Epidemiological and clinical features of cutaneous leishmaniasis cases in Jordan from 2013 to 2024

Abstract

Objective: To investigate the epidemiology, demographic risk factors, spatial distribution, and temporal trends of cutaneous leishmaniasis (CL) in Jordan from 2013 to 2024.Methods: A retrospective epidemiological study was performed utilizing confirmed CL cases from the Jordanian Ministry of Health. Demographic (age, sex, age group), clinical (lesion location, year and month), and geographic information (district type) were analyzed using GraphPad Prism 9 software. Spearman’s rank correlation and Chi-square test were used to explore the association between age and lesion locations.Results: Between 2013 and 2024, a total of 1 281 confirmed cases were documented. Males represented 63.0% of the cases, while rural areas accounted for 80.6% of the burden. The age groups of 6-18 and 19-60 years accounted for the highest overall CL burden. Lesions were primarily found on the head and neck in children (0-18 years) and on limbs in adults (19-60 years). Persistent hotspots were identified in the Azraq district and the Jordan Valley. Seasonal peaks were noted in late autumn and winter, aligning with the sandfly transmission cycle. Significant association was found between younger age and head and neck lesion counts (r=-0.127, P<0.001), while older patients exhibited a greater involvement of limb lesion counts (for upper limbs lesion counts, r=0.134, P<0.001; for lower limbs lesion counts: r=0.066, P=0.019). Pairwise comparisons also indicated significant differences in lesion locations among different age groups (most P<0.01).Conclusions: CL continues to pose a significant health threat in Jordan, especially in rural and refugee-affected areas. Factors such as underreporting, passive surveillance, and ecological risks contribute to ongoing transmission. A comprehensive national control strategy that includes molecular diagnostics, vector control, refugee health screening, and enhanced surveillance is required for better management of the disease.

Keywords

Cutaneous leishmaniasis / Jordan / Epidemiology

Conflict of interest statement

The authors declare no conflicts of interest.

Funding

This study was supported by grant number 2024/158, Deanship of Research, Jordan University of Science and Technology, Irbid, Jordan.

Authors' contributions

Sudi Maiteh: data collection and analysis, as well as manuscript writing and editing; Esra’a Al-Zoubi: data analysis, manuscript writing, and editing; Mira AlQousi: data analysis, manuscript writing, and editing; Yousef Khader: manuscript writing and editing; Khaldon Bodoor: conceptualization, data analysis, and manuscript writing and editing; Firas Qarqaz: conceptualization, data analysis, and manuscript writing and editing.

Publisher’s note

The Publisher of the Journal remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Edited by Lei Y, Zhang Q, Pan Y

Acknowledgements

We express our gratitude to Jordan University of Science and Technology/Deanship of Research for their financial support of this research, and to the Jordanian Ministry of Health for granting access to patient records throughout the duration of the study.

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