20 YEARS OF CUTANEOUS LEISHMANIASIS IN ALEPPO, SYRIA

Cutaneous leishmaniasis caused by Leishmania tropica has long been ass ociated with Aleppo in Syria. For 20 years up to the mid-1980s, the nu mber of cases reported annually in the city and environs has remained low not exceeding a few hundred. Since then, there has been a sudden i ncrease to several thousand cases reported each year. The increase see ms too great and too sudden to be attributable to improved case detect ion. Insecticide spraying, begun in 1991, was followed by a reduction in number of cases in 1992, but numbers increased subsequently in spit e of continued spraying. The cases are found mainly in areas undergoin g development outside the old centre of the city, and may be associate d with poor waste disposal and heaps of construction waste.