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埃塞俄比亚东部索马里地区皮肤利什曼病患者的临床症状及治疗结果

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

作者信息

Muse Abdilahi Ibrahim, Ibrahim Muse Obsiye, Ibrahim Muse Ahmed

机构信息

Regional Data Management Center for Health Somali Region Health Bureau Jigjiga Ethiopia.

Department of Public Health Institute of Health Science Jigjiga University Jigjiga Ethiopia.

出版信息

Skin Health Dis. 2024 Jun 30;4(5):e416. doi: 10.1002/ski2.416. eCollection 2024 Oct.

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.

摘要

背景

被忽视的热带病影响着超过10亿人,其中包括利什曼病,这是一种在20多种物种中发现的原生动物寄生虫。它分为三种类型:内脏利什曼病、皮肤利什曼病和黏膜皮肤利什曼病,其中皮肤利什曼病最为常见。狗和啮齿动物是利什曼病的主要宿主,该病由受感染的雌性白蛉传播。皮肤利什曼病出现在手臂、面部和腿部等暴露部位,临床表现多样,包括红斑性病变、大的无痛结节、溃疡以及最终的火山状形态。

目的

评估埃塞俄比亚东部索马里地区皮肤利什曼病患者的临床模式和治疗结果。

方法

本描述性研究在索马里地区开展,使用了2023年9月1日至2024年2月8日收集的被忽视热带病监测数据。数据经过清理后导出到STATA 17版本进行分析。

结果

2023年9月1日至2024年2月8日期间,900名患者被诊断为皮肤利什曼病。其中,105名(11.67%)患者患有局限性皮肤利什曼病,741名(82.33%)患有播散性皮肤利什曼病,20名(2.22%)患有弥漫性皮肤利什曼病,8名(0.89%)患有黏膜皮肤利什曼病,12名(1.33%)患有黏膜皮肤和播散性利什曼病,14名(1.56%)患有局限性和黏膜皮肤利什曼病。所有病例均为男性;患者最常见的体征和症状分别是丘疹、结节、溃疡和结痂791例(87.89%)以及瘙痒、发热和分泌物758例(84.22%)。大多数患者,823名(93.34%)接受了全身五价锑剂治疗,治愈率为886名(98.44%)。在这些患者中,14名(100%)失访的患者患有弥漫性皮肤利什曼病。

结论

所有参与者都去过白蛉常见的地区。大多数患者抱怨有瘙痒、发热和分泌物,超过三分之二患有播散性皮肤利什曼病(DCL),0.89%患有黏膜皮肤利什曼病。地区卫生局应建立强大的监测系统并开展教育活动,以提高对皮肤利什曼病及其传播、症状和预防措施的认识。此外,应建议患者严格遵守治疗计划和随访安排。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c34/11442055/87c396e9c968/SKI2-4-e416-g001.jpg

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