Leishmaniasis has long been known as a poverty-associated disease, which is particularly prevalent in developing and less developed countries. The role of socioeconomic status in the clinical course of the disease is less clearly defined. In this study, we investigated the potential relationship between the clinical course of cutaneous leishmaniasis in terms of its evolution into chronic forms and the socioeconomic status of the patients.
Methods:
A total of 140 patients attending the dermatology clinic in Imam Reza Hospital, Mashhad, Iran, were enrolled. The patients were grouped into high, medium, and low socioeconomic classes according to a comprehensive questionnaire. They received routine treatment protocols for leishmaniasis and were followed up for 1 year.
Results:
We found a statistically significant relationship between the clinical course of the disease and socioeconomic status.
Conclusion:
Poverty might prolong the course of cutaneous leishmaniasis for many different reasons.
AmeenM. Cutaneous leishmaniasis: advances in disease pathogenesis, diagnostics and therapeutics. Clin Exp Dermatol2010;35:699–705, doi:10.1111/j.1365-2230.2010.03851.x.
3.
Control of the leishmaniases. World Health Organ Tech Rep Ser2010;(949):xii–iii, 1–186, back cover.
4.
MurrayHWBermanJDDaviesCR. Advances in leishmaniasis. Lancet2005;366:1561–77, doi:10.1016/S0140-6736(05)67629-5.
5.
AlvarJYactayoSBernC. Leishmaniasis and poverty. Trends Parasitol2006;22:552–7, doi:10.1016/j.pt.2006.09.004.
6.
HotezPJDumonteilEHeffernanMJ. Innovation for the ‘bottom 100 million’: eliminating neglected tropical diseases in the Americas. Adv Exp Med Biol2013;764:1–12, doi:10.1007/978-1-4614-4726-9_1.
7.
RukunuzzamanMRahmanM. Epidemiological study of risk factors related to childhood visceral leishmaniasis. Mymensingh Med J2008;17:46–50.
8.
AntinoriSSchifanellaLCorbellinoM. Leishmaniasis: new insights from an old and neglected disease. Eur J Clin Microbiol Infect Dis2012;31:109–18, doi:10.1007/s10096-011-1276-0.
9.
BernCCourtenayOAlvarJ. Of cattle, sand flies and men: a systematic review of risk factor analyses for South Asian visceral leishmaniasis and implications for elimination. PLoS Negl Trop Dis2010;4:e599, doi:10.1371/journal.pntd.0000599.
10.
BeloVSWerneckGLBarbosaDS. Factors associated with visceral leishmaniasis in the Americas: a systematic review and meta-analysis. PLoS Negl Trop Dis2013;7:e2182, doi:10.1371/journal.pntd.0002182.
11.
BoelaertMMeheusFSanchezA. The poorest of the poor: a poverty appraisal of households affected by visceral leishmaniasis in Bihar, India. Trop Med Int Health2009;14:639–44, doi:10.1111/j.1365-3156.2009.02279.x.
12.
PadoveseVTerranovaMTomaL. Cutaneous and mucocutaneous leishmaniasis in Tigray, northern Ethiopia: clinical aspects and therapeutic concerns. Trans R Soc Trop Med Hyg2009;103:707–11, doi:10.1016/j.trstmh.2009.02.023.
13.
BrayRS. Leishmaniasis in the Old World. Br Med Bull1972;28:39–43.
14.
AccorsiSBarnabasGAFareseP. Skin disorders and disease profile of poverty: analysis of medical records in Tigray, northern Ethiopia, 2005-2007. Trans R Soc Trop Med Hyg2009;103:469–75, doi:10.1016/j.trstmh.2008.11.028.
15.
DedetJPPillotBGentiliniM. Evaluation of the socioeconomic costs of cutaneous leishmaniasis in French Guiana. Rev Epidemiol Sante Publique1991;39:129–33.
16.
ThakurCP. Socio-economics of visceral leishmaniasis in Bihar (India). Trans R Soc Trop Med Hyg2000;94:156–7, doi:10.1016/S0035-9203(00)90255-4.
17.
PearsonRDCoxGJeronimoSM. Visceral leishmaniasis: a model for infection-induced cachexia. Am J Trop Med Hyg1992;47(1 Pt 2):8–15.
18.
DayakarAChandrasekaranSVeronicaJ. Role of leptin in human visceral leishmaniasis?. Med Hypotheses2011;77:416–8, doi:10.1016/j.mehy.2011.05.032.
19.
DostrovskyA. Leishmania recidiva of the skin. Harefuah1934;8(May):i–ii.
20.
BoelaertMMeheusFRobaysJ. Socio-economic aspects of neglected diseases: sleeping sickness and visceral leishmaniasis. Ann Trop Med Parasitol2010;104:535–42, doi:10.1179/136485910X12786389891641.
21.
KopteridesPMourtzoukouEGSkopelitisE. Aspects of the association between leishmaniasis and malignant disorders. Trans R Soc Trop Med Hyg2007;101:1181–9, doi:10.1016/j.trstmh.2007.08.003.
22.
CaldasAJCostaJMSilvaAA. Risk factors associated with asymptomatic infection by Leishmania chagasi in north-east Brazil. Trans R Soc Trop Med Hyg2002;96:21–8, doi:10.1016/S0035-9203(02)90227-0.
23.
MonteiroWMNeitzke-AbreuHCFerreiraME. [Population mobility and production of American tegumentary leishmaniasis in the State of Parana, southern Brazil]. Rev Soc Bras Med Trop2009;42:509–14, doi:10.1590/S0037-86822009000500007.
24.
VanlerbergheVSinghSPPaudelIS. Determinants of bednet ownership and use in visceral leishmaniasis-endemic areas of the Indian subcontinent. Trop Med Int Health2010;15:60–7.
25.
Pedrosa FdeAXimenesRA. Sociodemographic and environmental risk factors for American cutaneous leishmaniasis (ACL) in the State of Alagoas, Brazil. Am J Trop Med Hyg2009;81:195–201.
26.
RijalSKoiralaSVan der StuyftPBoelaertM. The economic burden of visceral leishmaniasis for households in Nepal. Trans R Soc Trop Med Hyg2006;100:838–41, doi:10.1016/j.trstmh.2005.09.017.
27.
SebbagR. Drug access in poor countries. Bull Acad Natl Med2007;191:1601–2.
28.
AdhikariSRSupakankuntiSKhanMM. Incidence of kala-azar in Nepal: estimating the effects of individual and household characteristics. Trans R Soc Trop Med Hyg2010;104:720–5, doi:10.1016/j.trstmh.2010.08.013.
29.
DyeCWilliamsBG. Malnutrition, age and the risk of parasitic disease: visceral leishmaniasis revisited. Proc Biol Sci1993;254:33–9, doi:10.1098/rspb.1993.0123.
