Cutaneous leishmaniasis in the Jordanian side of the Jordan Valley: severe under‐reporting and consequences on public health management

OBJECTIVE: To test if cutaneous leishmaniasis (CL) is under-reported in the Jordanian Mid Jordan Valley, with resultant serious consequences for drug supply. METHODS: For 2001-2003, prescribed amounts of drug and laboratory log-books were investigated to estimate CL cases reported in Jordanian Mid Jordan Valley. From April 2004 to May 2005, passive detection and focused active 'index case cluster'-directed detection were used. RESULTS: An average of 75/100,000 cases per year was estimated to have occurred 2001-2003, resulting in under-reporting by a factor of 47. In 2004/2005, 313/100,000 cases per year were passively detected. Active case-finding detected additional cases. CONCLUSION: Cutaneous leishmaniasis is severely under-reported in Jordanian Mid Jordan Valley, which impacts its eradication.