Epidemiology of cutaneous leishmaniasis due to leishmania tropica at utut, Nakuru district, Kenya

Abstract

A cross-sectional immunological. clinical and parasitological investigation carried out on a sample population of 220 individuals in a new focus of cutaneous leishmaniasis at Utut area. Rift Valley Province in Kenya revealed a total positive leishmanin skin reactivity rate of 29.0%. This was compared with a reactivity rate of 23.4% in an adjacent area. Kongasis. The prevalence rates of active lesions and scars were 19.4% and 6.5% respectively for Utut and 3.7% and 6.9% respectively for Kongasis. The leishmanin test reacti vity and clinical profile by age in the study area was typical of a recent endemic focus of cutaneous leishmaniasis. and depicted an age distribution disease pattern consistent with people's habitation in tempdrary shelters and often in caves in the Utut focus of cutaneous le~shmaniasis Males were more commonly infected than females:131.3% males and 26.7% females in Utut. and 28.0% males and 18.9% females in Kongasis. Amastigotes were detected in 4 (30.8%) of 13 patients found wi th cutaneous lesions. Four species of sandflies: Phlebotomus guggisbergi, P. saevus, P. aculeatus and Sergentomyia schwetzi were distributed sympatrically throughout the study area. Gut promastigotes which grew in Novyl. MacNeal, Nicolle (NNN) culture were isolated from P. saevus. This gave a parasite rate of 23.5%. A total parasite rate of 16.7% was obtained in a sample of sandflies which included P. guggisbergi and P. aculeatus in which no parasites were detected. The distribution of previously proven vector P. guggisbergi and other suspected vectors of the genus Phlebotomus suggest that cases of cutaneous leishmaniasis may have contracted the disease from nearly all the sites as people moved frequently in the Utut focus