Manifestations of Cutaneous Leishmaniasis (CL): Does Elevated Blood Sugar Level have Implications for Clinical Management of CL?

Abstract

AbstractBackground: Cutaneous Leishmaniasis (CL) is a disease caused by a protozoan parasite transmitted through the bites of female sandflies. In Ethiopia, the predominant causative agent of CL is Leishmania aethiopica (L.aethiopica). However, there may be contributions from other parasite strains through genomic sharing. This parasite has developed sophisticated mechanisms to survive within host cells, evading immune responses. The resulting lesions caused by L. aethiopica display unique characteristics. The primary objective of this study was to compile a comprehensive dataset on lesion features and additional clinical attributes and explore the potential relation between blood glucose levels and CL in North-west Ethiopia.Method: A cross-sectional study was conducted at Lay Gayint District Nefas Mewcha Primary Hospital over four months, from September 2023 to December 2023. Skin slit samples were collected to check the presence of the amastigotes stage of Leishmania using 100× objective under microscope. Fasting blood glucose levels were measured using a glucometer. A blood sample was taken from the middle finger and applied to the strip. Blood glucose level reading was reported in mg/dl.Result: In a study period involving 14,080 patients at the hospital, 75 cases of CL were identified. The primary clinical form of the disease was Localized CL (LCL) (68%), with the majority of lesions appearing on the face (90%). Elevated blood glucose levels (>120mg/dl) were found in 27% of CL patients, with 56.5% in those ? 45 years old. A significant number of CL cases (18.4%) were clustered within the same household. Lesions larger than 4mm2 were seen in 75% of patients (?2:11; p<0.05), and nearly 78% lived with the lesion for over 6 months (?2: 20; P<0.05).Conclusion: The findings indicate that a significant proportion of Cutaneous Leishmaniasis (CL) patients exhibit elevated glucose levels, potentially exacerbating disease progression and lesion severity. Nonetheless, additional research is necessary to establish a causal link. It is imperative for leishmaniasis treatment initiatives to prioritize the management of comorbidities, such as hyperglycemia, and enhance patient access to timely treatment through educational interventions aimed at reducing treatment delays. [Ethiop. J. Health Dev. 2023; 37(2)]Keywords: Blood glucose, cutaneous leishmaniasis, Lesion size, North-west Ethiopia