Iraq | Programme areas | Leishmaniasis (visceral and cutaneous)

Leishmaniasis (visceral and cutaneous)

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Leishmaniasis is caused by parasitic protozoa of the genus Leishmania. Humans are infected via the bite of phlebotomine sandflies, which breed in forest areas, caves, or the burrows of small rodents. There are 4 main types of the disease:

  • In cutaneous forms, skin ulcers usually form on exposed areas, such as the face, arms and legs. These usually heal within a few months, leaving scars.
  • Diffuse cutaneous leishmaniasis produces disseminated and chronic skin lesions resembling those of lepromatous leprosy. It is difficult to treat.
  • In mucocutaneous forms, the lesions can partially or totally destroy the mucous membranes of the nose, mouth and throat cavities and surrounding tissues.
  • Visceral leishmaniasis, also known as kala azar, is characterized by high fever, substantial weight loss, swelling of the spleen and liver, and anaemia. If left untreated, the disease can have a fatality rate as high as 100% within 2 years.

Leishmaniasis (visceral and cutaneous), rabies and schistosomiasis are among the neglected tropical diseases found in the country. The incidence of visceral leishmaniasis has been reduced dramatically from 34.5 per 100 00 in 2010 to 1.1 per 100 000 in 2014. The reduction in the incidence is attributed to the comprehensive package of prevention and control activities conducted by the Iraqi Ministry of Health with technical and logistics support from WHO.

Population movements, overcrowding, lack of safe water and hygiene, and poor access to health services are common factors that can cause the spread of these diseases. Free diagnosis and treatment is available for all tropical diseases in public sector. Historically, leishmaniasis cases have been located in the greater Baghdad area, but the situation has now shifted to the poorer suburbs of Mosul, as well as to rural areas, mostly in the northern and western governorates. There is seasonal variation, and both internal migration and movements of refugees may result in epidemic visceral leishmaniasis.

In the last 5-6 years WHO collaborative support for communicable diseases has been substantial and covers wide range of activities, including assessments, situation analysis, support for development of policies, guidelines,  strategies and operational plans of action. A high priority was accorded to assist in strengthening the national immunization, disease surveillance, outbreak preparedness and response, laboratory upgrading and disease prevention and control. The collaborative activities have a special focus on leishmaniasis control, including many communicable diseases.

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Key health-related statistics

Total population (000s) 36 934
Total health expenditure on health (% of general government expenditure) 6.5
Maternal mortality ratio (per 100 000 live births) 50
Number of primary health care units and centres (per 10 000 population) 0.7
Total life expectancy at birth (years) 68.9

Source: Country statistical profiles (2016)

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