Evaluation and Risk Mapping of Cutaneous Leishmaniasis Cases Between 2007 and 2017 in Sanliurfa, Turkey

Abstract

Objective: The aim of the study is to identify the risky areas for cutaneous leishmaniasis (CL) by marking the cases reported in Sanliurfa between 2007 and 2017 on the provincial map and to examine demographic characteristics of the patients. Methods: Annual incidence rate was calculated using Turkish Statistical Institute's population data, and k coefficient was taken as 100 000. Sanliurfa province CL density map was created for each town according to the incidence. To evaluate future CL risk, risk maps were prepared with the scores given by a team consisting of 10 health care experts. Home addresses was converted into coordinates, and CL distribution maps were created using the ArcGIS 10.5 (Esri, Redlands, CA, USA) program. SPSS Statistics for Windows. Version 21.0 (Statistical Package for the Social Sciences, IBM Corp., Armonk, NY, USA) and Joinpoint Regression Program. Version 4.5. 0.1 (Statistical Research and Applications Branch, National Cancer Institute, Rockville, MD, USA) were used for data analysis. Annual Percentage Change and 95% confidence intervals corresponding for each trend according to incidence of cases were calculated by aiming to determine most appropriate point where the trend in incidence rate (decrease or increase) occurred. Results: There were 9777 cases admitting to the Center for Diagnosis and Treatment of Oriental Sore between 2007 and 2017, and annual mean of cases was 888.2 +/- 385.5 (range, 297-1615). Most (16.5%) of cases occurred in 2013. It was determined that the number of CL increased in Akcakale, Ceylanpinar, Harran and Viransehir between 2007 and 2015, in Haliliye between 2007 and 2013 and in Eyyubiye between 2010 and 2017. Eyyubiye was the town with the highest risk according to points given by ten experts. Although number of CL cases in Sanliurfa showed a three-fold increase from 2007 to 2017, most of the cases were in densely populated areas and in the areas receiving immigration. Conclusions: It was concluded that monitoring the incidence and risk of CL according to the towns would be the basis for an effective fight against the disease.