The burden of cutaneous leishmaniasis in Libya (2019-2022): Epidemiological insights and treatment practices.

Background: Cutaneous leishmaniasis (CL) has been a significant public health concern in Libya for five decades, with transmission dynamics that are both zoonotic and anthroponotic. The disease was first reported in 1930, and since then, it has become widespread, particularly in the north-western region. Aim: This study aimed to illustrate changes in the epidemiological characteristics and treatment practices of CL in Libya during the period 2019-2022. Methods: Data for this study were obtained from the Administration of Zoonotic Disease Control at the Libyan National Center for Disease Control NCDCL in Tripoli. The dataset included information from 40 endemic sites across 10 municipalities. A chi-square test was performed to analyze the relationships among 19 key variables related to the incidence, demographic distribution, and treatment patterns of CL. Results: Between 2019 and 2022, an estimated 13,625 CL cases were reported in Libyan hospitals, with fluctuating annual incidence rates. The highest number of cases was recorded in 2019, followed by a gradual decline over subsequent years. The age range of affected individuals ranged from 1 month to 95 years, with males accounting for 57.60% of cases and females accounting for 42.40%. Clinical diagnosis relied primarily on lesion features and epidemiological data, while laboratory confirmation was achieved using Giemsa staining. Cryotherapy has emerged as the predominant first-line treatment in regions with high disease prevalence. Conclusion: CL continues to pose a substantial public health challenge in Libya, intensified by the ongoing socio-political instability affecting disease surveillance and management systems. Comprehensive strategies integrating medical interventions and community-based initiatives are essential for mitigating the adverse medical and social impacts of CL in the country.