Clinical Manifestations and Traditional Practice in Patients with Cutaneous Leishmaniasis: Do Leishmaniasis Induce High Blood Glucose Levels?

Abstract

Background: Female sandflies transmit cutaneous leishmaniasis (CL), where cytokines influence ulcerative lesions. Certain parasite  strains may exacerbate disease severity. Pro-inflammatory cytokines can both control CL and trigger autoimmune disorders. Leishmania  aethiopica, prevalent in Ethiopia, exhibits unique lesion characteristics. Although previous studies have focused on CL's clinical  presentations and epidemiology, the link between lesion features, comorbidities, and autoimmune diseases—particularly blood glucose  levels was not researched. This study aims to investigate this connection.

Method: A cross-sectional study was conducted at Lay Gayint District Nefas Mewcha Primary Hospital over four months, from September  2023 to December 2023. Skin slit samples were collected to check the presence of the amastigotes stage of Leishmania, the clinical  variabilities' were characterized by a guiding atlas and demographic data collected on a checklist.. Fasting blood glucose levels were  measured using a glucometer. A blood sample was taken from the middle finger and applied to the strip. Blood glucose level reading was  reported in mg/dl. 

Result: The primary clinical form of the disease was Localized CL type (68%), with the majority of lesions appearing on the face (90%). About 45.5% of CL patients use traditional Medicine before visiting the hospital. Elevated blood glucose  levels (≥126mg/dl) were found in 27% of CL patients, with 69.2% ≤ 45 years old. The mucosal type of CL patients’ blood glucose level was  higher than the LCL type 31.2 %Vs 26.7% respectively, although it was not statistically significant. CL cases of (18.4%) were clustered  within the same household. Lesions larger than 4mm² were seen in 75% of patients (χ2:11; p<0.05). 

Conclusion: A significant proportion  of CL patients’ had a raised blood glucose level. High blood glucose level might exacerbate disease progression and lesion severity.  However, with a larger sample size a follow-up research is necessary to establish a causal link. It is imperative for leishmaniasis treatment  initiatives to prioritize the management of comorbidities, such as hyperglycemia. Also, it is equally important to enhance  patient access to timely treatment and educational interventions aimed at reducing treatment delays.