Geopolitical and Geospatial Conflicts Affecting Cutaneous Leishmaniasis: Iraqi Cases, 2014-2015

Abstract

In Iraq, increment of cutaneous leishmaniasis (CL) was reported, a zoonotic type caused by Leishmania major and an anthroponotic type caused by Leishmania tropica. This is attributed to environmental changes, irregular construction, increased waste, and stray dogs in the cities. Internal displacement, poverty, and malnutrition play a role in the occurrence of disease. Iraq has been exposed to wars, civil war, widespread violence, and terrorism, Internal displacement of population, unlawful housing, shortage of municipal services, and accumulation of garbage have been increasing in the cities since 2003. Reports from Iraqi MOH documented an increase in the rate of CL. Eventually, case investigation, vector, and reservoir controls were suspended. Geopolitical conflicts and geospatial health deterioration contributed to an increase in various dominant reservoir species in these areas, particularly for ZCL, and the activity of the sand flies. A sudden sharp increase in CL cases was observed during 2003–2015. In conclusion, ongoing crises exposed Iraq to deterioration, collapse, and destruction of health system infrastructure and uncontrolled urbanization, all of which can act as risk factors for Leishmaniasis.