Public Perceptions of Risk Factors for Zoonotic Cutaneous Leishmaniasis in an Endemic Area: A Case-Control Study in the Mehran District, Ilam Province, Southwestern Iran (2022–2023)

Ali  Jalilian; Seyedeh Zahra  Parkhideh; Alireza Zahraei-Ramazani; Ali-Ashraf  Aivazi; Reza  Pakzad; Morteza  Akbari; Asadollah  Jalali-Galousang; Nasrin  Rezaei; Sayena   Rafizadeh; Yavar  Rassi

doi:10.18502/jad.v19i1.19994

Ali Jalilian Department of Vector Biology and Control of Diseases, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Seyedeh Zahra Parkhideh Department of Medical Entomology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
Alireza Zahraei-Ramazani Department of Vector Biology and Control of Diseases, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
Ali-Ashraf Aivazi Department of Vector Biology and Control, School of Health, Ilam University of Medical Sciences, Ilam, Iran
Reza Pakzad Department of Epidemiology, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
Morteza Akbari Department of Vector Biology and Control, School of Health, Ilam University of Medical Sciences, Ilam, Iran
Asadollah Jalali-Galousang Department of Vector Biology and Control, School of Health, Ilam University of Medical Sciences, Ilam, Iran
Nasrin Rezaei Health Center of Mehran, Ilam University of Medical Sciences, Ilam, Iran
Sayena Rafizadeh Ministry of Health and Medical Education, Tehran, Iran
Yavar Rassi Department of Vector Biology and Control of Diseases, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jad.v19i1.19994

Keywords: Sand fly; Leishmaniasis; Risk factors; Environmental; Behavioral

Abstract

Background: Zoonotic cutaneous leishmaniasis (ZCL) is one of the most prevalent vector-borne diseases. The understanding of the knowledge, attitudes, and practices regarding ZCL in Iran has not been thoroughly examined. This investigation focused on the risk factors for ZCL within an endemic region in the Mehran District of Ilam Province.

Methods: This case-control study was conducted from 2022 to 2023. Cases (n=372) were selected using the incident case approach from the Centers for Disease Control (CDC). Similarly, 372 controls were chosen through cluster random sampling from the general population. To measure exposure to various risk factors, a validated, research-developed questionnaire was utilized. Binary logistic regression modelling was employed to assess the association between the development of leishmaniasis and several risk factors. A p-value of 0.05 was set as the threshold for statistical significance.

Results: Living near rodent nests or holes (Odds Ratio: 6.51), having bathroom and toilet located outside the house (OR: ), residing close to farms or gardens (OR: 8.26) or specific plants (OR: 6.22), observing a rodent near one's home (OR: 2.66), and the accumulation of building debris near residential areas (OR: 13.03) significantly increased risk of developing cutaneous leishmaniasis. In contrast, the use of insecticides (OR: 0.03) and lotions or other insect repellents (OR: 0.31) significantly decreased the risk of this disease.

Conclusion: The development of ZCL in the Mehran district, Ilam province, southwest Iran, is hindered by inadequate health education and public awareness regarding the disease, as well as insufficient adherence to Iran's care guidelines.