Most respondents were females, 69.1% and 30.9% males, the mean age was 38.5±2. The occupation of most of the respondents were housewives 39.2%, students 22.6%, farmers 13.6%, building construction workers 4.9%, unemployed 15.3%, office workers 3.2% and pensioned 1.2%. The domestic and pet animals found, in and around the houses, were domestic ruminants 47.2% and pets were 40.1%, and dogs 1.0%. Moreover, the rodent's burrows were abundant, in and around houses, which consider as potential reservoir hosts in the area. Most of the respondents used to sleep outdoors 87.8% and fewer indoors 12.2%. 86.6% did not use bed nets, 4.4% using bed nets and irregular users of bed nets were 9.0%. 75.4% used protective cloths when sleeping and the rest 24.6% didn’t. 91.0% were not affected by CL before, and only 9.0% had the disease before.
The onset of CL among the respondents was 59.5% for more than six years, 35.1% for 1-3 years, and 5.4% for 4-6 years. Concerning the sites of scars, 73% were found in the lower extremities, 16% in the upper extremities, 8.1% in all the exposed areas, and 2.9% in the face. Regarding the number of scars, 89.2% had 1-3 scars, 5.4% had 4-6 scars and 5.4% had more than six scars. In 62.2% of the respondents, the ulcer healed in 1-3 months, 10.8% in 4-6 months, and 27% in more than 6 months.
Results of Leishmanin Skin Test (Montenegro Skin Test)
LST results showed that 70.7% of respondents were positive while only 29.3% of the respondents were negative. The diameter of indurations ranged from 5 mm to 27 mm, the group had diameter 5-15 mm were 48.8%, 20-25 mm were 40.5% but only 10.7% had more than 25mm, figure (2) table (1).
Table 1: The indurations size of LST positive among study group
Indurations size
|
Frequency
|
Percent
|
(5-15 mm)
|
142
|
48.8 %
|
(16-26 mm)
|
117
|
40.5 %
|
(27 ≥ mm)
|
31
|
10.7 %
|
Total
|
290
|
100.0 %
|
X2 = 6.134 P-value = 0.040
Factors affecting LST results
Out of the 126 males in the study population, 72.2% (91/126) of them were positive and 27.8% (35/126) negative. Out of the 284 females, 70% (199/284) were positive and 30% (85/284) were negative. There was no significant difference between them (P-value = 0.658).
Table 2: Relationship between LST and sex
|
Leishmanin results
|
|
|
Positive
|
Negative
|
Total
|
|
|
Males
Females
|
|
91(72.2%)
|
35(27.8%)
|
126(100%)
|
|
|
199 (70%)
|
85(30%)
|
284(100%)
|
|
Total
|
|
290
|
120
|
310
|
|
|
|
|
|
|
|
|
|
|
|
|
X2 = 0.195 P-value = 0.658
Table (3) shows the relation of age groups with the leishmanin test results, in the age group 10-20 years out of 91, 45 (49%) of them were positive, age group 21-30 years out of 121, 84 (69%) of them were positive, the age group 31-40 years out of 124, 100 (80%) of them were positive and more than 40 years out of 74, 61 (82%) of them were positive. The result showed there was a significant difference between them (P- value = 0.005).
Table 3: Comparison of LST with age among study group
Age groups
|
Total
|
Leishmanin results
|
LST% (+ve)
|
Positive
|
Negative
|
10-20
|
91
|
45
|
46
|
49%
|
21-30
|
121
|
84
|
37
|
69%
|
31-40
|
124
|
100
|
24
|
80%
|
More
|
74
|
61
|
13
|
82%
|
Total
|
410
|
290
|
120
|
70.7%
|
X2 = 30.788 P-value = 0.005
The effect of occupation in the result of LST, out of the 56 farmers 46 (82%) of them were positive, out of the 20 building constructors 14 (70%) of them were positive, out of the 13 office workers 9 (69%) of them were positive, out of 93 students, 44 (47%) of them were positive, out of 205 housewives, 158 (77%) of them were positive, the 5 Pensioned showed a 100 % positivity and out of the 18 unemployed, 14 (77%) of them were positive. The result showed there was a significant difference between them (P-value = 0.000) table (4).
Table 4: Comparison of LST with occupation among study group
|
|
Leishmanin
|
LST% (+ve)
|
Occupations
|
Total
|
Positive
|
Negative
|
Farmer
|
56
|
46
|
10
|
82%
|
B.constructors
|
20
|
14
|
6
|
70%
|
Office workers
|
13
|
9
|
4
|
69%
|
Students
|
93
|
44
|
49
|
47%
|
Housewives
|
205
|
158
|
47
|
77%
|
Pensioned
|
5
|
5
|
0
|
100%
|
Unemployed
|
18
|
14
|
4
|
77%
|
Total
|
410
|
290
|
120
|
70.7%
|
X2= 34.663 P-value < 0.000
As shown in table (5), the domestic and pets animals found in and around the houses, dogs found in four houses, all the people found in these houses were positive, three houses having cats and dogs two were positive and one negative. The result showed there was a significant difference between them (P-value = 0.013).
Table 5: Comparison of domestic and pets animals with LST results
|
Animals
|
|
|
G, S, Ca
|
C, G, S, Ca
|
D
C
|
N
|
Total
|
C
|
Do
|
Leishmanin
|
+ve
|
113
|
4
|
20
|
147
|
2
|
4
|
290
|
-ve
|
52
|
0
|
20
|
47
|
1
|
0
|
120
|
Positive %
|
165 68%
|
4
100%
|
40
50%
|
194
89.7%
|
3
66.6%
|
4
0%
|
410
70%
|
|
|
|
|
|
|
|
|
|
|
X2= 14.423 P-value = 0.013
C:Cat, G:Goats, S:Sheep, Ca: Cattle, D:Dog,
N:Notfound, T:Total
Comparing sleeping habits of the respondents with LST, out of 361 sleeping outdoors, 71.7% (259/361) of them were positive and 28.3% (102/361) of them were negative. Out of the 49 sleeping indoors, 63.3% (31/49) of them were positive and 36.7% (18/49) of them were negatives. The result showed no significant difference between them (P-value = 0.220) table (6).
Table 6: The comparison of sleeping habits with LST results
|
Sleeping habits
|
Total
|
Indoor
|
Outdoor
|
LST
|
+ve
|
31 (63.3%)
|
259 (71.7%)
|
290
|
-ve
|
18 (36.7%)
|
102 (28.3%)
|
120
|
|
Total
|
49
|
361
|
410
|
X2 =1.499 P-value= 0.22
The effect of using bed nets on LST results showed that out of the 37 rare using bed nets, 67.5% (25/37) were positive and 32.5% (12/37) were negative. Out of the 18 always using bed nets, 78% (14/18) were positive and 22% (4/18) were negative. Out of the 355 not using bed nets, 71% (251/355) were positive and 29% (104/355) were negative, the result showed no significant difference between them (P-value = 0.737) table (7).
Table 7: Effect of using bed nets on LST results
|
Use of bed nets
|
Total
|
Rare
|
Always
|
Not use
|
LST
|
+ve
|
25(67.5%)
|
14 (78%)
|
251(71%)
|
290
|
-ve
|
12(32.5%)
|
4.0(22%)
|
104(29%)
|
120
|
Total
|
37 (100%)
|
18 (100%)
|
355(100%)
|
410
|
X2 = 0.611 P-value = 0.737
The results of LST among the respondents having the disease before, all 37 (100%) were positive, table (8).
Table 8: Relationship between LST results and those having the disease before
|
Having dieses
|
Total
|
Yes
|
No
|
LST
|
+ve
|
37(100%)
|
253 (67.8%)
|
290
|
-ve
|
0(0%)
|
120(32.2%)
|
120
|
Total
|
37
|
373
|
410
|
X2 = 16.829 P-value = 0.000