{'fraction_non_alphanumeric': 0.03468208092485549, 'fraction_numerical': 0.030635838150289016, 'mean_word_length': 5.031358885017422, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
An An outbreak of cutaneous leishmaniasis in Erbil governorate of Iraqi Kurdistan Region in 2015.

INTRODUCTION
This study aimed to identify the sociodemographic factors associated with the occurrence of an outbreak of cutaneous leishmaniasis in Erbil governorate and to determine the geographical distribution and clinical pattern of the disease during this outbreak.


METHODOLOGY
This cross-sectional study involved 234 cutaneous leishmaniasis cases from Erbil governorate. A questionnaire completed in an interview provided data on sociodemographic and clinical characteristics, risk factors, and preventive measures.


RESULTS
About 60% of participants were younger than 35 years; 59.4% were living in urban areas. Most cases (40.2%) were from Maxmur district, while 20.9% were internally displaced persons and 7.7% were refugees. Nearly 70% of the cases had a low socioeconomic status. Cases with multiple lesions constituted 65.5%. Upper limb lesions constituted 44.7%. Most lesions were 1-5 cm in size (64.7%) and were wet (63.6%). Nearly three-quarters of the cases had a history of traveling to endemic areas; most (49.7%) to Maxmur district. Around 80% reported fogging around the houses and 44.4% in the working area. The peak incidence of the cutaneous leishmaniasis cases was in December, with a total of 115 cases.


CONCLUSIONS
Cutaneous leishmaniasis was not endemic in Erbil governorate, but it became a public health challenge in 2015. Most of the cases were reported in Maxmur district and among internally displaced people and military personnel deployed there. Control and prevention activities, including fogging and spraying, face important challenges and need strengthening, especially in Maxmur district.