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 Table of Contents  
LETTER TO EDITOR
Year : 2017  |  Volume : 4  |  Issue : 3  |  Page : 64-65

Containing leishmaniasis in the war-affected Syria


1 Department of Community Medicine, Member of the Medical Education Unit and Medical Research Unit, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India
2 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Chennai, Tamil Nadu, India

Date of Web Publication28-Aug-2018

Correspondence Address:
Dr. Saurabh RamBihariLal Shrivastava
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, 3rd Floor, Ammapettai Village, Thiruporur - Guduvancherry Main Road, Sembakkam Post, Kancheepuram - 603 108, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/cai.cai_13_17

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How to cite this article:
Shrivastava SR, Shrivastava PS. Containing leishmaniasis in the war-affected Syria. Community Acquir Infect 2017;4:64-5

How to cite this URL:
Shrivastava SR, Shrivastava PS. Containing leishmaniasis in the war-affected Syria. Community Acquir Infect [serial online] 2017 [cited 2019 Oct 16];4:64-5. Available from: http://www.caijournal.com/text.asp?2017/4/3/64/240008



Dear Editor,

Leishmaniasis is one of the neglected tropical diseases of protozoal origin and is quite frequent among people with poor socioeconomic status living in poor housing conditions and those who are either malnourished or have a weaker immune system.[1],[2] The disease presents in 3 forms, and the presence of migration or lack of financial support significantly enhances the incidence of the disease.[1],[2] Further, the occurrence of the disease is determined by various environmental factors such as deforestation and urbanization.[1] Even though, a small proportion of the infected people actually will suffer from the disease, still close to 1 million new cases and almost 25,000 deaths have been attributed to the disease each year.[1]

Syria has been experiencing war for quite some time, and thousands of cases have been reported in the nation.[3] In fact, favorable conditions prevail in the region for the disease-carrying flies to thrive, such as the interruption in the regular insect spraying practices or other preventive measures, population movement, improper waste management, heaps of garbage, compromised sanitation mechanisms, and huge amount of debris due to the destruction in the on-going war.[3],[4] It is very important to understand that when the local residents are coerced for either internal displacement or migration to neighboring nations, they might carry the infectious agent and introduce the same to new communities.[3] Thus, the movement is one of the major challenges in the nation, and health workers have to look for population movement at an hourly basis.[1],[3]

It is worth knowing that the disease is curable, but presentation of patients in late stages often leads to disfigurement (cutaneous type) or death (visceral type, especially among infants and children).[1],[4] The World Health Organization in collaboration with other welfare organizations and national ministry has acknowledged the scope of the problem and is working to treat and protect the local population.[1],[3] In the nation, a Mentor Initiative has been started which broadly focuses on the disease transmitted by insects.[3] Under this initiative, small-mesh nets are distributed to people living in camps to prevent sandflies from biting people.[3]

In addition, the tedious and expensive, yet effective task of spraying is also carried out with the help of trained local workers.[3] The community is sensitized about the scope and need of the same, and the chemical is sprayed in every room.[1],[3] Even though the refusal rate for spraying from people is quite less, nevertheless, it is never a priority for the people who have been living with the threat of war and constant killings and bombing.[3] Further, the component of early diagnosis and effective case management has also been strengthened with the help of special clinics, and the health workers have been trained to identify the symptoms of the disease.[1],[2],[3] Furthermore, efforts have been taken to improve the surveillance and control of animal reservoirs.[1],[2]

To conclude, the problem of leishmaniasis is a definitive public health concern in the war-affected Syria due to the presence of various disease proliferating factors. However, there is a great need to increase the awareness about the disease and develop partnerships with the concerned sectors to succeed in the mission of reducing the incidence and sufferings associated with the disease.



 
  References Top

1.
World Health Organization. Leishmaniasis – Fact Sheet No. 375; 2017. Available from: http://www.who.int/mediacentre/factsheets/fs375/en/. [Last accessed on 2017 Nov 03].  Back to cited text no. 1
    
2.
Shrivastava SR, Shrivastava PS, Ramasamy J. Dearth in research & development of health products for responding to neglected diseases: An urgent public health need. Ann Trop Med Public Health 2016;9:366-7.  Back to cited text no. 2
  [Full text]  
3.
World Health Organization. Danger in the Rubble: Fighting Leishmaniasis in Syria; 2017. Available from: http://www.emro.who.int/syr/syria-news/danger-in-the-rubble-fighting-leishmaniasis- in-syria.html. [Last accessed on 2017 Nov 03].  Back to cited text no. 3
    
4.
Al-Nahhas SA, Kaldas RM. Characterization of leishmania species isolated from cutaneous human samples from central region of Syria by RFLP analysis. ISRN Parasitol 2013;2013:308726.  Back to cited text no. 4
    




 

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