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概要

Clinical and Epidemiological Characteristics of Patients Presenting with Cutaneous Leishmaniasis to the General Practice Departments (Outbreak; Tozeur, Tunisia, 2016) Managing Cutaneous Leishmaniasis Outbreak in General Medicine (Tozeur, Tunisia, 2016)

Sawssen Bargaoui , Hela Abroug, Manel Ben Fredj , Imen Zemni, Sana Bhiri , Asma Sriha Belguith and Monia Youssef

Background: We aimed at describing, by an active investigation, an outbreak of Cutaneous Leshmaniasis (CL) occurred in Dghoumes, an area near a natural reserve (NR), with high animal density and low economic level, in south Tunisia. Methods: we performed a prospective study, from September 2015 to August 2016. All cases with confirmed diagnoses of CL were included (n=173). Results: Median age was 15 years (IQR: 5-34). Outbreak covered six months. We notified a density of 34 cases per 100 Km2 during outbreak. The Annual attack rate (AAR) of CL was 6.06 cases /1000 inh. Among children under 5 and, "Dghoumes" inhabitants AARs reached respectively 14.46 and 23.94 per 1000 inh. The risk of developing CL for inhabitant near NR was 21 folds higher than in other distant region. We have emphases a relation-ship between monthly attack rates and distance from NR to neighborhoods of cases (b=-7.63; p=0.000). In the first half of November the rise of CL cases was quite large (b=16.0; p=0.000) followed by a slow decrease (b=-2; p=0.000). Overall the 173 cases of CL had 231 lesions altogether. The face or the neck, were affected in 23.2% of cases. During follow up, complete recover was noted among 60% of patients. Conclusions: CL, responsible for o