Objective (s): Cutaneous leishmaniasis has persistently represented a substantial public health concern in endemic areas due to its considerable incidence and the enduring lesions it causes. This study intended to examine the trends in the incidence and severity of cutaneous leishmaniasis in Damghan County, highlighting the necessity for ongoing disease monitoring in these regions.
Methods: This descriptive study examined the status of all 2,085 reported cases of cutaneous leishmaniasis from 2019 to 2023. The data collection process utilized a researcher-designed questionnaire. The content validity of the questionnaire was rigorously confirmed, achieving scores of 0.96 for the Content Validity Ratio (CVR) and 0.92 for the Content Validity Index (CVI), as evaluated by a panel of 10 experts. The data were collected in the summer of 2023 by interviewing patients and reviewing extant records in surveillance systems. The study assessed demographic and contextual factors related to leishmaniasis, as well as the trends in disease incidence. Disease severity was evaluated based on variables such as the number of lesions (ulcers) in patients, lesion size, the presence or absence of discharge from lesions, and the involvement of multiple body parts. Qualitative variables were reported as frequency (percentage), and quantitative variables as mean (standard deviation). Trends in incidence and severity were analyzed using Joint Point Regression.
Results: The results showed that 59.1% of patients were male, while 41.9% were female, with a mean age of 37.2 ± 19.7 years. The incidence rate of cutaneous leishmaniasis per 100,000 population decreased from 646 cases in 2019 to 7 cases in 2023. A marked decline in the involvement of multiple body parts (from 33% to 14%) was also evident. The reduction in discharging lesions from 86% to 57%, the decrease in the average number of lesions per patient from 2.59 to 1.85, and the reduction in the average lesion diameter from 1.88 cm to 1.28 cm during this period were noteworthy findings.
Conclusions: The incidence and severity of cutaneous leishmaniasis in Damghan County have significantly decreased. However, considering the disease's endemic nature in this region, strict future control measures, especially targeting reservoirs and vectors, should remain a priority.