Clinical pattern and treatment outcome of Cutaneous Leishmaniasis in two hospitals in Bahir Dar, Ethiopia (2017-2021)

Abstract

Introduction: Cutaneous Leishmaniasis (CL) in Ethiopia is caused by a unique species, L. aethiopica. In Ethiopia, there are limited studies that provide detailed clinical descriptions of CL, treatment options, and treatment outcomes.
 Methodology: We conducted a descriptive study based on routinely collected data in medical files from two hospitals in Bahir Dar, Ethiopia, from 2017 to 2021. Three months following the end of therapy, we retrieved sociodemographic and clinical data, as well as data on the treatment outcome.
 Result: Between March 2017 and June 2021, 94 patients were diagnosed with CL at the two hospitals. Of those, 46 (48.9%) of individuals had localized CL, 36 (38.3%) mucocutaneous leishmaniasis (MCL), and 12 (12.8%) diffuse CL. Sixty-five (69.1%) of the participants were men. The most prevalent morphologic appearances were plaque (n = 42, 46.2%), nodule (n = 38, 41.8%), infiltrative (n = 34, 36.2%), crusted (n = 32, 34%), and ulcerated (n = 24, 25.5%). Scarred, volcanic, and patchy lesions were also documented. Systemic pentavalent antimonials were the most common treatment (n = 55, 58.5%), curing 21/38 (55%) of the patients. Pentavalent antimonials were also given intralesionally to seventeen patients (18.1%), with 15/16 (94%) of them being cured. Overall, 61% (40/66) of patients with documented treatment outcomes were cured.
 Conclusions: As CL in Ethiopia has a wide array of clinical presentations, clinicians should be suspicious of patients from endemic areas who present with dermatologic manifestations. Physicians can employ local treatment as a first line before resorting to systemic therapy.

Treatment outcomes of cutaneous leishmaniasis due to Leishmania aethiopica: A systematic review and meta-analysis

“…A total of 808 study subjects participated in the 22 studies [ 8 – 11 , 13 – 18 , 25 – 36 ]. Twelve studies (nine case series [ 8 , 9 , 25 – 27 , 29 , 30 , 32 , 33 ] and three case reports [ 10 , 11 , 35 ]) documented treatment outcomes as part of routine clinical practice.…”

“…Twelve studies (nine case series [ 8 , 9 , 25 – 27 , 29 , 30 , 32 , 33 ] and three case reports [ 10 , 11 , 35 ]) documented treatment outcomes as part of routine clinical practice. All case series and case reports scored less than five in the NOS, but seven observational studies (five cohort studies [ 14 , 15 , 17 , 18 , 34 ] and two retrospective chart reviews [ 16 , 36 ]) scored five and above (Table A in S1 Table ). As shown in Table B in S1 Table , three studies were clinical trials [ 13 , 28 , 31 ], but only one has low RoB [ 13 ].…”

“…Sixty-six participants were involved in three clinical trial studies [ 13 , 28 , 31 ]. In the seven studies [ 14 – 18 , 34 , 36 ] which were used for meta-analysis, 677 study subjects participated.…”

“…In the 16 studies [ 8 – 10 , 13 – 18 , 25 , 26 , 28 , 32 – 36 ], the authors did parasitological confirmation of CL using SSS. The clinical phenotypes of CL were reported in 17 studies [ 11 , 13 , 14 , 16 – 18 , 25 , 27 – 36 ] and unspecified in five studies [ 8 – 10 , 15 , 26 ]. Ten studies [ 11 , 13 , 14 , 16 – 18 , 31 , 33 , 34 , 36 ] documented LCL clinical phenotype.…”

“…The clinical phenotypes of CL were reported in 17 studies [ 11 , 13 , 14 , 16 – 18 , 25 , 27 – 36 ] and unspecified in five studies [ 8 – 10 , 15 , 26 ]. Ten studies [ 11 , 13 , 14 , 16 – 18 , 31 , 33 , 34 , 36 ] documented LCL clinical phenotype. Most studies recorded treatment outcomes with antimonial drugs.…”