Zoonotic cutaneous leishmaniasis in Saudi Arabia: results of a preliminary epidemiological survey in Al-Ahsa oasis.

This paper reports the results of a cross-sectional survey of lesions (active cases) and scars (past cases) of zoonotic cutaneous leishmaniasis (ZCL) carried out in 1986 in 2 villages in the eastern region of Al-Ahsa oasis in Saudi Arabia. The epidemiological pattern of ZCL was strikingly similar in both villages. Overall, 2.8% residents were found to have lesions. Only 3.7% were found with scars, presumably due to under-recording. The age distribution of lesions was bimodal, the number of cases being highest in the age-groups 0-3 and 24-27 years. The sharp fall between 3 and 15 years in the number of persons with lesions is typical of an active endemic infection which induces long-lasting immunity. The exceptional number of active adult cases were predominantly non-Saudi males. Infected non-Saudis also contributed substantially to statistically significant clustering of case in households and influenced the sex ratio of cases. More active cases were found in males than in females, and more active cases were male than were past cases. In 1985, residents reported a broad peak in the monthly discovery of lesions--from July to February. Interpretation of the available information was limited because it was not possible to standardize the data for age and sex.