Effectiveness of Attractive Toxic Sugar Baits (ATSB) in Reducing Cutaneous Leishmaniasis among Military Personnel in Isfahan Province, Central Part of Iran

Background: We aimed to evaluate the effectiveness of Attractive Toxic Sugar Baits (ATSB) in reducing the incidence of Cutaneous leishmaniasis (CL) among military personnel in Isfahan Province, Iran. Methods: The ATSB solution was prepared and applied to vegetation located approximately 500 meters from residential areas to target and eliminate sand fly vectors. Clinical samples were subsequently collected from individuals with suspected CL. The number of CL new cases among military personnel in 2022 was compared with collected historical data from 2012 to 2021, including the number of CL new cases, demographic characteristics, and seasonal incidence patterns. Statistical analysis was performed using ANOVA to assess whether the intervention led to a significant reduction in disease occurrence. Results: Following the application of ATSB, the new cases of CL among military personnel decreased from an average of 196 cases per year (2012–2021) to 55 cases in 2022. Seasonal analysis revealed a decline across all seasons, with the most notable reduction observed in autumn. Demographic analysis showed reductions in both male and female groups. However, statistical analysis using ANOVA indicated that the observed differences before and after the intervention were not statistically significant (P=0.087). Conclusion: Despite a decline in CL case numbers in the studied areas, the reduction following ATSB application was not statistically significant. Nevertheless, ATSB may serve as a promising complementary approach for controlling CL in endemic regions. Further studies with larger sample sizes and extended follow-up periods are recommended to validate its effectiveness.