title: Evidence for a long-term increase in the incidence of Leishmania tropica in Aleppo, Syria.
abstract: We report the results of a short study of the epidemiology of Leishmania tropica in the Sheikh Maksoud District of Aleppo, Syria. The present and past status of infection in a community of about 100,000 people are assessed from prevalence and incidence data obtained by active and passive case detection, and from a skin test survey. L. tropica has apparently been endemic for at least 2-3 human generations in Aleppo, and incidence has increased over the past decade. The current estimated force of infection is 0.174/year, the incidence is about 5%, and the average age of infection is 14 years. L. tropica has the essential characteristics of a cyclic infectious disease, and the recent rise in incidence could be part of a long period cycle. A survey of leishmanial scars seriously underestimated the fraction of persons immune, as scar surveys usually do. We estimate that a passive case registration scheme, which has been established in response to growing concern about leishmaniasis in Aleppo, succeeds in recording and treating about one in 4 cases.
authors.affiliation: Laboratoire d'Ecologie Médicale et Pathologie Parasitaire, Université de Montpellier, France.
authors.forename: R W
authors.initials: RW
authors.lastname: Ashford
authors.forename: J A
authors.initials: JA
authors.lastname: Rioux
authors.forename: L
authors.initials: L
authors.lastname: Jalouk
authors.forename: A
authors.initials: A
authors.lastname: Khiami
authors.forename: C
authors.initials: C
authors.lastname: Dye
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000818:Animals; D002648:Child; D002675:Child, Preschool; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007895:Leishmania tropica; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012882:Skin Tests; D013593:Syria / Q000453:epidemiology