Abstract:
Background
Cutaneous leishmaniasis (CL) is a major public health concern in Turkey and Sanliurfa represents the most endemic city in Turkey. Although children are most commonly affected by
CL, detailed studies of pediatric CL in Turkey are lacking.
Methodology/Principal Findings
In this report we retrospectively evaluated clinical and epidemiological data of 8786 pediatric CL
cases, and how children respond to antimonial therapy. CL was observed most frequently in
children between 6–10 years old. Interestingly this group showed shorter duration of disease
and smaller lesions compared to 0–5 year and 11–15 year old groups. Females were more
affected in all groups. Lesion localization and types varied among groups, with 0–5 year old presenting head/neck and mucosal lesions, and more often suffered from recidivans type, this
could be associated to the longest duration of the disease in this group. Eleven-15 year old
group showed fewer lesions in the head/neck but more generalized lesions. Evaluation of treatment response revealed that intra-lesional treatment was preferred over intramuscular treatment. However, 0–5 year old received intramuscular treatment more often than the other
groups. Furthermore, the majority of 0–5 year old group which received intra-lesional treatment
did not received subsequent intra-lesional cycles, as did children in the range of 6–15 years old.
Conclusions/Significance
We report an increase in pediatric CL patients within the last four years. Analysis of pediatric
CL patients by age revealed significant differences in CL progression. The data suggestthat children between 0–5 years old responded better than other groups to intralesional
treatment, since they received more often a single cycle of IL treatment, although follow up
observation is required since they were more prone to develop recidivans. Eleven-15 year
old patients comprise the largest percentage of patients receiving two or three cycles of
intralesional treatment, suggesting that this group did not respond efficiently to intralesional
treatment and highlighting the need for more effective therapeutic strategies against CL.
