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Abstract
Background: Cutaneous leishmaniasis is a significant public health concern in southern Khyber Pakhtunkhwa, Pakistan, yet person-specific risk factors in this endemic region remain poorly characterized.
Methods: This clinical case series was conducted at the Leishmania Unit of Khalifa Gul Nawaz Hospital, Bannu, from October 2024 to May 2025. A total of 198 laboratory-confirmed cases of cutaneous leishmaniasis were enrolled using convenience sampling. A bilingual (English/Pushto) questionnaire captured personal protective, ecological, housing, and clinical data. Analysis was limited to descriptive statistics.
Results: Disease awareness was strikingly low (11.2%). Outdoor sleeping (67.8%), non-use of bed nets (79.4%), in-house livestock keeping (85.9%), and proximity to open sandfly breeding sites (93%) were the predominant risk factors. Summer accounted for 70.1% of symptom onsets. Window screens were absent in 64.1% of households; mud construction predominated for flooring (63.3%) and roofing (50.8%). Lesions were located primarily on exposed body parts: the face was most commonly affected (36.3%), followed by feet (25.7%) and hands (19.2%). Most cases presented with solitary lesions and a chronic disease course.
Conclusion: Cutaneous leishmaniasis in southern Khyber Pakhtunkhwa is perpetuated by modifiable behavioral, ecological, and housing-related factors. Targeted health education, promotion of personal protective measures, and improvements in housing infrastructure are needed to reduce disease transmission in this endemic region.