{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:13:44Z","timestamp":1790806424289,"version":"4.1.0"},"reference-count":81,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Vector-borne Infectious Diseases Laboratory, College of Public Health, National Taiwan University, Taipei, Taiwan","award":["NTUCPH-2022-SEA-01"],"award-info":[{"award-number":["NTUCPH-2022-SEA-01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Cutaneous leishmaniasis (CL) is a zoonotic infection caused by obligate intracellular protozoa of the genus Leishmania. This study aimed to investigate CL in Khyber Pakhtunkhwa, Pakistan and to estimate the risk of epidemics. Clinico-epidemiological data of 3188 CL patients were collected from health facilities in 2021. Risk factors were analyzed using the chi-square test. ArcGIS V.10.7.1 was applied for spatial analysis. The association between CL occurrence and climatic variables was examined by Bayesian geostatistical analysis. The clinical data revealed males or individuals younger than 20 years old were more affected. Most patients presented with a single lesion, and the face was the most attacked body part. CL was prevalent in the southern region in winter. A proportional symbol map, a choropleth map, and a digital elevation model map were built to show the distribution of CL. Focal transmission was predicted by inverse distance weighting interpolation. Cluster and outlier analysis identified clusters in Bannu, Dir Lower, and Mardan, and hotspot analysis suggested Bannu as a high-risk foci. Bayesian geostatistical analysis indicated that increasing precipitation and temperature as well as low altitudes were associated with CL infection. The study has provided important information for public health sectors to develop intervention strategies for future CL epidemics.<\/jats:p>","DOI":"10.3390\/tropicalmed8020128","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T01:36:37Z","timestamp":1676856997000},"page":"128","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Distribution and Risk of Cutaneous Leishmaniasis in Khyber Pakhtunkhwa, Pakistan"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2582-1767","authenticated-orcid":false,"given":"Wasia","family":"Ullah","sequence":"first","affiliation":[{"name":"Department of Zoology, Abdul Wali Khan University, Mardan 23300, Khyber Pakhtunkhwa, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0920-534X","authenticated-orcid":false,"given":"Tsai-Ying","family":"Yen","sequence":"additional","affiliation":[{"name":"Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100025, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadaf","family":"Niaz","sequence":"additional","affiliation":[{"name":"Department of Zoology, Abdul Wali Khan University, Mardan 23300, Khyber Pakhtunkhwa, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasreen","family":"Nasreen","sequence":"additional","affiliation":[{"name":"Department of Zoology, Abdul Wali Khan University, Mardan 23300, Khyber Pakhtunkhwa, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1705-7404","authenticated-orcid":false,"given":"Yu-Feng","family":"Tsai","sequence":"additional","affiliation":[{"name":"Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100025, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3340-8059","authenticated-orcid":false,"given":"Roger Ivan","family":"Rodriguez-Vivas","sequence":"additional","affiliation":[{"name":"Facultad de Medicina Veterinaria y Zootecnia, Campus de Ciencias Biologicas y Agropecuarias, Universidad Autonoma de Yucat\u00e1n, Km 15.5 Carretera M\u00e9rida\u2013Xmatkuil, Merida 97100, Yucatan, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adil","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Botany\/Zoology, Bacha Khan University, Charsadda 24420, Khyber Pakhtunkhwa, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6154-113X","authenticated-orcid":false,"given":"Kun-Hsien","family":"Tsai","sequence":"additional","affiliation":[{"name":"Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei 100025, Taiwan"},{"name":"Department of Public Health, College of Public Health, National Taiwan University, Taipei 100025, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,20]]},"reference":[{"key":"ref_1","unstructured":"Mandell, G.L., Bennett, J.E., and Dolin, R. 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