Cutaneous Leishmaniasis: It’s burden and challenge for patients and the health care system at Boru Meda Hospital, North-Central Ethiopia

Abstract

AbstractBackground: Cutaneous Leishmaniasis (CL) has become a growing concern in Ethiopia, affecting a larger population across a wider geographical area. The L. aethiopica form of the disease typically presents its lesion about six months after being bitten by an infected sand fly. Treatment for CL can be challenging, as some patients may not fully recover and may continue to experience persistent and troubling lesions. Despite efforts to address the issue, there is a lack of comprehensive monitoring of CL cases based on clinical manifestations and treatment outcomes. This study aims to assess the burden of CL by clinical form and examine the trends in treatment response among CL cases treated at Boru Meda Hospital following the civil unrest in the region.Method: A retrospective analysis was conducted between April and June of the year 2023, focusing on individuals diagnosed with Cutaneous Leishmaniasis (CL) within the period spanning from March 2022 to February 2023. The examination primarily involved scrutinizing the registration logbook for fundamental demographic and clinical information. Descriptive statistical methods were employed to elucidate the characteristics of the variables under consideration, while the associations among these variables were evaluated through the application of the chi-square test.Result: During the study period, 492 out of 40,324 total patients were diagnosed with cutaneous leishmaniasis, resulting in a prevalence rate of 1.22%. Males exhibited a significantly higher incidence of CL compared to females (?2:7; P<0.05), with individuals aged ? 20 years being notably affected by the disease (?2:120; P<0.05). The mean age of patients was 22.59±16.96 years. Approximately one-third of the patients were returning; requiring retreatment. The main disease form, 72% of CL were localized cutaneous and the occurance of the clinical form of CL were statistically significant (?2:95; P<0.05). The chi-square test showed that treatment history (New Vs. Repeat) and age category, sex difference and microscopic result didn’t show any significant association while CL type had association (p<0.05).Conclusion: Cutaneous Leishmaniasis poses a significant burden on patients and the healthcare system at Boru Meda Hospital in North-Central Ethiopia. The rise in cutaneous leishmaniasis cases after civil unrest underscores the susceptibility of these individuals to sand fly bites and possibly the introduction of CL to new areas which could potentially lead to epidemics. The recurrence of patients (1/3rd of them) also highlights the difficulties in effectively treating and preventing CL in this population, that put heavy sress on the health care system as well affecting the patients life style, emphasizing the need for ongoing surveillance and improved treatment strategies to control the spread of the disease. Exploring genomic variations and the efficacy of SSG in treating CL further is crucial for better understanding and managing this public health concern. [Ethiop. J. Health Dev. 2023; 37(2): 00-00]Keywords: Cutaneous Leishmaniasis, Leishmania aethiopica, Treatment response, Repeat cutaneous leishmaniasis