Evaluating the Efficacy of Topical Silver Nitrate and Intramuscular Antimonial Drugs in the Treatment of Cutaneous Leishmaniasis in Sokoto, Nigeria

Abstract

Background: Cutaneous leishmaniasis (CL) is a disease of public health importance in Nigeria, with high prevalence in the Northwest and Northeastern part of the country. The side effects of antimonial drugs {stibogluconate (SSG) and meglumine antimoniate} in the treatment of CL have often resulted in poor drug adherence and default by patients and possible drug resistance. The increasing default to follow-up and the significant side effects associated with antimonial therapy necessitated the dire need of alternative therapeutic modalities. Thus, this study aimed at comparing the efficacy of topical silver nitrate with the antimonial drugs in the treatment of CL. Methods: A total of 95 patients with clinically diagnosed leishmaniasis and parasitologically proven CL participated in the study after their informed-consent had been obtained. The treatment selection was optional to the participants. Sixty (63.2%) patients received alternative therapy of topical silver nitrate as a single dose while 35(36.8%) patients received antimonial therapy for 21 days at 20mg/kg body weight. Results: On day 30 of treatment, 68 (86.1%) lesions among patients on topical silver nitrate healed completely as compared with only 5 (6.8%) among those on i.m. SSG. There was no improvement in 25 (34.2%) lesions among those on i.m. SSG compared with only 1 (1.2%) lesion among those on topical silver nitrate. Overall, there was a  statistically significant difference in the cure rate among patients on silver nitrate as compared with those on i.m. SSG on the 21st and 30th days of treatment.(p<0.05). Conclusion: Topical silver nitrate therapy is an effective and better drug treatment for CL among this study
population.

Keywords: Cutaneous leishmaniasis, efficacy, Silver nitrate, Sodium Stibogluconate, Sokoto