The Effects of Prevention Knowledge Compared to the Improvement of Housing Conditionsin Control of Anthroponotic Cutaneous Leishmaniasis: a Natural Experience of Earthquake in Bam/Iran

Background and Aims: There are still many unknowns about prevention and control of Anthroponotic cutaneous leishmaniasis (ACL). Bam district is one of the old foci of CL. The aim of this study was to compare the effect of knowledge of prevention and improving housing, conditions in control of ACL based on a natural experience of earthquack, in Bam city. Methods: This comparative – analytical study was carried out in two time periods of before and after the 2003 bam Earthquake. Sampling was performed through random cluster method from the CL high risk areas within the city of Bam. The selected houses were actively visited in a similar manner and data about houses, hygienic conditions and the history of CL infection in the last three years were recorded. Data were analyzed through SPSS software and using t, Chi-Square and regression tests. Results: Both knowledge of CL prevention and housing, conditions were significantly better (p<0.0001) after the 2003 earthquake than before the earthquake. While the knowledge of CL prevention alone had no direct effect on the incidence rate of disease during both two time periods, improvement of housing, conditions was effective in decreasing the incidence rate significantly (p<0.0001). The household heads of houses with better living conditions indicated a high knowledge of prevention (r= 0.7, p<0.001). Conclusion: As it was seen, the earthquake has caused basic changes in hygienic conditions of houses and promotion of knowledge of CL prevention. Therefore, consequenthy improvement of housing, conditions directly and improvement of prevention knowledge indirectly decreased the incidence rate of CL. Therefore, for control and elimination of ACL, in addition to the early treatment, improvement of housing conditions is highly important.