Cutaneous Leishmaniasis Case Investigation Report in Khanom District, Nakhon Si Thammarat Province, December 2013

Abstract

Leishmaniasis caused by a protozoan parasite called Leishmania. The parasite is transmitted to humans and animals through the bite of an infected sandfly. In 2007 and 2012, there were 2 reported cases in Nakhon Si Thammarat, accordingly. The latest cutaneous leishmaniasis case was reported in November 25, 2013. Nakhon Si Thammarat provincial health office conducted a descriptive epidemiological study to verify the disease, do active case finding in a community, survey infected sand fly and determine prevention and control measures. This case was female aged 45 years old who lived in Khanom subdistrict, Khanom district, Nakhon Si Thammarat province. Her occupation was professional service for party food. The onset started in June 2013 with papules on left cheek and painless. Skin biopsy from the left cheek showed presence of amastigotes forms of Leishmania sp. She had never travelled out of the country. There were 80 neighbors around the case. Five of the 80 neighbors were met a criteria of suspected cutaneous leishmaniasis. All of the five suspected case showed negative results for polymerase chain reaction (PCR) test. Further serological investigation was conducted in 36 reservoir animals by direct agglutination test (DAT). All 36 serums of the animals showed negative results. Species of the genus Sergentomyia gammea were mostly trapped in an amount of 46 sandflies, but not to be found Leishmania spp. in those sandflies. The investigation team introduced health education, improvement of environment in the communities, close observation among the suspected case at least for two years, and strengthening zoonotic network between human and animal health sectors.