Clinical pattern and treatment outcome of cutaneous leishmaniasis patients in Somali region, eastern Ethiopia.

Abstract

Background: Neglected tropical diseases, affecting over a billion people, include leishmaniasis, a protozoan parasite found in over 20 species. It is classified into three types: visceral, cutaneous, and muco-cutaneous leishmaniasis, with cutaneous leishmaniasis being the most common. Dogs and rodents are the primary reservoirs of leishmaniasis, which is transmitted by infected female sandflies. Cutaneous leishmaniasis, found on exposed parts such as the arms, face and legs, presents with diverse clinical manifestations, including erythematous lesions, large, painless nodules, ulceration and an eventual volcanic form.

Objective: To assess the clinical pattern and treatment outcome of cutaneous leishmaniasis patients in the Somali region of eastern Ethiopia.

Methods: This descriptive study was conducted in the Somali region using neglected tropical disease surveillance data collected from 1 September 2023, to 8 February 2024. The data were cleaned and then exported to STATA version 17 for analysis.

Results: From 1 September 2023, to 8 February 2024, 900 patients were diagnosed with cutaneous leishmaniasis. Of these, 105 (11.67%) patients had localised cutaneous leishmaniasis, 741 (82.33%) had disseminated cutaneous leishmaniasis, 20 (2.22%) had diffuse cutaneous leishmaniasis, 8 (0.89%) had mucocutaneous leishmaniasis, 12 (1.33%) had mucocutaneous and disseminated leishmaniasis and 14 (1.56%) had localised and mucocutaneous leishmaniasis. All of the cases were male; the most common signs and symptoms the patients showed were papule, nodule, ulcer and crust 791 (87.89%) and itching, fever and discharges 758 (84.22%), respectively. Most of the patients, 823 (93.34%), were given systemic pentavalent antimonials, and the cure rate was 886 (98.44%). Of the patients, 14 (100%) who were defaulted on had diffuse cutaneous leishmaniasis.

Conclusions: All the participants had travelled to an area where sandflies were common. The majority of patients complained of itching, fever and discharges, with over two-thirds having disseminated cutaneous leishmaniasis (DCL) and 0.89% having mucocutaneous leishmaniasis. The regional health bureau should set up a strong surveillance system and launch educational campaigns to raise awareness about cutaneous leishmaniasis, its transmission, symptoms and preventive measures. Furthermore, patients should be advised to strictly adhere to their treatment schedule and follow-ups.