Factors Associated with Early Referral for Pediatric Cutaneous Leishmaniasis

Determinants of early referral to healthcare providers, which may be useful for health policy, have not been investigated in pediatric cutaneous leishmaniasis with multivariate analyses. We aimed to explore determinants of early healthcare seeking in children with cutaneous leishmaniasis. Records of 1115 children with cutaneous leishmaniasis admitted to our hospital in Adana, Turkey were reviewed. Effects of age, sex, residential distance, lesion number, and faciocervical onset on early referral were evaluated with multivariate logistic regression analyses. The mean duration of the disease was 12.7 months. Early referral was significantly more likely in patients aged 1-5 and 6-10 years (odds ratio 2.32 and 1.32, respectively) than patients aged 11-18 years. A borderline-significant association was present for faciocervical onset. Early referral in younger children might be due to the fact that the younger the child, the greater the parental concerns about their child's health problems. The rate of late referral in older children may be decreased by some school-based health interventions.