Environmental factors and building conditions for risk of cutaneous leishmaniasis in the northeast of Iran: a population-based case-control study

Background Leishmaniasis is a tropical disease that significantly affects countries in the developing world. This study evaluated the environmental factors and building conditions associated with cutaneous leishmaniasis (CL) in northeast Iran. Methods A population-based case-control study was performed between 1 July 2018 and 1 March 2021 in northeast Iran; two controls were selected for each case. Patients and controls were compared for environmental factors, building conditions and demographic characteristics. Results There were 170 confirmed leishmaniasis cases during the study period. Familiarity with people with active leishmaniasis in open areas of the body increased the odds of getting the disease (odds ratio [OR] 2.41 [95% confidence interval {CI} 1.18 to 4.93]). In the case group, the history of contact with animals such as sheep, goats, cows, mice and camels was significantly higher. Housewives (OR 0.08 [95% CI 0.02 to 0.27]) and self-employed people (OR 0.22 [95% CI 0.07 to 0.70]) were less likely to become infected. The individuals who lived in houses with asbestos cement roofs were more likely to become infected (OR 4.77 [95% CI 1.34 to 16.91]) compared with those who lived in houses with bituminous roofs. Conclusions The most significant risk factor identified in the present study was the type and condition of the home's roof. Housing construction improvement is vital to prevent leishmaniasis in northeast Iran.