Investigating factors influencing Cutaneous Leishmaniasis occurrence in an endemic area of Morocco: A PLS-SEM Approach

Background Cutaneous leishmaniasis (CL) is a vector-borne infectious disease endemic in many regions of the world, including Morocco. Its occurrence is influenced by multiple climatic and socio-demographic factors such as temperature, humidity, and population density. Understanding the interplay between these factors is essential for identifying disease risk determinants and guiding prevention strategies. Methods A multivariate analysis was conducted using Partial Least Squares Structural Equation Modeling (PLS-SEM) to explore the factors influencing CL occurrence in an endemic area of southeastern Morocco. The conceptual model incorporated climatic variables (temperature, precipitation, humidity) and population characteristics (population density, proportion under 15 years of age) to assess their direct and indirect effects on CL incidence. Results The analysis revealed that climatic indicators were the most significant determinants of CL occurrence (β = − 0.576, p < 0.001). Population characteristics had a weaker but significant positive association with CL (β = 0.247, p < 0.001). Furthermore, population characteristics mediated the relationship between climate and CL occurrence (β = 0.207, p = 0.053). The overall model explained 33.3% of the variance in CL incidence. Conclusion Climatic and demographic factors play key roles in shaping the spatial and temporal patterns of cutaneous leishmaniasis in southeastern Morocco. These findings highlight the importance of integrating environmental and population data in disease surveillance and can support the design of targeted public health interventions for leishmaniasis control.