<p>Dear all<br>
Cutaneous leishmaniasis in endemic in FATA region of Pakistan. These tribal areas are located at border of Afghanistan. Pakistan shares more than 2100 km border with Afghanistan and almost all the tribal areas at border are endemic for leishmanias due to movement of local people across the border. Afghan refugees were the most important source of infection to local people not only in FATA but also other settled areas of Khyber pakhtunkhwa and balochistan province of Pakistan. In past Pakistan has hosted more than 2 million afghan refugees who resided in refugee camps in different parts of Khyber pakhtunkhwa and balochistan province.<br>
Recent story is more drastic in nature. The FATA region is under military operations and internal displaced people (IDPs) are now most important source of bringing cutaneous leishmaniasis infection to urban areas of Khyber pakhtunkhwa. CL surge is being observed in different urban areas particularly kohat, karak , hangu, dir etc. There is no case recording system in local government hospitals so majority of cases remain unnoticed. <br>
The most serious problem in urban areas is shortage of glucantime in local hospitals and in market. The prices are very high. FATA is getting help from different health agencies and WHO in controlling the CL. But poor infected people in settled urban areas other than FATA also require help and assistance in form of provision of doses of glucantime and also in initiating vector control program in affected villages. I personally visited some affected villages in my home district kohat where hundreds of poor people are unable to afford Cl treatment. So they also require attention of WHO or any other health agency.<br>
Thanks<br>
best regards </p>
<div class="gmail_quote">On Jun 8, 2013 2:38 AM, "jeffrey shaw" <<a href="mailto:jayusp@hotmail.com">jayusp@hotmail.com</a>> wrote:<br type="attribution"><blockquote class="gmail_quote" style="margin:0 0 0 .8ex;border-left:1px #ccc solid;padding-left:1ex">
<div><div dir="ltr"><br><div>> From: ProMED-mail <<a href="mailto:promed@promed.isid.harvard.edu" target="_blank">promed@promed.isid.harvard.edu</a>><br>> Date: 2013/5/18<br>> Subject: PRO/AH/EDR> Leishmaniasis - Pakistan (02): (FATA), cutaneous<br>
> To: <a href="mailto:promed-ahead-edr@promedmail.org" target="_blank">promed-ahead-edr@promedmail.org</a><br>> <br>> <br>> LEISHMANIASIS - PAKISTAN (02): (FEDERALLY ADMINISTERED TRIBAL AREAS),<br>> CUTANEOUS<br>
> *******************************************************************************<br>> A ProMED-mail post<br>> <<a href="http://www.promedmail.org" target="_blank">http://www.promedmail.org</a>><br>> ProMED-mail is a program of the<br>
> International Society for Infectious Diseases<br>> <<a href="http://www.isid.org" target="_blank">http://www.isid.org</a>><br>> <br>> Date: Thu, 16 May 2013 18:33:46 +0200<br>> Source: Pak Observer<br>
> <<a href="http://pakobserver.net/detailnews.asp?id=206947" target="_blank">http://pakobserver.net/detailnews.asp?id=206947</a>><br>> <br>> <br>> Surge of cutaneous Leishmaniasis in Federally Administered Tribal<br>
> Areas, Pakistan<br>> ------------------------------------<br>> Cutaneous leishmaniasis is on the increase in Pakistan's Federally<br>> Administered Tribal Areas (FATA), according to reports by FATA's<br>
> Directorate of Health.<br>> <br>> In response, the international medical organisation Medecins Sans<br>> Frontieres/Doctors Without Borders (MSF) has donated supplies of<br>> medicines to treat the disease.<br>
> <br>> Cutaneous leishmaniasis is the common form of leishmaniasis, a<br>> parasitic disease transmitted by sand flies. It causes ulcer-like<br>> lesions and can lead to severe disfigurement. If left untreated, it<br>
> can complicate by affecting<br>> internal organs.<br>> <br>> FATA is endemic to leishmaniasis. The recent surge in cases saw 1335<br>> patients with cutaneous leishmaniasis treated from January to March<br>
> 2013, according to the FATA Directorate of Health, an increase of over<br>> 270 cases compared to the same period last year [2012]. MSF donated<br>> 1200 vials of the drug Meglumine Antimoniate (Glucantime) in the last<br>
> week of April [2013]. This was almost 30 percent of the quantity that<br>> had been requested across FATA for an entire year, based on last<br>> year's patient numbers.<br>> <br>> Since the 1st reported outbreak in FATA in 2002, the Health<br>
> Directorate launched a national response programme in 2003 to tackle<br>> the disease. The World Health Organization's Disease Early Warning<br>> System (DEWS) programme has been supporting the treatment of the<br>
> disease in FATA since 2010. The sudden increase in cases of cutaneous<br>> leishmaniasis reverses a trend, which had seen cases fall over recent<br>> years.<br>> <br>> During 2012, MSF treated 298 patients for the disease at the Sadda<br>
> Tehsil Headquarter hospital in Kurram Agency - a 50 percent drop on<br>> the previous year. "Timely treatment of the disease was a big factor<br>> in the significant drop in cases in the area," said MSF medical<br>
> coordinator Dr Isaac Chikwanha. Using bed nets reduces the risk of<br>> being bitten by sand flies and infected with the disease<br>> <br>> --<br>> Communicated by:<br>> ProMED-mail from HealthMap alerts<br>
> <<a href="mailto:promed@promedmail.org" target="_blank">promed@promedmail.org</a>><br>> <br>> [Cutaneous leishmaniasis, CL, is endemic in Pakistan and in<br>> Afghanistan. The fall of the Taliban regime showed that the country<br>
> had experienced a huge increase in cases, with no proper control<br>> measures being implemented and treatment facilities grossly<br>> inadequate. CL increased in Pakistan with the increase in refugees<br>> from Afghanistan. The present increase needs to be analysed further.<br>
> Were the cases refugees or residents in FATA? When were they exposed?<br>> With an incubation period of up to 4 months or even longer a history<br>> of movements over the past months is needed to understand the dynamics<br>
> of the infection.<br>> <br>> Prevalence rates are provided in the ProMED posting the 3rd March 2013<br>> (see below). - Mod. EP<br>> <br>> A HealthMap/ProMED-mail map can be accessed at:<br>> <<a href="http://healthmap.org/r/1iGJ" target="_blank">http://healthmap.org/r/1iGJ</a>>.]<br>
> <br>> [see also:<br>> Leishmaniasis - Pakistan: (KP) 20130303.1568339<br>> 2012<br>> ----<br>> Leishmaniasis - Pakistan (03):(KP) 20121228.1473148<br>> Leishmaniasis - Pakistan (02):(KP) 20121122.1420716<br>
> Leishmaniasis - Pakistan: (KP) cutaneous: 20120429.1117486<br>> Leishmaniasis - UK ex Afghanistan: military 20120108.1003634<br>> 2010<br>> ----<br>> Leishmaniasis - Afghanistan (03):(HR) 20101106.4015<br>
> Leishmaniasis - Afghanistan (02) 20101016.3753<br>> Leishmaniasis - Afghanistan 20101016.3750<br>> 2007<br>> ----<br>> Leishmaniasis - Afghanistan 20070508.1487<br>> 2005<br>> ----<br>> Leishmaniasis - Pakistan (Balochistan, Sindh)(02) 20050206.0403<br>
> Leishmaniasis - Pakistan (Balochistan, Sindh) 20050113.0115<br>> 2004<br>> ----<br>> Leishmaniasis - Pakistan & India: background 20040201.0392<br>> Leishmaniasis - Pakistan (02): (Sind) 20040127.0324<br>
> Leishmaniasis - Pakistan: (Sind) 20040126.0309<br>> 2003<br>> ----<br>> Leishmaniasis - Iraq, Kuwait, Afghanistan: military 20031024.2669<br>> Leishmaniasis - Afghanistan 20030909.2267<br>> 2002<br>> ----<br>
> Leishmaniasis - Afghanistan (07) 20020703.4662<br>> Leishmaniasis - Afghanistan (06) 20020629.4633<br>> Leishmaniasis - Afghanistan (05) 20020515.4212<br>> Leishmaniasis - Afghanistan (04) 20020523.4304<br>> Leishmaniasis - Afghanistan (Kabul): alert 20020508.4134<br>
> 1996<br>> ----<br>> Infectious diseases - Afghanistan 19960802.1377]<br>> .................................................sb/ep/mpp<br>> *##########################################################*<br>> ************************************************************<br>
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