Travel history and occupation among diagnosed Cutaneous Leishmaniasis cases in Guyana: A multi-site retrospective case series, 2017–2021
6 affiliations
- 1College of Medical Sciences, University of Guyana, Georgetown, Guyana
- 2Caribbean Center for Health and Wellness, Castries, Saint Lucia
- 3Vector Control Services, Ministry of Health, Georgetown, Guyana
- 4Lazaridis School of Business and Economics, Wilfrid Laurier University, Waterloo, Ontario, Canada
- 5Research Department, Joshi Health Inc., Oakville, Ontario, Canada
- 6Office of Research, International Executive School, Strasbourg, France
Abstract
Background: Cutaneous Leishmaniasis (CL) in Guyana has not been systematically characterised in the peer-reviewed literature for several decades. This study aimed to describe the demographic, occupational, geographic, and clinical profile of diagnosed CL cases at Guyana's principal diagnostic sites, and to test, within this case series, whether field-based occupation is associated with reported interior travel and whether travel history is associated with time to presentation. Methodology/Principal Findings: Retrospective case series (chart review) of CL diagnoses recorded at three facilities in Georgetown and the interior (2017–2021). Of 223 available case records, a random subsample of 170 was abstracted. Occupation and interior travel were patient-declared; their association was tested directly, then via adjusted logistic regression. Most patients (61.8%) reported interior travel, and 45.3% held field-based occupations, chiefly mining and military. Interior travel was more common among field-based than non-field workers (84.4% vs 43.0%; OR = 7.18 [95% CI, 3.42-15.04]; p < .001), and this association persisted after adjustment for age and sex (OR = 7.08 [3.07-16.30]). Younger age was associated with interior travel (OR = 0.96 [0.94-0.98]; p = .001), whereas sex was not. The sample was predominantly male (81.8%; median age 33 years). Patients with interior travel presented earlier than those without (Mdn = 61 vs 243 days; p < .001). Conclusions/Significance: Most diagnosed CL cases in this series occurred in people reporting interior travel, predominantly those in field-based occupations, and this travel history was associated with earlier presentation. All participants had CL and there was no comparison group, so these findings describe the case population and associations within it rather than risk factors for acquiring infection; they also rest on a single, retrospectively recorded travel variable. They nonetheless indicate where pre-deployment prevention, occupational screening, and traveller advisories could be focused, and they support a case-control study with validated exposure measurement. Author summary: In Guyana, cutaneous leishmaniasis is a skin disease spread by the bite of infected sandflies, which are found mainly in the forested interior of the country. The records of 170 patients diagnosed with this disease at three health facilities between 2017 and 2021 were reviewed to describe who was affected. Most patients had recently travelled into the interior, and this was especially common among miners and soldiers. Younger patients were more likely to have travelled, and those who had travelled sought care much sooner after their skin sore appeared than those who had not. The study included only people who already had the disease, so it cannot show that travel or a particular job causes infection; it shows how these characteristics are distributed among patients. Even so, these findings can help Guyana's health authorities decide where to focus prevention efforts, such as protective measures for workers heading into the interior and faster diagnosis for anyone returning from such trips with a new skin lesion. They also point to the need for studies that compare people with and without the disease.
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BibTeX
@article{kurup2026travel,
title = {{Travel history and occupation among diagnosed Cutaneous Leishmaniasis cases in Guyana: A multi-site retrospective case series, 2017–2021}},
author = {Rajini Kurup and Tiffany Roberts and Jimmy Naipaul and Zeska Williams and Alexus Michael and Annastacia Sampson and Reza Niles-Robin and Rita Persaud and Abilash Nair and Tejroi Naipaul},
journal = {PLOS Neglected Tropical Diseases},
year = {2026},
month = oct,
doi = {10.1371/journal.pntd.0014800},
url = {https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014800},
note = {CC BY},
}
RIS
TY - JOUR
TI - Travel history and occupation among diagnosed Cutaneous Leishmaniasis cases in Guyana: A multi-site retrospective case series, 2017–2021
AU - Rajini Kurup
AU - Tiffany Roberts
AU - Jimmy Naipaul
AU - Zeska Williams
AU - Alexus Michael
AU - Annastacia Sampson
AU - Reza Niles-Robin
AU - Rita Persaud
AU - Abilash Nair
AU - Tejroi Naipaul
PY - 2026
DA - 2026/10/01
JO - PLOS Neglected Tropical Diseases
DO - 10.1371/journal.pntd.0014800
UR - https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0014800
AB - Background: Cutaneous Leishmaniasis (CL) in Guyana has not been systematically characterised in the peer-reviewed literature for several decades. This study aimed to describe the demographic, occupational, geographic, and clinical profile of diagnosed CL cases at Guyana's principal diagnostic sites, and to test, within this case series, whether field-based occupation is associated with reported interior travel and whether travel history is associated with time to presentation. Methodology/Principal Findings: Retrospective case series (chart review) of CL diagnoses recorded at three facilities in Georgetown and the interior (2017–2021). Of 223 available case records, a random subsample of 170 was abstracted. Occupation and interior travel were patient-declared; their association was tested directly, then via adjusted logistic regression. Most patients (61.8%) reported interior travel, and 45.3% held field-based occupations, chiefly mining and military. Interior travel was more common among field-based than non-field workers (84.4% vs 43.0%; OR = 7.18 [95% CI, 3.42-15.04]; p < .001), and this association persisted after adjustment for age and sex (OR = 7.08 [3.07-16.30]). Younger age was associated with interior travel (OR = 0.96 [0.94-0.98]; p = .001), whereas sex was not. The sample was predominantly male (81.8%; median age 33 years). Patients with interior travel presented earlier than those without (Mdn = 61 vs 243 days; p < .001). Conclusions/Significance: Most diagnosed CL cases in this series occurred in people reporting interior travel, predominantly those in field-based occupations, and this travel history was associated with earlier presentation. All participants had CL and there was no comparison group, so these findings describe the case population and associations within it rather than risk factors for acquiring infection; they also rest on a single, retrospectively recorded travel variable. They nonetheless indicate where pre-deployment prevention, occupational screening, and traveller advisories could be focused, and they support a case-control study with validated exposure measurement. Author summary: In Guyana, cutaneous leishmaniasis is a skin disease spread by the bite of infected sandflies, which are found mainly in the forested interior of the country. The records of 170 patients diagnosed with this disease at three health facilities between 2017 and 2021 were reviewed to describe who was affected. Most patients had recently travelled into the interior, and this was especially common among miners and soldiers. Younger patients were more likely to have travelled, and those who had travelled sought care much sooner after their skin sore appeared than those who had not. The study included only people who already had the disease, so it cannot show that travel or a particular job causes infection; it shows how these characteristics are distributed among patients. Even so, these findings can help Guyana's health authorities decide where to focus prevention efforts, such as protective measures for workers heading into the interior and faster diagnosis for anyone returning from such trips with a new skin lesion. They also point to the need for studies that compare people with and without the disease.
SN - 1935-2735
SN - 1935-2727
ER -