Cutaneous leishmaniasis in Sudan is caused by L. major, zymodeme LON-1. The disease is endemic in many parts of the country. The vector is Ph. Papatasi and the animal reservoir host is probably the Nile rat Arvicanthis niloticus.
The first known outbreak of cutaneous leishmaniasis in Khartoum involved about 10 000 recorded cases. The peak of the outbreak was in September 1986. The disease was widespread all over the province, but most of the affected areas were along the banks of the River Nile. People of both sexes, all age groups, different ethnic origins, and all socioeconomic classes were equally affected, suggesting that this epidemic was a new occurrence among a non-immune population.
Prevalence studies of cutaneous leishmaniasis among school children in villages on both banks of the Nile River north of Khartoum, in the aftermath of a 1985 epidemic showed 4% of the population had active cutaneous leishmaniasis lesions, 47% had healed lesions, and another 43% reacted positively to sensitization with leishmanin in the absence of past or active lesions. Ninety-one percent of the total population reacted positively to leishmanin. A leishmaniasis clinic was established and 736 cases were treated and studied. The duration of the lesions varied from a few days to 4 months, usually (56%) 1–3 months. The ulcers were mainly located on lower and upper limbs. Lesions were also found on the ear, scalp, genitalia and mucocutaneous junctions. Possible contributory factors were mass population movement from known endemic areas of cutaneous leishmaniasis in Sudan, expanding towns and new settlements in previously uninhabited areas, high population densities of sandflies, and an increase in the rodent population, including Arvicanthis species.