Zoonotic Cutaneous Leishmaniasis Prevalence Among Farmers in Central Tunisia, 2014.

OBJECTIVE: Zoonotic cutaneous leishmaniasis (ZCL) is endemic in central Tunisia and is more prevalent in rural agricultural areas. The aim of this work was to determine ZCL prevalence among farmers and to test their availability to take ownership of the problem and participate actively to fight and address the disease.

METHODS: A sample of farmers from Sidi Bouzid, central Tunisia, was selected randomly. Farmers were interviewed using a standardized questionnaire about ZCL lesion occurrence, its date of onset among family members, and the farmers' availability to contribute to fighting this disease.

RESULTS: ZCL occurred in at least one of the family members of 38.5% interviewed farmers. The disease was endemic with recurrent epidemics every 4 or 5 years. ZCL among farmers was associated with irrigation management. With regard to ZCL preventive measures, the majority of farmers agreed and expressed willingness to collaborate (93.1%), to follow health care facilities instructions (73.1%), and to join the nongovernmental organization (NGO) (56.9%). However, they did not agree to reduce irrigation activities mainly at night, to live far from their irrigated fields, or to sleep out of their houses at night.

CONCLUSIONS: ZCL is more prevalent in farmers engaged in irrigation activities. Farmers are not agreeable to reducing their activity to avoid exposure to the sand fly bites. Thus, population involvement and commitment is required to implement effective control measures to fight and address ZCL.