Abstract— Leishmaniasis is the collective name for a number of diseases caused by protozoan flagellates of the genus Leishmania, which is transmitted by Phlebotomine sandfly, the disease has diverse clinical manifestations and found in many areas of the world, particularly in Africa, Latin America, South and Central Asia, the Mediterranean basin and the Middle East. This study was done to assess primary health care physicians’ knowledge (PHP) and attitude about leishmaniasis and to assess awareness of local inhabitants about the disease and its vector in four areas in west Alexandria, Egypt. It is a cross sectional survey that was conducted in four PHC units in west Alexandria. All physicians currently working in these units during the study period were invited to participate in the study; only 20 PHP completed the questionnaire. 60 local inhabitants were selected randomly from the four areas of the study, 15 from each area; Data was collected through two different specially designed questionnaires. Results showed that 11 (55%) percent of the physicians had satisfactory knowledge; they answered more than 9 (60%) questions out of a total 14 questions about leishmaniasis and sandfly. On the other hand when attitude of the primary health care physicians about leishmaniasis was measured, results showed that 17 (85%) had good attitude and 3 (15%) had poor attitude. The second questionnaire showed that the awareness of local inhabitants about leishmaniasis and sandfly as a vector of the disease is poor and needs to be corrected. (90%) of the interviewed inhabitants had not heard about leishmaniasis, Only 3 (5%) of them said they know sandfly and its role in transmission of leishmaniasis. Thus we conclude that knowledge and attitudes of physicians are acceptable. However, there is, room for improvement and could be done through formal training courses and distribution of guidelines. In addition to raising the awareness of primary health care physicians about the importance of early detection and notification of cases of leishmaniasis, health education for raising awareness of the public regarding the vector and the disease is necessary because related studies have demonstrated that for inhabitants to take enough protective measures against the vector, they should perceive that it is responsible for causing a disease. Keywords—Attitude, knowledge, PHP, leishmaniasis, sandfly, local inhabitants, inside and outside housing conditions. I. INTRODUCTION HLEBOTOMINE sandflies of the genus Phlebotomus transmit the protozoan parasites responsible for leishmaniasis and a number of viruses known to cause human R. A. Mahran and N. F. Loutfy are with the High Institute of Public Health, Alexandria University, Egypt (phone: +203 4285575-6; e-mail: randamahran@alexu.edu.eg, nloutfy@link.net). O. M. Awad is with the Tropical Health Department, University of Alexandria, on leave from the High Institute of Public Health, Alexandria, Egypt (e-mail: osamamohawad@yahoo.com). illness. Leishmaniasis is a worldwide disease, affecting 88 countries, it is estimated that about 350 million people are at risk of leishmaniasis. Overall prevalence is 12 million people with annual mortality of about 60,000. Annual incidence is 1,500,000 cases of cutaneous leishmaniasis (CL) worldwide and half million cases of visceral Leishmaniasis (VL) [1], [2]. Leishmaniasis includes two major diseases, cutaneous leishmaniasis which causes skin ulcers and visceral leishmaniasis which causes a severe systemic disease that is usually fatal without treatment. Mucocutaneous leishmaniasis is a rare but severe form affecting the nasal and oral mucosa [3]. Epidemics of visceral leishmaniasis have occurred in East Africa since the Second World War, and in recent years the disease has appeared in new areas for example the north of Kartoum, in which deadly epidemics of VL periodically flare up but go mostly unnoticed in spite of case–fatality rates as high as 10% or more. In the 1990s Sudan suffered a crisis with an excess mortality of 100 000 deaths among people at risk. The disease is highly endemic in north-eastern Brazil where small scattered outbreaks occur periodically [4], [5]. Development projects in progress in many endemic areas of the Old and New World may introduce non-immune individuals into the region which can result in an alarming number of new infections. The self-healing lesions of cutaneous leishmaniasis caused by L.major and L. tropica limit their public health importance, but the working time lost and the costs of treatment can be significant socio- economically. The estimated global burden of disease is believed to be inaccurate due to the passive case detection data used to estimate the disease prevalence in many endemic countries [6]. Both VL and CL occur in Egypt although the prevalence is relatively low, it is primarily a disease of rural populations, but in some areas urban transmission exists. VL was found near Alexandria, in El Agamy in the eighties while CL was primarily identified in northern Sina [7], [8]. According to the unit of leishmania, filaria and malaria of ministry of health, the vector is present but there are no recorded cases of visceral leishmaniasis in Alexandria since 1996 till now. Official data frequently underestimates the real problem of leishmaniases since most of the official data are obtained exclusively through passive case detection. Numerous cases are undiagnosed, misdiagnosed or unreported due to several factors, including the scarcity or absence of diagnostic capabilities, poor accessibility by patients to medical facilities, Attitude and Knowledge of Primary Health Care Physicians and Local Inhabitants about Leishmaniasis and Sandfly in West Alexandria Randa M. Ali, Naguiba F. Loutfy, Osama M. Awad P World Academy of Science, Engineering and Technology International Journal of Humanities and Social Sciences Vol:9, No:6, 2015 2167 International Scholarly and Scientific Research & Innovation 9(6) 2015 ISNI:0000000091950263 Open Science Index, Humanities and Social Sciences Vol:9, No:6, 2015 publications.waset.org/10002367/pdf