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1 Department of Family and Community Medicine, College of Medicine, University of Duhok, Duhok, Iraq. 2 Department of Medicine, College of Medicine, University of Duhok, Duhok, Iraq. 3 Preventive Health Department, Duhok General Directorate of Health, Duhok, Iraq. 4 Duhok General Directorate of Health, Duhok, Iraq. * Correspondence: samimaldabbagh@yahoo.com Introduction 2005, 2006 and 2008. Before ISIS poor suburb of Mosul has frequently considered as a main foci of the disease providing ideal conditions for the sand fly to breed and lay eggs The disease was rare in Duhok, and in 2013-2014 Duhok was the only province in Iraq, where no cases of CL were detected among the native population. The situation has, however, changed in 2013, where 39735 Syrian refugees came to Duhok. A total of 21 CL cases were reported among Syrian refugees and was for the first time such Background and objective: Cutaneous leishmaniasis is an endemic disease in Iraq, mainly in central and southern regions. The disease is, however, lower or rare in Kurdistan region of Iraq; which is situated to the north of the country. After the summer of 2014, there was a massive displacement of population to Kurdistan, mainly from the central region. The aim of this work was to investigate the outbreak reported by Duhok preventive health department among internally displaced persons from Ninewa to Duhok governorate between 2015-2017. Methods: A cross sectional study design was conducted on the records of internally displaced persons from Nineveh governorate who were diagnosed clinically as cutaneous leishmaniasis by Duhok health authority. Information regarding age, gender, occupation, places of current residency, expected vector exposure, displacement date and status, number of lesions, and date of onset. Results: A total of 451cases were reported during the study period. The mean age was 22.7±17.1 years, and about 69% of cases were in the age group of 5-44 years. The mean number and SD of lesions was 3.6 (±4.2), with a range of 1-35lesions. Three quarter of patients were off camps during diagnosis. Cases were mainly encountered in autumn. All, except 17, have suspected vector exposure outside Duhok governorate. No significant variation was noted regarding gender, age, occupation, urban/rural residency, and displacement status. Conclusion: A significant outbreak has occurred in Duhok, an area not known to be endemic with the disease. Close surveillance and strict preventive measures are highly recommended.

zanco journal of medical sciences

An outbreak of cutaneous leishmaniasis among internally displaced persons from the Nineveh governorate reported by Duhok Preventive Health Department from 2015 to 2017