{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T14:14:44Z","timestamp":1786198484955,"version":"build-2736575974"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In Pakistan, cutaneous leishmaniasis is an emerging tropical disease and a very high number (&gt;70%) of children are afflicted by this marring infection. This study aimed to scrutinise the prevalence, spatial distribution and socio\u2010demographic and behavioural risk factors associated with cutaneous leishmaniasis in children aged &lt;5\u201315 \u2009years in Khyber Pakhtunkhwa.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 1, 559 clinically confirmed records of children diagnosed with cutaneous leishmaniasis (January\u2013December) from 2020 and 2022 were obtained from selected district hospitals. In addition, a risk factors\u2010related questionnaire was administered to 1, 011 households (400 in 2020 and 611 in 2022) in nine districts during a household survey.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The maximum number of cutaneous leishmaniasis cases was recorded in 2022 (<jats:italic>n<\/jats:italic>\u2009=\u2009877, 56.25%) as compared to 2020 (<jats:italic>n<\/jats:italic>\u2009=\u2009682, 43.75%). The hospital records showed a greater number of male patients in the 2022 cohort (<jats:italic>n<\/jats:italic>\u2009=\u2009603, 68.76%). The highest number of cases were observed in children aged 5\u20139\u2009years in 2022 (<jats:italic>n<\/jats:italic>\u2009=\u2009282, 32.16%) and 2020 (<jats:italic>n<\/jats:italic>\u2009=\u2009255, 37.39%). In 2020 and 2022, cutaneous leishmaniasis cases showed peak aggregation in March (<jats:italic>n<\/jats:italic>\u2009=\u2009118, 17.3%) and January (<jats:italic>n<\/jats:italic>\u2009=\u2009322, 36.72%). From a spatial analysis, the maximum number of cutaneous leishmaniasis cases was recorded at 59\u20131700\u2009m elevation in various land\u2010use\/land\u2010cover and climatic regions with quaternary alluvium rock formations. A multivariate logistic regression model analysis of risk factors from the households survey suggested that age group, socio\u2010economic status, construction materials of the house, use of insect repellents, Afghan refugee camps in the village\/district, knowledge and biting times of sand flies, frequent use of mosquito bed nets, presence of domestic animals in the house, knowledge of the transmission period and peak month of leishmaniasis infection increased the risk of acquiring cutaneous leishmaniasis (<jats:italic>p<\/jats:italic>\u2009 value &lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our analysis demonstrated that cutaneous leishmaniasis in children is influenced by a variety of environmental, socio\u2010demographic and behavioural risk factors in Khyber Pakhtunkhwa. The increase in recorded cases of cutaneous leishmaniasis in children in 2022 compared to 2020 suggests that the infection likely extended to new foci in the province.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tmi.14005","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T22:56:45Z","timestamp":1715641005000},"page":"633-646","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Epidemiology of cutaneous leishmaniasis in children of Khyber Pakhtunkhwa, Pakistan"],"prefix":"10.1111","volume":"29","author":[{"given":"Chao","family":"Lu","sequence":"first","affiliation":[{"name":"Hefei University of Technology  Hefei Anhui China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5377-104X","authenticated-orcid":false,"given":"Khurshaid","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Zoology Abdul Wali Khan University Mardan  Mardan Khyber Pakhtunkhwa Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fawad","family":"Khan","sequence":"additional","affiliation":[{"name":"District Integrated Vector Control Department  Lower Dir Khyber Pakhtunkhwa Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Safeer Ullah","family":"Shah","sequence":"additional","affiliation":[{"name":"National Centre of Excellence in Geology University of Peshawar  Peshawar Khyber Pakhtunkhwa Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhsin","family":"Jamal","sequence":"additional","affiliation":[{"name":"Department of Microbiology Abdul Wali Khan University Mardan  Mardan Khyber Pakhtunkhwa Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor","family":"Badshah","sequence":"additional","affiliation":[{"name":"Department of Zoology Abdul Wali Khan University Mardan  Mardan Khyber Pakhtunkhwa Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,13]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"WHO.Number of cases of cutaneous leishmaniasis reported data by country. 2023. 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