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Childhood and adult cutaneous leishmaniasis in Tunisia

Cutaneous leishmaniasis (CL) is an infection caused by various species of Leishmania protozoa, which are mainly transmitted by the bite of Phlebotomine sandflies. It occurs widely throughout Africa, Asia, South America, the Middle East, and the Mediterranean region. In Tunisia, three epidemic clinical forms of CL are recognized. The most frequent one is zoonotic cutaneous leishmaniasis caused by Leishmania major MON-25. It is spreading in the center and south of the country. The second form is the anthroponotic CL occurring in the south-east of Tunisia and caused by Leishmania killicki and the final type is sporadic cutaneous leishmaniasis (SCL) occurring in north of Tunisia caused by Leishmania infantum. The leishmaniases are one of the so-called neglected tropical diseases. Whilst not fatal, CL can lead to significant morbidity as well as social stigma. CL can arise at any age and it often causes cosmetic disfiguration. The aim of this study was to describe the epidemiological, clinical, and therapeutic features of CL in Tunisia and to compare the clinical features of childhood and adult CL.