Residential environment, human behavior and socio-economic status in transmission of cutaneous leishmaniasis in central Iran

Cutaneous leishmaniasis (CL) is a vector-borne disease occurred through the bite of sandflies. Due to impact of environmental factors on the disease, this study aimed to assess the association between socio-economic status (SES), domestic, peri-domestic, and human behavior factors and the transmission of CL in Isfahan province in central Iran. This case-control study was conducted from March 2021 till March 2022 on 322 participants. Cases and controls were selected among CL patients and people with no history of leishmaniasis respectively by cluster random sampling method in a ratio of 1:1. A semi-structured questionnaire was completed for each patient and control. Multiple logistic regression models and odds ratio (OR) estimator were used to assess the relationships. In final model after adjusting for potential confounders the variables "moderate social and economic status", "individuals who rest outside at night in summer", "the presence of animals near the residence" and also the variables related to distance of homes to gathering places of insects remained significant. Adults and individuals who use preventive measures such as insecticides, insect repellent pen and sleeping the mosquito net significantly decrease the risk of disease. Our findings showed that human behavior and peri-domestic factors have most effects on transmission of leishmaniasis.