Prevalence and Distribution of Leishmaniasis, Kingdom of Saudi Arabia, 2010 - 2014 Público

Abstract

Background: Leishmaniasis is a vector-born, parasitic disease transmitted to mammals by the bite of an infected phlebotomine sand fly. It affects people in 98 countries and is a major public health concern and endemic in the Middle East, including the Kingdom of Saudi Arabia (KSA). We investigated trends in leishmaniasis prevalence from 2010 - 2014 in KSA to make recommendations for the national control program.

Methods: Leishmaniasis incidence rates (IRs) per 100,000 population in KSA and 95% confidence intervals (CIs) from 2010 - 2014 were stratified by nationality, gender, and 13 administrative provinces.

Results: We observed a decreasing trend in the IRs of leishmaniasis in KSA, by year. This decrease was statistically significant from 2010 (IR=14.97; 95%CI=14.52-15.44) to 2014 (IR=7.11; 95%CI=6.82-7.42). The IR among Saudis was lower than that of non-Saudis and the difference in IRs by nationality was statistically significant for all years of the study. We also observed a significantly decreasing trend in leishmaniasis IRs from 2010 to 2014 for both males and females. For males, the IR was 20.76 (95%CI=20.05 -21.49) per 100,000 population in 2010 and sharply decreased almost 50% to IR of 9.53 (95%CI=9.08- 10.00) in 2014. A similar trend was observed for females, whose IR was 7.62 (95%CI=7.14 - 8.12) in 2010, decreasing to IR of 4.03 (95%CI=3.71- 4.38) in 2014. We observed higher IRs of leishmaniasis in AL-Madinah, Al-Qasim, and Hail provinces during the study period.

Discussion: Leishmaniasis significantly decreased in KSA from 2010 - 2014. The KSA eradication effort for leishmaniasis has been successful. We recommend active surveillance for early detection and continuous health education for both healthcare professionals and the public.

Table of Contents

Chapter 1: Background ..………………………………………………1

Chapter 2: Literature Review …………………………………………8

Chapter 3: Manuscript, Methods, Result and Discussion ………38

Chapter 4: Conclusion and Recommendation ……………………50

References ……………………………………………………………….52

Appendix ………………………………………………………………...56

About this Master's Thesis

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School	Rollins School of Public Health
Department	Hubert Department of Global Health
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palabra Clave	Visceral Program Cutaneous Leishmaniasis Control
Committee Chair / Thesis Advisor	McNabb, Scott JN, Emory University
Partnering Agencies	Non-US governmental agency (e.g., Minister of Health in Haiti)

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