cutaneous leishmaniasis who were admitted to the Department of Dermatology at Kahramanmaras Sutcu Imam University Faculty of Medicine between January 2011 and June 2014.ResultsA total of 110 patients included in the study; 50 (45%) were males, and 60 (55%) were females. The age range of the study group was 1–78 years, and the infection was more prevalent in the 0–20 year age group. Of these patients, 76 (69%) were Syrian refugees living in tent camps and 34 (31%) were Turkish citizens. The majority of the cases were diagnosed between October and December.ConclusionsImmigrations to endemic regions of Turkey from neighbouring countries where CL incidence is higher may lead to large increases in case numbers. In order to decrease the risk of exposure, housing conditions of the refugees must be improved, routine health controls must be performed, effective measures must be set in place for vector control, and infected individuals must be diagnosed and treated to prevent spread of the infection.

Syrian Refugees at Risk of Hepatitis Diseases in Turkey, in Şanliurfa?

“…The majority of the participants were women, young adults and married people. As stated in other studies, the fact that men stay in their countries to fight, that the Syrian population is young in general, and that the young population has high mobility to move away from their environments are effective in these results [21][22][23]. The educational level of Syrian refugees is quite low.…”

Cutaneous leishmaniasis in Syria: A review of available data during the war years: 2011–2018

“…Several authors have noted that the onset of the war coincided with a significant increase in number and distribution of CL cases across the country [10][11][12][13][14][15][16][17][18][19][20][21] and that movements of Syrian refugees led to a general increase in number of CL cases reported from resettlement countries [22][23][24][25][26][27][28][29][30]. Our analysis focuses on a comprehensive quantification of the evolution of CL epidemiology throughout Syria's territory, an exercise that, to our knowledge, has not yet been attempted.…”

Addressing a clinical challenge: guidelines for the diagnosis and treatment of leishmaniasis

“…In a GeoSentinel surveillance study, 32% of adult Syrian refugees evaluated for migration-related illness had CL [4]. Increased CL rates were also reported in the neighboring countries of Jordan [5], Lebanon [6, 7], and Turkey [8, 9], primarily among Syrian refugee populations. Poor living conditions, disrupted healthcare infrastructure, vector control programs, inadequate sanitation, and mass migration from non-endemic regions of Syria through endemic areas all likely contribute to an increased disease burden of leishmaniasis in Syrian refugees.…”