Outbreak of cutaneous leishmaniasis in Somniani, Balochistan - implementation of preventive measures for deployed personnel of armed forces

Objective To evaluate the number of cutaneous leishmaniasis (CL) cases reporting from Somniani between years 2001 to 2005 and to explore the preventive measures being used against sandfly bite.Patients and methods This observational study was conducted at the dermatology department of Combined Military Hospital, Malir Cantonment, Karachi from January 2001 to December 2005. Between year 2001 and 2005, suspected cases of CL reporting from Somniani, Balochistan were identified, evaluated, diagnosed and included in this study. Diagnosis was based on clinical examination, slit skin smear for detection of Leishman-Donovan (LD) bodies and skin biopsy for histopathology. Patients were then asked to fill a structured, anonymous, self-administered and close ended questionnaire which included questions about the use of various preventive measures against cutaneous leishmaniasis.Results A total of 108 patients were diagnosed as CL from Somniani during the study period. The peak was seen in year 2004 (n=58) which coincided with increased troop activity in the area. Nodulo-ulcerative lesions were the commonest mode of presentation. Skin biopsy for histopathology was the most effective method of diagnosis. Overall only 28% personnel were using preventive measures against sand fly bite. Only 15% personnel had disease awareness.Conclusion Lack of application of preventive measures and knowledge of disease were the reasons for increase in CL cases