Cutaneous Leishmaniasis among Attending Hospitals and Health Centers in Amran Governorate, Yemen

Cutaneous Leishmaniasis among Attending Hospitals and Health Centers in Amran Governorate, Yemen | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Cutaneous Leishmaniasis among Attending Hospitals and Health Centers in Amran Governorate, Yemen Mohammed Ali Alshahethi, Ali Ahmed Al-Hadheq, Wadhah Hassan Edrees, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4971316/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background and Aim : Cutaneous Leishmaniasis (CL) is a broad spectrum of diseases. There is no published data on the epidemiology or risk factors of leishmaniasis in Amran Governorate. This study aimed to scrutinise the prevalence and behavioural risk factors associated with CL among visitors to hospitals and health centres in Amran Governorate. Methods: A descriptive cross-sectional study was conducted. Data were collected from 68 patients with lesion clinically suggestive of CL. A pretested questionnaire was used to collect sociodemographic data, risk factors, and influence factors of CL. Results : Sixty-eight cutaneous leishmaniasis were recorded during the month December 20 (29.4%), and the Jabal Yazid District was more infected with the parasite 14 (20.6%). The majority were from males 45 (26.2%), individuals with age groups of 0–20 years old 34 (50%), single individuals 52 (76.5%), and those who come from rural areas 38 (55.9%), with a significant difference ( P <0.05), and the major risk factors were by bite of female sandfly 55 (80.9%), with a significant difference ( P <0.05). Conclusion: Cutaneous leishmaniasis was highly prevalent in Amran Governorate among children (0-20). Our study showed that the risk factor associated with cutaneous leishmaniasis could help the ministry of health in the establishment of an effective program. Infectious Diseases Cutaneous Leishmania Sand Fly Risk Factors Amran Yemen. Figures Figure 1 Introduction Leishmaniasis is a disease that is caused by the parasite Leishmania; comprising of at least 20 species that affect humans. The parasite is primarily transmitted by the sand flies that belong to the Phlebotomus in the old world and Lutzomyia in the new world; however, other principal hosts are rodents such as Rhombomys opimus, Tatera indica, Meriones hurrianae , and Meriones libycus gerbils, which are of the Zoonotic cutaneous leishmaniasis (ZCL) [ 1 – 5 ]. The clinical manifestations of leishmaniasis can range from subclinical (inapparent), or a self-resolving cutaneous ulcer to a disseminated infection (cutaneous, mucosal, or visceral) and even to a lethal systemic illness [ 6 – 10 ]. Leishmania infects some of the poorest people in the world, and is linked to population displacement, malnutrition, lack of financial resources, and poor housing [ 5 ]. Cutaneous leishmaniasis can be observed in all age groups; however, children are a special population affected by this marring disease and are a substantial public health concern [ 11 ]. The greater incidence of cutaneous leishmaniasis in young children could be due to a lack of cutaneous leishmaniasis-specific immunity, poverty, peri-domestic anthroponotic transmission, lack of awareness, and access to basic health services [ 12 ]. The clinical manifestation starts with a skin lesion at the vector bite site (usually without pain or pruritus) and progressively increases in size to form a rounded nodule that is usually exposed to secondary bacterial or fungal infections. It can then produce purulent and painful ulcers, mainly on the exposed parts of the body, leaving life-long scars and serious disability or severe social stigma [ 13 , 19 ]. Cutaneous leishmaniasis is predominant in 88 countries, including 77 developing countries; tens of millions of people are at risk of getting this disease, and it is estimated that each year 1–1.5 million new cases appear. CL was endemic in Yemen [ 15 , 16 , 22 ]. It has been recognised as a public health problem predominated by infection with the highest burden of leishmaniasis but has not been fully documented; cutaneous leishmaniasis is endemic, and most of the cases are registered in Hajjah, Abun, Lahj, Sa'adah, and Taiz Governorates [ 17 , 29 ]. Yemen is a developing country that lacks strategies and programs to control or prevent the transmission of pathogenic microorganisms among populations [ 14 , 18 , 37 ]. To date, there are no published data on the incidence rate and risk factors associated with cutaneous leishmaniasis in Amran Governorate, Yemen. The main purpose of this study was to determine the incidence rate of cutaneous leishmaniasis and its associated risk factors among people attending health centers in Amran Governorate, Yemen. Establishing baseline data and understanding the local epidemiology of cutaneous leishmaniasis would aid in controlling this health problem. Materials and Methods Study area and period This is a cross-sectional study carried out among visitors to hospitals and health centres in Amran Governorate during the period from January 2023 to November 2023.Amran is a small city in western and central Yemen. It is located 50 kilometers north of Sana'a city, between Sana'a governorate and Sa'adah along the central highlands. Amran has a total area of 9,587 km 2 (3,702 sq mi) and a population of approximately 1,221,908. It is divided into 20 administrative districts. Data collection We gathered data from each patient using a standard predesigned questionnaire, specifically designed for this study, which included demographic information such as name, age, gender, and risk factors. Investigators collected participant information through face-to-face interviews and filled out the questionnaire. Additionally, participation was voluntary, and participants completed the consent form. We constructed the questionnaire in Arabic and translated it into English. Specimens collection Skin lesion samples were obtained from patients exhibiting clinical indications of skin infection. Prior to collection, the cutaneous lesions were cleansed and sterilised using 100% ethanol. The puncture was performed between the thumb and forefinger to treat the lesions. Biopsy samples were obtained from the periphery of the wound using a sterile lancet and left on one side of the slide. A dense coating on one side of the examination slide was created and sustained in 100% methanol for a duration of 30 minutes. A permanent marker was used to label the slides with a serial number. Staining and diagnosis by microscopy The diagnosis of cutaneous leishmaniasis can be immediately confirmed by directly observing the parasite in impression smears or by examining skin biopsies stained with giemsa stain. The process involved immersing dry, thin prepared slides containing skin lesions from infested patients into a staining jar containing Giemsa stain for a duration of 30 minutes. Following the staining process, the slides were allowed to dry naturally and then rinsed delicately with water before being air-dried once more. The slides were examined using a microscope with an oil immersion objective lens (10 x 100 magnifications) to identify the protozoan parasite. Ethical statement The Research Ethics Review Committee of the Department of Biology, Faculty of Applied Science and Humanities of Amran University approved the study's ethical statement, and the Public Health Office in Amran Governorate, granted permission to begin collecting data and specimens from the study area. Statistical analysis The data were analyzed using the SPSS program (version 22.0). Categorical variables were reported as frequencies and percentages in tables and figures. Additionally, all probability values were considered statistically significant at P -values <0.05. Results Sixty-eight cases of cutaneous Leishmaniasis were recorded among visitors to Amran hospitals and health centres; the majority of cutaneous leishmaniasis was in males 45 (66.2%), individuals with age groups of 0–20 years old 34 (50%), single individuals 52 (76.5%), and those who come from rural areas 38 (55.9%), primary education 28 (41.2%), with a significant difference ( P < 0.05), as shown in Table 1. Table 1. The prevalence of leishmania infections according to gender, age group, marital status, residence, and educational Variables Frequency Rate (%) χ 2 P-value Gender Male 45 66.2 7.11 0.0079 Female 23 33.8 Age group 0–20 34 50 17.32 0.0002 21-40 27 39.7 ≥ 41 7 10.3 Marital status Single 52 76.5 19.06 0.0001 Married 16 23.5 Residence Urban 30 44.1 0.941 0.332 Rural 38 55.9 Educational status Illiterate 18 26.5 11.882 0.0078 Primary 28 41.2 Secondary 13 19 Graduate 9 13.2 χ 2 = Chi-square test ≥ 3.84 (significant), P value < 0.05 (statistically significant) The present study included eight sixty-eight (68) patients; the results showed that Jabal Yazid District was more infected with the parasite 14 (20.6%), and the reasons are due to the nature of the climate. Influencing factors and the nature of the land, and Khamiar was lower infected with the parasite 1 (1.5%). Additionally, the highest infection rate was during the month of December and reached 20 (29.4%), while the lowest infection rate was during the month of October, which reached 5 (7.4%), as shown in Figure 1. The present outcomes revealed that Leishmania infections according to family number were significantly higher among 6-10 (51.5%). A high rate of Leishmania infection according to the site of infection was reported in the face (58.3%), hands (23.6%), feet (13.9), back (2.8%), and chest (1.4%), as listed in Table (2). Table 2. The prevalence of leishmania infections according to family number and site of infections Variables Frequency Rate (%) χ 2 P -value Family No. 0-5 16 23.5 10.088 0.0064 6-10 35 51.5 ≥ 11 17 25 Site of Infections Faces 42 58.3 77.861 0.0001 Hands 17 23.6 Foots 10 13.9 Chest 1 1.4 Back 2 2.8 χ 2 = Chi-square test ≥ 3.84 (significant), P value < 0.05 (statistically significant) This outcome showed the major influencing factors were the presence of ponds and swaps at 42 (37.2%), cows and sheep at 41 (36.3%), sewage at 19 (16.8%), and immunocompromised patients at 11 (9.7%), with significant differences ( P <0.05), as listed in Table 3. Table 3. The influence factors of leishmania infection Influencing Factors No. (%) χ 2 P -value Presence of cows, sheep 41 36.3 26.008 0.000 Presence of ponds, swap 42 37.2 Presence of sewage 19 16.8 Immunocompromised 11 9.7 χ 2 = Chi-square test ≥ 3.84 (significant), P value < 0.05 (statistically significant) Furthermore, our results revealed that the major risk factors were the bite of a female sandfly at 55 (80.9%), insect bites at 28 (25.5%), needle prick at 17 (15.4%), dog bites at 4 (3.6%), blood transfusions at 4 (3.6%), and transplants at 1 (0.9%), with a significant difference ( P < 0.05), as shown in Table 4. Table 4. The major risk factors of leishmania infection Risk factors No. (%) χ 2 P-value Bites Sand fly 55 80.9 98.36 0.0001 Blood transfusion 4 3.6 Insect bites 28 25.5 Transportation 1 0.9 Needle prick 17 15.4 Dogs bites 4 3.6 χ 2 = Chi-square test ≥ 3.84 (significant), P value < 0.05 (statistically significant) Discussion Cutaneous leishmaniasis causes a public health problem worldwide. Leishmaniasis has gradually spread to many governorates of Yemen and is considered an endemic disease [20]. Its prevalence is underestimated due to underreporting, misdiagnosis, or non-diagnosis [21]. Sixty-eight cases of cutaneous leishmaniasis were recorded among visitors to Amran hospitals and health centers; the highest infection rate occurred during December and reached 20 (29.4%). The high prevalence in our study can be attributed to the fact that only clinically suspected patients were included. In addition, the present study recorded a significantly higher prevalence rate in males (66.2%) than in females (33.8%) ( P < 0.05). This finding is consistent with results reported in Yemen [22], Sri Lanka [23], Iraq [24], Saudi Arabia [25-26]. The rationale for gender differences comes in the fact that males make up the majority of seasonal immigrant workers, who typically wear less clothing than women and operate in open surroundings. As a result, they are likely to have greater exposure to sandflies, particularly in rural societies. Given that the majority of CL cases resided in rural areas and typically worked as farmers, which exposed them to the danger of being bitten by sand flies, it is not surprising that the aforementioned results were obtained. Regarding the age group, the current study revealed that the highest prevalence rate of cutaneous leishmaniasis in the 0-20 age group (50%), and the lowest in more than 40 years (10.3%). The same results were reported in West Kordofan, Sudan [27], and in Oti Region, Ghana [28]. It's possible that children are more likely to get mosquito bites because they're active and spend a lot of time outside. Additionally, the clothing they wear increases their vulnerability to mosquito bites. The results showed that 30 (44.1%) participants were from urban areas and 38 (55.9%) were from rural areas. Similarly results have been recorded in by many studies curried in Yemen, Hadhramout and Taiz governorates [17, 29], Iran [30], Iraqi Kurdistan region [31], and Pakistan, Khyber Pakhtunkhwa [32]. The aforementioned results are to be expected, given that most instances of CL were found in rural areas where individuals were engaged in agricultural activities, making them vulnerable to sand fly bites. Moreover, the high occurrence of CL can be ascribed to factors such as low socioeconomic position, substandard housing circumstances, limited knowledge about the disease's source, and inadequate healthcare availability. Regarding the clinical profile of cutaneous leishmaniasis lesions, the most common sites of infection were the faces, hands, feet, chest, and back, with significant differences ( P < 0.0). The study found an elevated incidence of leishmaniasis in the facial region, likely due to the face's prominent exposure to sand fly bites. Moreover, several factors may contribute to the elevated occurrence of CL lesions in the nose. Firstly, the nose is a stationary region of the face, making it more susceptible to sand fly bites. Secondly, it is a prominent and exposed area of the face, further increasing its vulnerability. Lastly, the nose lacks protective mechanisms to avoid sand fly bites, making it the most susceptible part of the face. Several risk factors were significant associated with cutaneous leishmaniasis, such as bite sand fly, blood transfusion, insect bites, transplantation, needle prick, and dog bites. These findings were also similar to those of a to those of a study in Brazil [33]. Moreover, ecology, geography, climate change, cultural, gender- and age-specific tasks, urban activities at night, popular treatment methods, illiteracy, overcrowding, the practice of keeping domestic animals indoors, continuous increases in rodent and dog populations, and inadequate diagnosis, treatment, housing, hygiene, and sanitation may contribute to the increase in leishmaniasis [21]. There are various explanations behind Yemen's high prevalence of Cl infections, particularly in Amran Governorate. These challenges encompass living situations, economic and environmental factors, a lack of public health awareness, a lack of sanitary facilities and infrastructure, and a lack of access to safe drinking water [34–41]. Conclusion Cutaneous leishmaniasis was highly prevalent in Amran Governorate among children. It is critical to develop and implement effective and innovative strategies to raise awareness and knowledge of leishmaniasis, support early diagnosis, and detect and control leishmaniasis in the community. Furthermore, health education, finding the patients and treating them, fighting rodents, improving the environmental condition should be also taken into consideration. Declarations Conflict of Interest Authors have no conflict of interest. Acknowledgments The authors would like to thank the team investigators, including Samah Al-Raboui, Ahlam Al-Nizari, Iman Al-Nazari, Tahani Nejad, Pardis Tamis, Tunis Rajah, Asma Zahiya, Hayah Al-Mahmai, Amat Al-Rahim Muzaffar, Khadija Saleh, Raneem Dabwan, and Haifa Al Aliy, for their generous help in collecting data. 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Al-Awar, “Factors associated with prevalence of intestinal parasitic infection among schoolchildren in Amran city, Yemen,” Al-Razi Univ J Med Sci, Vol. 6, no. 2, PP. 1-10. Juan, 2022. Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4971316","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":344707515,"identity":"9c0096cc-ddae-4ae3-a31c-2af0af08cf79","order_by":0,"name":"Mohammed Ali Alshahethi","email":"","orcid":"","institution":"Department of Biology, Faculty of Applied Science and Humanities, Amran University, Amran, Yemen","correspondingAuthor":false,"prefix":"","firstName":"Mohammed","middleName":"Ali","lastName":"Alshahethi","suffix":""},{"id":344707516,"identity":"0e11494f-53ed-4754-8912-8a1324cd6b17","order_by":1,"name":"Ali Ahmed Al-Hadheq","email":"","orcid":"","institution":"Department of Biology, Faculty of Applied Science and Humanities, Amran University, Amran, Yemen Department of Laboratory, Faculty of Medicine and Health Sciences, Amran University, Amran, Yemen","correspondingAuthor":false,"prefix":"","firstName":"Ali","middleName":"Ahmed","lastName":"Al-Hadheq","suffix":""},{"id":344707517,"identity":"2ca3fbfe-5dd1-4c2f-a7d0-75b8eb3b7e46","order_by":2,"name":"Wadhah Hassan Edrees","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6klEQVRIiWNgGAWjYFCCBBBhw8PPzHwAyJCQIVZLmpxkexuIJcFDrJbDxgZnzhiAWIS18LPnPnz44w9zYsONnM+vbtRY8DCwHz66AZ8WyZ7nxsa8bWyJjTNyt1nnHAM6jCct7QY+LQY30tikGRt4EpslcrcZ57ABtUjwmOHVYn8jjf3njz8SiW0SOc+Mc/4RocVAIo2NgYfNwJiH5wzz49w2IrRInHnGLM3bliAnwd5mxpzbJ8HDRsgv/O1pjB9//PnPY3+Y+fHnnG91cvzsh4/h1YIM2CTAJLHKQYD5AymqR8EoGAWjYOQAAOBLRVcJGMmrAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0000-0002-7799-0466","institution":"3Medical Microbiology Department, Faculty of Applied Sciences, Hajjah University, Yemen. 4Medical Laboratory Department, Faculty of Medical Sciences, Al-Razi University, Yemen.","correspondingAuthor":true,"prefix":"","firstName":"Wadhah","middleName":"Hassan","lastName":"Edrees","suffix":""},{"id":344707518,"identity":"3a55b827-c8db-4068-b3e3-70c25a0b5805","order_by":3,"name":"Qais Yusuf Abdullah","email":"","orcid":"","institution":"Department of Microbiology/Biological Sciences, Faculty of Sciences, Sana’a University, Sana’a, Yemen","correspondingAuthor":false,"prefix":"","firstName":"Qais","middleName":"Yusuf","lastName":"Abdullah","suffix":""},{"id":344707519,"identity":"3b5e9e27-f65a-4596-b896-6d1c9b409c15","order_by":4,"name":"Mohammed Sadeq Al-Awar","email":"","orcid":"","institution":"Department of Medical Laboratory, Faculty of Medical Sciences, Al-Razi University, Sana’a, Yemen","correspondingAuthor":false,"prefix":"","firstName":"Mohammed","middleName":"Sadeq","lastName":"Al-Awar","suffix":""}],"badges":[],"createdAt":"2024-08-25 05:27:34","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":true,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":true},"doi":"10.21203/rs.3.rs-4971316/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4971316/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":63365436,"identity":"cd0bf8c5-74e0-4b3c-8c04-40f9ff2a0eb4","added_by":"auto","created_at":"2024-08-27 11:10:17","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":51707,"visible":true,"origin":"","legend":"\u003cp\u003eDistribution of Cl infection according to the district name and month of infection\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4971316/v1/63a9bae574a7fc36fed01152.png"},{"id":63366174,"identity":"a8e4703d-bd2d-4393-922e-48ef99d9bc22","added_by":"auto","created_at":"2024-08-27 11:18:17","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":600019,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4971316/v1/f024bbba-e401-4bad-ac6f-7165dda72246.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003e\u003cstrong\u003eCutaneous Leishmaniasis among Attending Hospitals and Health Centers in Amran Governorate, Yemen\u003c/strong\u003e\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eLeishmaniasis is a disease that is caused by the parasite Leishmania; comprising of at least 20 species that affect humans. The parasite is primarily transmitted by the sand flies that belong to the Phlebotomus in the old world and Lutzomyia in the new world; however, other principal hosts are rodents such as \u003cem\u003eRhombomys opimus, Tatera indica, Meriones hurrianae\u003c/em\u003e, and \u003cem\u003eMeriones libycus\u003c/em\u003e gerbils, which are of the Zoonotic cutaneous leishmaniasis (ZCL) [\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The clinical manifestations of leishmaniasis can range from subclinical (inapparent), or a self-resolving cutaneous ulcer to a disseminated infection (cutaneous, mucosal, or visceral) and even to a lethal systemic illness [\u003cspan additionalcitationids=\"CR7 CR8 CR9\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Leishmania infects some of the poorest people in the world, and is linked to population displacement, malnutrition, lack of financial resources, and poor housing [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCutaneous leishmaniasis can be observed in all age groups; however, children are a special population affected by this marring disease and are a substantial public health concern [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The greater incidence of cutaneous leishmaniasis in young children could be due to a lack of cutaneous leishmaniasis-specific immunity, poverty, peri-domestic anthroponotic transmission, lack of awareness, and access to basic health services [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The clinical manifestation starts with a skin lesion at the vector bite site (usually without pain or pruritus) and progressively increases in size to form a rounded nodule that is usually exposed to secondary bacterial or fungal infections. It can then produce purulent and painful ulcers, mainly on the exposed parts of the body, leaving life-long scars and serious disability or severe social stigma [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eCutaneous leishmaniasis is predominant in 88 countries, including 77 developing countries; tens of millions of people are at risk of getting this disease, and it is estimated that each year 1\u0026ndash;1.5\u0026nbsp;million new cases appear. CL was endemic in Yemen [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. It has been recognised as a public health problem predominated by infection with the highest burden of leishmaniasis but has not been fully documented; cutaneous leishmaniasis is endemic, and most of the cases are registered in Hajjah, Abun, Lahj, Sa'adah, and Taiz Governorates [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eYemen is a developing country that lacks strategies and programs to control or prevent the transmission of pathogenic microorganisms among populations [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e]. To date, there are no published data on the incidence rate and risk factors associated with cutaneous leishmaniasis in Amran Governorate, Yemen. The main purpose of this study was to determine the incidence rate of cutaneous leishmaniasis and its associated risk factors among people attending health centers in Amran Governorate, Yemen. Establishing baseline data and understanding the local epidemiology of cutaneous leishmaniasis would aid in controlling this health problem.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy area and period\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis is a cross-sectional study carried out among visitors to hospitals and health centres in Amran Governorate during the period from January 2023 to November 2023.Amran is a small city in western and central Yemen. It is located 50 kilometers north of Sana'a city, between Sana'a governorate and Sa'adah along the central highlands. Amran has a total area of 9,587\u0026nbsp;km\u003csup\u003e2\u003c/sup\u003e (3,702 sq mi) and a population of approximately 1,221,908. It is divided into 20 administrative districts.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe gathered data from each patient using a standard predesigned questionnaire, specifically designed for this study, which included demographic information such as name, age, gender, and risk factors. Investigators collected participant information through face-to-face interviews and filled out the questionnaire. Additionally, participation was voluntary, and participants completed the consent form. We constructed the questionnaire in Arabic and translated it into English.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSpecimens collection\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSkin lesion samples were obtained from patients exhibiting clinical indications of skin infection. Prior to collection, the cutaneous lesions were cleansed and sterilised using 100% ethanol. The puncture was performed between the thumb and forefinger to treat the lesions. Biopsy samples were obtained from the periphery of the wound using a sterile lancet and left on one side of the slide. A dense coating on one side of the examination slide was created and sustained in 100% methanol for a duration of 30 minutes. A permanent marker was used to label the slides with a serial number.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStaining and diagnosis by microscopy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe diagnosis of cutaneous leishmaniasis can be immediately confirmed by directly observing the parasite in impression smears or by examining skin biopsies stained with giemsa stain.\u0026nbsp;The process involved immersing dry, thin prepared slides containing\u0026nbsp;skin lesions from infested patients into a staining jar containing Giemsa stain for a duration of 30 minutes. Following the staining process, the slides were allowed to dry naturally and then rinsed delicately with water before being air-dried once more. The slides were examined using a microscope with an oil immersion objective lens (10 x 100 magnifications) to identify the protozoan parasite.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe Research Ethics Review Committee of the Department of Biology, Faculty of Applied Science and Humanities of Amran University approved the study's ethical statement, and the Public Health Office in Amran Governorate, granted permission to begin collecting data and specimens from the study area.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe data were analyzed using the SPSS program (version 22.0). Categorical variables were reported as frequencies and percentages in tables and figures. Additionally, all probability values were considered statistically significant at \u003cem\u003eP\u003c/em\u003e-values \u0026lt;0.05.\u003c/p\u003e"},{"header":"Results ","content":"\u003cp\u003eSixty-eight cases of cutaneous Leishmaniasis were recorded among visitors to Amran hospitals and health centres; the majority of cutaneous leishmaniasis was in males 45 (66.2%), individuals with age groups of 0\u0026ndash;20 years old 34 (50%), single individuals 52 (76.5%), and those who come from rural areas 38 (55.9%), primary education 28 (41.2%), with a significant difference (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05), as shown in Table 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 1.\u0026nbsp;\u003c/strong\u003eThe prevalence of leishmania infections according to gender, age group, marital status, residence, and educational\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.26973684210526%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.43421052631579%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e\u003cstrong\u003eRate (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.348684210526315%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.322368421052632%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.57236842105263%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eGender\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.69736842105263%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.43421052631579%\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e66.2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.348684210526315%\" rowspan=\"2\"\u003e\n \u003cp\u003e7.11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.322368421052632%\" rowspan=\"2\"\u003e\n \u003cp\u003e0.0079\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.70796460176991%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFemale\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.26843657817109%\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.023598820058996%\"\u003e\n \u003cp\u003e33.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.57236842105263%\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge group\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.69736842105263%\"\u003e\n \u003cp\u003e\u003cstrong\u003e0\u0026ndash;20\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.43421052631579%\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.348684210526315%\" rowspan=\"3\"\u003e\n \u003cp\u003e17.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.322368421052632%\" rowspan=\"3\"\u003e\n \u003cp\u003e0.0002\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.70796460176991%\"\u003e\n \u003cp\u003e\u003cstrong\u003e21-40\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.26843657817109%\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.023598820058996%\"\u003e\n \u003cp\u003e39.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.70796460176991%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026ge; 41\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.26843657817109%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.023598820058996%\"\u003e\n \u003cp\u003e10.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.57236842105263%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.69736842105263%\"\u003e\n \u003cp\u003e\u003cstrong\u003eSingle\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.43421052631579%\"\u003e\n \u003cp\u003e52\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e76.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.348684210526315%\" rowspan=\"2\"\u003e\n \u003cp\u003e19.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.322368421052632%\" rowspan=\"2\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.70796460176991%\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarried\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.26843657817109%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.023598820058996%\"\u003e\n \u003cp\u003e23.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.57236842105263%\" rowspan=\"2\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.69736842105263%\"\u003e\n \u003cp\u003e\u003cstrong\u003eUrban\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.43421052631579%\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e44.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.348684210526315%\" rowspan=\"2\"\u003e\n \u003cp\u003e0.941\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.322368421052632%\" rowspan=\"2\"\u003e\n \u003cp\u003e0.332\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.70796460176991%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eRural\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.26843657817109%\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.023598820058996%\"\u003e\n \u003cp\u003e55.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.57236842105263%\" rowspan=\"4\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.69736842105263%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eIlliterate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.43421052631579%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.625%\"\u003e\n \u003cp\u003e26.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.348684210526315%\" rowspan=\"4\"\u003e\n \u003cp\u003e11.882\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.322368421052632%\" rowspan=\"4\"\u003e\n \u003cp\u003e0.0078\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.70796460176991%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePrimary\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.26843657817109%\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.023598820058996%\"\u003e\n \u003cp\u003e41.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.70796460176991%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSecondary\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.26843657817109%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.023598820058996%\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"40.70796460176991%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eGraduate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"31.26843657817109%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.023598820058996%\"\u003e\n \u003cp\u003e13.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026chi;\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e= Chi-square test \u0026ge; 3.84 (significant), \u003cem\u003eP\u003c/em\u003e value\u0026thinsp;\u0026lt; 0.05 (statistically significant)\u003c/p\u003e\n\u003cp\u003eThe present study included eight sixty-eight (68) patients; the results showed that Jabal Yazid District was more infected with the parasite 14 (20.6%), and the reasons are due to the nature of the climate. Influencing factors and the nature of the land, and Khamiar was lower infected with the parasite 1 (1.5%). Additionally, the highest infection rate was during the month of December and reached 20 (29.4%), while the lowest infection rate was during the month of October, which reached 5 (7.4%), as shown in Figure 1.\u003c/p\u003e\n\u003cp\u003eThe present outcomes revealed that Leishmania infections according to family number were significantly higher among 6-10 (51.5%). A high rate of Leishmania infection according to the site of infection was reported in the face (58.3%), hands (23.6%), feet (13.9), back (2.8%), and chest (1.4%), as listed in Table (2).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003eThe prevalence of leishmania infections according to family number and site of infections\u003c/p\u003e\n\u003cdiv align=\"center\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"42.88537549407115%\" colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariables\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.786561264822133%\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.42687747035573%\"\u003e\n \u003cp\u003e\u003cstrong\u003eRate (%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.462450592885375%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.438735177865613%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.960474308300395%\" rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily No.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.92490118577075%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e0-5\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.786561264822133%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.42687747035573%\"\u003e\n \u003cp\u003e23.5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.462450592885375%\" rowspan=\"3\"\u003e\n \u003cp\u003e10.088\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.438735177865613%\" rowspan=\"3\"\u003e\n \u003cp\u003e0.0064\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.577060931899645%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e6-10\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.25806451612903%\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.164874551971327%\"\u003e\n \u003cp\u003e51.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.577060931899645%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026ge; 11\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.25806451612903%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.164874551971327%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"19.960474308300395%\" rowspan=\"5\"\u003e\n \u003cp\u003e\u003cstrong\u003eSite of Infections\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.92490118577075%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFaces\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.786561264822133%\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.42687747035573%\"\u003e\n \u003cp\u003e58.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.462450592885375%\" rowspan=\"5\"\u003e\n \u003cp\u003e77.861\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"13.438735177865613%\" rowspan=\"5\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.577060931899645%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eHands\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.25806451612903%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.164874551971327%\"\u003e\n \u003cp\u003e23.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.577060931899645%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFoots\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.25806451612903%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.164874551971327%\"\u003e\n \u003cp\u003e13.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.577060931899645%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eChest\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.25806451612903%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.164874551971327%\"\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"41.577060931899645%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBack\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"32.25806451612903%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.164874551971327%\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026chi;\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e= Chi-square test \u0026ge; 3.84 (significant), \u003cem\u003eP\u003c/em\u003e value\u0026thinsp;\u0026lt; 0.05 (statistically significant)\u003c/p\u003e\n\u003cp\u003eThis outcome showed the major influencing factors were the presence of ponds and swaps at 42 (37.2%), cows and sheep at 41 (36.3%), sewage at 19 (16.8%), and immunocompromised patients at 11 (9.7%), with significant differences (\u003cem\u003eP\u003c/em\u003e \u0026lt;0.05), as listed in Table 3.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3.\u0026nbsp;\u003c/strong\u003eThe influence factors of leishmania infection\u003c/p\u003e\n\u003cdiv align=\"Left\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"442\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.11738148984199%\"\u003e\n \u003cp\u003e\u003cstrong\u003eInfluencing Factors\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.124153498871332%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.284424379232505%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.83295711060948%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eP\u003c/em\u003e\u003c/strong\u003e\u003cstrong\u003e-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"36.11738148984199%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of cows, sheep\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.124153498871332%\" valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\" valign=\"top\"\u003e\n \u003cp\u003e36.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.284424379232505%\" rowspan=\"4\"\u003e\n \u003cp\u003e26.008\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.83295711060948%\" rowspan=\"4\"\u003e\n \u003cp\u003e0.000\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"56.53710247349823%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of ponds, swap\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.674911660777386%\" valign=\"top\"\u003e\n \u003cp\u003e42\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78798586572438%\" valign=\"top\"\u003e\n \u003cp\u003e37.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"56.53710247349823%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePresence of sewage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.674911660777386%\" valign=\"top\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78798586572438%\" valign=\"top\"\u003e\n \u003cp\u003e16.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"56.53710247349823%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eImmunocompromised\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"23.674911660777386%\" valign=\"top\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"19.78798586572438%\" valign=\"top\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026chi;\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e= Chi-square test \u0026ge; 3.84 (significant), \u003cem\u003eP\u003c/em\u003e value\u0026thinsp;\u0026lt; 0.05 (statistically significant)\u003c/p\u003e\n\u003cp\u003eFurthermore, our results revealed that the major risk factors were the bite of a female sandfly at 55 (80.9%), insect bites at 28 (25.5%), needle prick at 17 (15.4%), dog bites at 4 (3.6%), blood transfusions at 4 (3.6%), and transplants at 1 (0.9%), with a significant difference (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05), as shown in Table 4.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 4.\u0026nbsp;\u003c/strong\u003eThe major risk factors of leishmania infection\u003c/p\u003e\n\u003cdiv align=\"Left\"\u003e\n \u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"450\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.212389380530972%\"\u003e\n \u003cp\u003e\u003cstrong\u003eRisk factors\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.15929203539823%\"\u003e\n \u003cp\u003e\u003cstrong\u003eNo.\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.035398230088497%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.79646017699115%\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.79646017699115%\"\u003e\n \u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"27.212389380530972%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBites Sand fly\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.15929203539823%\" valign=\"top\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.035398230088497%\" valign=\"top\"\u003e\n \u003cp\u003e80.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.79646017699115%\" rowspan=\"6\"\u003e\n \u003cp\u003e98.36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.79646017699115%\" rowspan=\"6\"\u003e\n \u003cp\u003e0.0001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.59090909090909%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eBlood transfusion\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.242424242424242%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.59090909090909%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eInsect bites\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.242424242424242%\" valign=\"top\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e25.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.59090909090909%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eTransportation\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.242424242424242%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e0.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.59090909090909%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeedle prick\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.242424242424242%\" valign=\"top\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e15.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"46.59090909090909%\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eDogs bites\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"24.242424242424242%\" valign=\"top\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"29.166666666666668%\" valign=\"top\"\u003e\n \u003cp\u003e3.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026chi;\u003csup\u003e2\u0026nbsp;\u003c/sup\u003e= Chi-square test \u0026ge; 3.84 (significant), \u003cem\u003eP\u003c/em\u003e value\u0026thinsp;\u0026lt; 0.05 (statistically significant)\u003c/p\u003e"},{"header":"Discussion ","content":"\u003cp\u003eCutaneous leishmaniasis causes a public health problem worldwide. Leishmaniasis has gradually spread to many governorates of Yemen and is considered an endemic disease [20]. Its prevalence is underestimated due to underreporting, misdiagnosis, or non-diagnosis [21].\u003c/p\u003e\n\u003cp\u003eSixty-eight cases of cutaneous leishmaniasis were recorded among visitors to Amran hospitals and health centers; the highest infection rate occurred during December and reached 20 (29.4%). The high prevalence in our study can be attributed to the fact that only clinically suspected patients were included.\u0026nbsp;In addition, the present study recorded a significantly higher prevalence rate in males (66.2%) than in females (33.8%) (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.05). This finding is consistent with results reported in Yemen [22], Sri Lanka [23], Iraq [24], Saudi Arabia [25-26].\u003c/p\u003e\n\u003cp\u003eThe rationale for gender differences comes in the fact that males make up the majority of seasonal immigrant workers, who typically wear less clothing than women and operate in open surroundings. As a result, they are likely to have greater exposure to sandflies, particularly in rural societies. Given that the majority of CL cases resided in rural areas and typically worked as farmers, which exposed them to the danger of being bitten by sand flies, it is not surprising that the aforementioned results were obtained.\u003c/p\u003e\n\u003cp\u003eRegarding the age group, the current study revealed that the highest prevalence rate of cutaneous leishmaniasis in the 0-20 age group (50%), and the lowest in more than 40 years (10.3%). The same results were reported in West Kordofan, Sudan [27], and in Oti Region, Ghana [28]. It's possible that children are more likely to get mosquito bites because they're active and spend a lot of time outside. Additionally, the clothing they wear increases their vulnerability to mosquito bites.\u003c/p\u003e\n\u003cp\u003eThe results showed that 30 (44.1%) participants were from urban areas and 38 (55.9%) were from rural areas.\u0026nbsp;Similarly results have been recorded in by many studies curried in Yemen, Hadhramout and Taiz governorates [17, 29], Iran [30], Iraqi Kurdistan region [31], and Pakistan, Khyber Pakhtunkhwa [32].\u0026nbsp;The aforementioned results are to be expected, given that most instances of CL were found in rural areas where individuals were engaged in agricultural activities, making them vulnerable to sand fly bites. Moreover, the high occurrence of CL can be ascribed to factors such as low socioeconomic position, substandard housing circumstances, limited knowledge about the disease's source, and inadequate healthcare availability.\u003c/p\u003e\n\u003cp\u003eRegarding the clinical profile of cutaneous leishmaniasis lesions, the most common sites of infection were the faces, hands, feet, chest, and back, with significant differences (\u003cem\u003eP\u003c/em\u003e \u0026lt; 0.0).\u0026nbsp;The study found an elevated incidence of leishmaniasis in the facial region, likely due to the face's prominent exposure to sand fly bites. Moreover, several factors may contribute to the elevated occurrence of CL lesions in the nose. Firstly, the nose is a stationary region of the face, making it more susceptible to sand fly bites. Secondly, it is a prominent and exposed area of the face, further increasing its vulnerability. Lastly, the nose lacks protective mechanisms to avoid sand fly bites, making it the most susceptible part of the face.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSeveral risk factors were significant associated with cutaneous leishmaniasis, such as bite sand fly, blood transfusion, insect bites, transplantation, needle prick, and dog bites. These findings were also similar to those of a to those of a study in Brazil [33]. Moreover, ecology, geography, climate change, cultural, gender- and age-specific tasks, urban activities at night, popular treatment methods, illiteracy, overcrowding, the practice of keeping domestic animals indoors, continuous increases in rodent and dog populations, and inadequate diagnosis, treatment, housing, hygiene, and sanitation may contribute to the increase in leishmaniasis [21]. There are various explanations behind Yemen's high prevalence of Cl infections, particularly in Amran Governorate. These challenges encompass living situations, economic and environmental factors, a lack of public health awareness, a lack of sanitary facilities and infrastructure, and a lack of access to safe drinking water [34–41].\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eCutaneous leishmaniasis was highly prevalent in Amran Governorate among children. It is critical to develop and implement effective and innovative strategies to raise awareness and knowledge of leishmaniasis, support early diagnosis, and detect and control leishmaniasis in the community. Furthermore, health education, finding the patients and treating them, fighting rodents, improving the environmental condition should be also taken into consideration.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of Interest\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthors have no conflict of interest.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to thank the team investigators, including Samah Al-Raboui, Ahlam\u0026nbsp;Al-Nizari, Iman Al-Nazari, Tahani Nejad, Pardis Tamis, Tunis Rajah, Asma Zahiya, Hayah Al-Mahmai, Amat Al-Rahim Muzaffar, Khadija Saleh, Raneem Dabwan, and Haifa Al Aliy, for their generous help in collecting data. All authors would like to express their gratitude to patients and doctors for their contribution and support throughout the various aspects of the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAlshahethi and Al-Hadheq Conceived and designed the experiments. Alshahethi performed the experiments: Alshahethi, Abdullah, and Edrees analyzed the data and wrote the manuscript's first draft. Ahmed contributed to the manuscript's creation. Alshahethi, Al-Hadheq, and Al-Awar concur with the manuscript's findings and conclusions. All authors have read, revised, and approved the final manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eKarmaoui, A. B. Salem, D. Sereno, S. E. Jaafari, and L. Hajji, \u0026ldquo;Geographic distribution of \u003cem\u003eMeriones shawi\u003c/em\u003e,\u003cem\u003ePsammomys obesus\u003c/em\u003e, and \u003cem\u003ePhlebotomus papatasi\u003c/em\u003e the main reservoirs and principal vector of zoonotic cutaneous leishmaniasis in the Middle East and North Africa\u003cem\u003e,\u0026rdquo; Parasite Epidemiology and Control,\u003c/em\u003e vol. 17, p. e00247, May 2022.10.1016/j.parepi.2022.e00247\u003c/li\u003e\n\u003cli\u003eE. Javadian, M. Dehestani, A. Nadim, Y. Rassi, Gh. Tahvildar-bidruni, M.A. Seyedi-Rashti, A. 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Abdullah, A. A. Al-Hadheq, B. A. Al-Ofairi, A. A. Al-Asbahi, W. A. Al-Shehari, and A. A. F. Khardesh, \u0026ldquo;Epidemiological of Hepatitis Viruses in Hajjah Governorate, Yemen. Between 2020-2023,\u0026rdquo; Electronic Journal of University of Aden for Basic and Applied Sciences, vol. 5, no. 2, pp. 201\u0026ndash;209, Jun. 2024. https://doi.org/10.47372/ejua-ba.2024.2.353\u003c/li\u003e\n\u003cli\u003eA. Al-Hatheq, A. D. Abakar, and B. Al-Ofairi, \u0026ldquo;Seroprevalence of Hepatitis C Virus Infection among Blood Donors and Clinical Visitors in Amran Governorate, Yemen,\u0026rdquo; Vol. 2, PP. 25\u0026ndash;33; 31-Aug-2019. [Online]. Available: https://psmjournals.org/index.php/ijmm/article/view/335. \u003c/li\u003e\n\u003cli\u003eM. A. Alshahethi, W. H. Edrees, N. M. Mogalli, and A. A. Al-Halani, \u0026ldquo;Prevalence of \u003cem\u003eEntamoeba histolytica\u003c/em\u003e among Children attending Healthcare Centres at Amran Governorate, Yemen,\u0026rdquo; Vol. 5. No. 3, PP. 98-105.31-Jul-2020. [Online]. Available: https://psmjournals.org/index.php/biolres/article/view/429.\u003c/li\u003e\n\u003cli\u003eM. A. Alshahethi, W. H. Edrees, N. M. Mogalli, A. A. Al-Halani, W. A. Al-Shehari, and A. Reem, \u0026ldquo;Distribution and risk factors for \u003cem\u003eGiardia\u003c/em\u003e\u003cem\u003elamblia\u003c/em\u003e among children at Amran Governorate, Yemen,\u0026rdquo; Universal Journal of Pharmaceutical Research, Jul. 2020.\u003c/li\u003e\n\u003cli\u003eN. M. Mogalli, et al., \u0026ldquo;Prevalence of intestinal parasitic infections among primary schoolchildren in Kohlan district at Hajjah governorate, Yemen,\u0026rdquo; Al-Razi Univ J Med Sci, Vol. 4, no. 2, PP. 34-39; Juan, 30, 2020.\u003c/li\u003e\n\u003cli\u003eW. H. Edrees, M. A. Alshahethi, and M. S. Al-Awar, \u0026ldquo;Factors associated with prevalence of intestinal parasitic infection among schoolchildren in Amran city, Yemen,\u0026rdquo; Al-Razi Univ J Med Sci, Vol. 6, no. 2, PP. 1-10. Juan, 2022.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":true,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cutaneous Leishmania, Sand Fly, Risk Factors, Amran, Yemen.","lastPublishedDoi":"10.21203/rs.3.rs-4971316/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4971316/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground and Aim\u003c/strong\u003e: Cutaneous Leishmaniasis (CL) is a broad spectrum of diseases. There is no published data on the epidemiology or risk factors of leishmaniasis in Amran Governorate. This study aimed to scrutinise the prevalence and behavioural risk factors associated with CL among visitors to hospitals and health centres in Amran Governorate.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A descriptive cross-sectional study was conducted. Data were collected from 68 patients with lesion clinically suggestive of CL. A pretested questionnaire was used to collect sociodemographic data, risk factors, and influence factors of CL.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Sixty-eight cutaneous leishmaniasis were recorded during the month December 20 (29.4%), and the Jabal Yazid District was more infected with the parasite 14 (20.6%). The majority were from males 45 (26.2%), individuals with age groups of 0–20 years old 34 (50%), single individuals 52 (76.5%), and those who come from rural areas 38 (55.9%), with a significant difference (\u003cem\u003eP\u003c/em\u003e \u0026lt;0.05), and the major risk factors were by bite of female sandfly 55 (80.9%), with a significant difference (\u003cem\u003eP\u003c/em\u003e \u0026lt;0.05).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eCutaneous leishmaniasis was highly prevalent in Amran Governorate among children (0-20). Our study showed that the risk factor associated with cutaneous leishmaniasis could help the ministry of health in the establishment of an effective program.\u003c/p\u003e","manuscriptTitle":"Cutaneous Leishmaniasis among Attending Hospitals and Health Centers in Amran Governorate, Yemen","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-08-27 11:10:11","doi":"10.21203/rs.3.rs-4971316/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"204b7d24-2076-46ed-8d25-980fe042f7e8","owner":[],"postedDate":"August 27th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":36533771,"name":"Infectious Diseases"}],"tags":[],"updatedAt":"2024-08-27T11:10:11+00:00","versionOfRecord":[],"versionCreatedAt":"2024-08-27 11:10:11","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4971316","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4971316","identity":"rs-4971316","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}