RESUMO
OBJECTIVE: To assess the common presentations of leech infestation in leech endemic areas of Pakistan and to establish its association with unsafe water drinking habits of the individual. DESIGN: A cohort study. PLACE AND DURATION OF STUDY: CMH, Kohat, between 1st February 1997 and 30th April 2002. PATIENTS AND METHODS: Fourteen patients with leech infestation who reported to ENT department of CMH, Kohat, during the above period were selected for study. A specific comparison of their water drinking habits was made with a control group of 42 normal individuals who had come from the same leech endemic area as the first group and belonged to the same socioeconomic class. RESULTS: Twelve cases (83.4%) in the first group had unsafe water drinking habit i.e. they drank water directly from marshes without seeing its contents substituting cupped palm of hand for a drinking cup. This was in contrast to the control group where only 6 individuals (14%) gave a history of unsafe water drinking habits. Nose was the most common ENT site of leech infestation (71%) with epistaxis being the most prominent symptom. Other sites included hypopharynx (14%), nasopharynx (7 %) and oropharynx (7 %). All the 14 cases with leech infestation were males, 26.09 years being the mean age. The association between patient s unsafe water drinking habits and leech infestation in ENT region was statistically proved with odds ratio being 36. CONCLUSION: Epistaxis or any other related symptom must be taken with suspicion in leech endemic area. This condition is closely related to unsafe water drinking habits, therefore, the incidence of this infestation can be significantly reduced by educating the individuals to adopt safe water drinking habits.
