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Objective: To get a clear epidemiological picture of cutaneous leishmaniasis in a new endemic\udfocus, in order to address the most probable epidemic threats and its spread to the neighboring\udregions.\udMethods: A total of 870 clinically diagnosed patients were included in the study after taking\udconsent and filling questionnaires from each individual. The field Giemsa-stained slides and\udcultures were examined microscopically. The data was organized in tables and graphs and\udanalyzed using statistical package SPSS V 21.\udResults: The ratio of male was higher than females (499:371), cutaneous and mucocutaneous\udcases were 96.00% and 4.00%, and only 25.20% patient’s used bed nets. A total of 57.10% had\uddirty places near their homes. Similar cases in the neighborhood and in families were 48.50%\udand 67.10% respectively. Only 87.35 % of Patients in the age range of 1–20 years received\udtreatment. Up to five lesions per individual were noticed and 72.20% of them had symptomatic\udsecondary infections. The lesions were observed on different sites of the body.\udConclusions: Leishmaniasis is neglected in Landi Kotal Khyber Agency, the reasons being\udprevailing security situations and political sensitivity. North Atlantic Treaty Organization\udforces in Afghanistan are in contact with Afghanis and with local people of Landi Kotal for\udlogistic purposes. They may act as carriers in co-spreading of the species. There are potential\udrisks of cross border transmission, with the probability of future epidemics in the surrounding\udregions

New endemic focus of cutaneous leishmaniasis in Pakistan and future epidemics threats