Old World leishmaniasis focus: Kabul , Afghanistan

This flat, residential area of Kabul has a lower incidence of cutaneous leishmaniasis (CL) than the surrounding hilly areas. It is thought that this distribution might be due to the sand fly vector which prefers to breed in the habitat of the surrounding hills. Phlebotomus sergenti transmits the parasite when it bites people at night in their homes. Leishmania tropica, the causative agent of CL in Kabul, is a major public health problem. In the late 1990s at the peak of the epidemic there were up to 50,000 cases annually. This situation was precipitated by the migration of people due to war and political unrest which provided a source of nonimmune individuals.