Multifaceted Impact of Cutaneous Leishmaniasis: Treatment Challenges and Implications for Healthcare Systems and Society in Boru Meda Hospital, North-Central Ethiopia

Abstract

Background: Cutaneous Leishmaniasis (CL) is an increasing public health concern in Ethiopia, particularly with the L. aethiopica strain.  The disease often presents with and resulting persistent lesions, approximately six months after infection. This study aims to assess the  burden of CL based on clinical type, analyze trends in treatment responses, and identify challenges within the healthcare system among  cases treated at Boru Meda Hospital following the civil unrest.

Method: A retrospective analysis from April to June 2023 examined Cutaneous Leishmaniasis cases diagnosed between March 2022 to  February 2023. Demographic and clinical data were extracted from the registration logbook. Descriptive statistics summarized the  variables, while Non parametric test assessed associations among them.

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 (P<0.05), with individuals aged ≤ 20 years being  notably affected by the disease (120; P<0.05). The mean age of patients was 22.59±16.96 years. Approximately one-third of the patients  were repeat comers; requiring retreatment for more than one cycle. The proportion of clinical forms of CL in new and repeat were  similar. The main disease form, 72% of CL was localized cutaneous and the occurrence of the clinical form of CL was statistically  significant (P<0.05). Following civil unrest, the burden of the CL problem increased threefold. 

Conclusion: Cutaneous Leishmaniasis poses  a significant burden on patients' lifestyles and presses the healthcare system at Boru Meda Hospital. There is an influx of CL  patients, and still prominent number of patients need retreatment, which informs the difficulty of effectively treating the cases. It may  also entail epidemiologically higher parasite infectivity might circulate in the population and be reflected by the rise in CL cases after civil unrest. All this creates stress on the health system's operation. There is a need for ongoing surveillance and improved treatment  strategies to control the spread of the disease. Exploring genomic variations and the efficacy of treatment options used for CL is crucial.