Case Notification of Cutaneous Leishmaniasis at Different Elevations in the North-Central Ethiopia from 2018 To 2022
,
Abstract
Background: We aimed to analyze a four-year trend of Cutaneous leishmaniasis (CL) to determine risk levels and hotspots in North-central Ethiopia.
Methods: This retrospective study was conducted at Boru Meda Hospital (BMH) from March to April 2023, focusing on CL patients treated at the leishmaniasis treatment center (LTC). Data collected included age, gender, CL type, and other clinical factors. Each patient's origin was traced and geographically mapped by elevation to assess CL risk levels.
Results: There were a total of 573 CL patients reported from 46 districts, with a higher number of male patients (n=356) compared to female patients (n=217) (P <0.001). The median age of the patients was 21 years [15-30], with the highest number of CL cases observed among individuals aged 16 to 30 years. The majority of cases (69%) presented with localized CL (LCL). About 39% of patients had a previous treatment history for CL. A significant clustering of CL cases was observed at elevation of 2301-3300 meters above sea level (χ2:17.5; P <0.001), with the highest incidence (case notification) of 14.2/100,000 population.
Conclusion: Foci of CL, were burdened at higher elevations and no clinical variation were observed between elevation differences. The majority of cases were concentrated in an area covering approximately 21.4% of the total land mass. CL continues to be a significant issue in North-central Ethiopia and has the potential to spread to new areas.
1. Cardoso FO, Zaverucha do Valle T, Almeida-Souza F, Abreu-Silva AL, Calabrese KDS. Modulation of cytokines and extracellular matrix proteins expression by Leishmania amazonensis in susceptible and resistant mice. Front Microbiol. 2020;11:1986.
2. Bisetegn H, Zeleke AJ, Gadisa E, et al. Clinical, parasitological, and molecular profiles of cutaneous leishmaniasis and its associated factors among clinically suspected patients attending Borumeda Hospital, North-East Ethiopia. PLoS Neg Trop Dis. 2020;14(8):e0008507.
3. Yohannes M, Abebe Z, Boelee E. Prevalence and environmental determinants of cutaneous leishmaniasis in rural communities in Tigray, northern Ethiopia. PLoS Neg Trop Dis. 2019;13(9):e0007722.
4. Van Henten S, Adriaensen W, Fikre H, et al. Cutaneous Leishmaniasis Due to Leishmania aethiopica. EClinicalMedicine. 2018;6:69-81.
5. Shita EY, Semegn EN, Wubetu GY, Abitew AM, Andualem BG, Alemneh MG. Prevalence of Leishmania RNA virus in Leishmania parasites in patients with tegumentary leishmaniasis: A systematic review and meta-analysis. PLoS Neg Trop Dis. 2022;16(6):e0010427.
6. World Health Organization. Leishmaniasis. 2023 [Accessed: November 27, 2023]. Available from: https://www.who.int/news-room/fact-sheets/detail/leishmaniasis
7. Negera E, Gadisa E, Yamuah L, et al. The outbreak of cutaneous leishmaniasis in Silti woreda, Ethiopia: risk factor assessment and causative agent identification. Trans R Soc Trop Med Hyg. 2008;102:883–890.
8. Assefa A. Leishmaniasis in Ethiopia: a systematic review and meta-analysis of prevalence in animals and humans. Heliyon. 2018; 4:e00723.
9. Eshetu B, Mamo H. Cutaneous leishmaniasis in north-central Ethiopia: trend, clinical forms, geographic distribution, and determinants. Trop Med Health. 2020; 48:39.
10. Lemma W, Erenso G, Gadisa E, Balkew M, Gebre-Michael T, Hailu A. A zoonotic focus of cutaneous leishmaniasis in Addis Ababa, Ethiopia. Parasit Vectors. 2009;2:60.
11. Guideline for diagnosis, treatment, and prevention of leishmaniasis in Ethiopia. 2nd Edition June 2013.
12. Berhanu A, Dugassa S, Maru M, Animut A, Erko B, Hailu A, Gebresilassie A. Cutaneous leishmaniasis in Kutaber District, Ethiopia: Prevalence, sand fly fauna and community knowledge, attitude and practices. Heliyon. 2023;9:e18286.
13. Fikre H, Mohammed R, Atinafu S, van Griensven J, Diro E. Clinical features and treatment response of cutaneous leishmaniasis in North-West Ethiopia. Trop Med Int Health. 2017;22(10):1293-1301.
14. Zeleke AJ, Derso A, Yeshanew A, Mohammed R, Fikre H. A Ten-Year Trend of Cutaneous Leishmaniasis at University of Gondar Hospital, Northwest Ethiopia: 2009-2018. J Parasitol Res. 2021:8860056.
15. Dassoni F, Daba F, Naafs B, Morrone A. Leishmaniasis recidivans in Ethiopia: cutaneous and mucocutaneous features. J Infect Dev Ctries. 2017;11(1):106-110.
16. Solomon M, Fuchs I, Glazer Y, Schwartz E. Gender and Cutaneous Leishmaniasis in Israel. Trop Med Infect Dis. 2022;7:179.
17. Tilahun F, Alemu W, Mulatu G. Magnitude and associated factors of cutaneous leishmaniasis in Mekelle City, Ayder Referral Hospital, Tigray, Northern Ethiopia, 2014. Clin Med Res. 2014;3:189.
18. Arunashantha S, Jayarathne M, Wijesekera S, Sakalasooriya N, Kottage C. GIS-Based Situational Analysis of Cutaneous Leishmaniasis Disease (CLD) in Sri Lanka. Journal of Geoscience & Environment Protection. 2023;11:70-86.
19. Yared S, Gebresilassie A, Akililu E, et al. Diversity and altitudinal distribution of phlebotomine sandflies in visceral leishmaniasis endemic areas of northwest Ethiopia. Acta Trop. 2017;176:1-10.
20. Foster WA. Studies on leishmaniasis in Ethiopia. III. Resting and breeding sites, Flight behavior, and seasonal abundance of Phlebotomus longipes. Ann Trop Med Parasitol. 1972;66(3):313–28.
21. Sang DK, Chance ML. Studies on the Phlebotomus fauna of Mount Elgon, Kenya. Ann Trop Med Parasitol. 1993;87(5):509-515.
22. Ashford RW, Bray MA, Hutchinson MP, Bray RS. The epidemiology of cutaneous leishmaniasis in Ethiopia. Trans R Soc Trop Med Hyg. 1973;67(4):568-601.
23. Bastola A, Shrestha M, Lamsal M, et al. A case of high altitude cutaneous leishmaniasis in a non-endemic region in Nepal. Parasit Int. 2020; 74:101991.
24. Pareyn M, Rutten A, Merdekios B, et al. High-resolution habitat suitability model for Phlebotomus pedifer, the vector of cutaneous leishmaniasis in southwestern Ethiopia. Parasit Vectors. 2020;13:467.
25. Jones CM, Welburn SC. Leishmaniasis Beyond East Africa. Front Vet Sci. 2021;8:618766.
26. Ramezankhani R, Sajjadi N, Nezakati Esmaeilzadeh R, Jozi SA, Shirzadi MR. Spatial analysis of cutaneous leishmaniasis in an endemic area of Iran based on environmental factors. Geospatial Health. 2017;12(2):578.
27. Firouraghi N, Mostafavi SM, Raouf-Rahmati A, et al. Spatial-time Visualization of Cutaneous Leishmaniasis in an Urban Area: Informing Health Policy and Practice. Res Square. 2020.
28. Zeinali M, Mohebali M, Shirzadi, MR, et al. Integration and evaluation of cutaneous leishmaniasis laboratory diagnosis in the primary health care laboratory network. East Mediterr Health J.2023;29(10):810-818.
29. Mohebali M, Edrissian GhH, Shirzadi MR, et al. Integrated visceral leishmaniasis surveillance system in primary care for children in Meshkin-Shahr district, north-western Islamic Republic of Iran. East Mediterr Health J. 2010;16(10):1050-1054.
2. Bisetegn H, Zeleke AJ, Gadisa E, et al. Clinical, parasitological, and molecular profiles of cutaneous leishmaniasis and its associated factors among clinically suspected patients attending Borumeda Hospital, North-East Ethiopia. PLoS Neg Trop Dis. 2020;14(8):e0008507.
3. Yohannes M, Abebe Z, Boelee E. Prevalence and environmental determinants of cutaneous leishmaniasis in rural communities in Tigray, northern Ethiopia. PLoS Neg Trop Dis. 2019;13(9):e0007722.
4. Van Henten S, Adriaensen W, Fikre H, et al. Cutaneous Leishmaniasis Due to Leishmania aethiopica. EClinicalMedicine. 2018;6:69-81.
5. Shita EY, Semegn EN, Wubetu GY, Abitew AM, Andualem BG, Alemneh MG. Prevalence of Leishmania RNA virus in Leishmania parasites in patients with tegumentary leishmaniasis: A systematic review and meta-analysis. PLoS Neg Trop Dis. 2022;16(6):e0010427.
6. World Health Organization. Leishmaniasis. 2023 [Accessed: November 27, 2023]. Available from: https://www.who.int/news-room/fact-sheets/detail/leishmaniasis
7. Negera E, Gadisa E, Yamuah L, et al. The outbreak of cutaneous leishmaniasis in Silti woreda, Ethiopia: risk factor assessment and causative agent identification. Trans R Soc Trop Med Hyg. 2008;102:883–890.
8. Assefa A. Leishmaniasis in Ethiopia: a systematic review and meta-analysis of prevalence in animals and humans. Heliyon. 2018; 4:e00723.
9. Eshetu B, Mamo H. Cutaneous leishmaniasis in north-central Ethiopia: trend, clinical forms, geographic distribution, and determinants. Trop Med Health. 2020; 48:39.
10. Lemma W, Erenso G, Gadisa E, Balkew M, Gebre-Michael T, Hailu A. A zoonotic focus of cutaneous leishmaniasis in Addis Ababa, Ethiopia. Parasit Vectors. 2009;2:60.
11. Guideline for diagnosis, treatment, and prevention of leishmaniasis in Ethiopia. 2nd Edition June 2013.
12. Berhanu A, Dugassa S, Maru M, Animut A, Erko B, Hailu A, Gebresilassie A. Cutaneous leishmaniasis in Kutaber District, Ethiopia: Prevalence, sand fly fauna and community knowledge, attitude and practices. Heliyon. 2023;9:e18286.
13. Fikre H, Mohammed R, Atinafu S, van Griensven J, Diro E. Clinical features and treatment response of cutaneous leishmaniasis in North-West Ethiopia. Trop Med Int Health. 2017;22(10):1293-1301.
14. Zeleke AJ, Derso A, Yeshanew A, Mohammed R, Fikre H. A Ten-Year Trend of Cutaneous Leishmaniasis at University of Gondar Hospital, Northwest Ethiopia: 2009-2018. J Parasitol Res. 2021:8860056.
15. Dassoni F, Daba F, Naafs B, Morrone A. Leishmaniasis recidivans in Ethiopia: cutaneous and mucocutaneous features. J Infect Dev Ctries. 2017;11(1):106-110.
16. Solomon M, Fuchs I, Glazer Y, Schwartz E. Gender and Cutaneous Leishmaniasis in Israel. Trop Med Infect Dis. 2022;7:179.
17. Tilahun F, Alemu W, Mulatu G. Magnitude and associated factors of cutaneous leishmaniasis in Mekelle City, Ayder Referral Hospital, Tigray, Northern Ethiopia, 2014. Clin Med Res. 2014;3:189.
18. Arunashantha S, Jayarathne M, Wijesekera S, Sakalasooriya N, Kottage C. GIS-Based Situational Analysis of Cutaneous Leishmaniasis Disease (CLD) in Sri Lanka. Journal of Geoscience & Environment Protection. 2023;11:70-86.
19. Yared S, Gebresilassie A, Akililu E, et al. Diversity and altitudinal distribution of phlebotomine sandflies in visceral leishmaniasis endemic areas of northwest Ethiopia. Acta Trop. 2017;176:1-10.
20. Foster WA. Studies on leishmaniasis in Ethiopia. III. Resting and breeding sites, Flight behavior, and seasonal abundance of Phlebotomus longipes. Ann Trop Med Parasitol. 1972;66(3):313–28.
21. Sang DK, Chance ML. Studies on the Phlebotomus fauna of Mount Elgon, Kenya. Ann Trop Med Parasitol. 1993;87(5):509-515.
22. Ashford RW, Bray MA, Hutchinson MP, Bray RS. The epidemiology of cutaneous leishmaniasis in Ethiopia. Trans R Soc Trop Med Hyg. 1973;67(4):568-601.
23. Bastola A, Shrestha M, Lamsal M, et al. A case of high altitude cutaneous leishmaniasis in a non-endemic region in Nepal. Parasit Int. 2020; 74:101991.
24. Pareyn M, Rutten A, Merdekios B, et al. High-resolution habitat suitability model for Phlebotomus pedifer, the vector of cutaneous leishmaniasis in southwestern Ethiopia. Parasit Vectors. 2020;13:467.
25. Jones CM, Welburn SC. Leishmaniasis Beyond East Africa. Front Vet Sci. 2021;8:618766.
26. Ramezankhani R, Sajjadi N, Nezakati Esmaeilzadeh R, Jozi SA, Shirzadi MR. Spatial analysis of cutaneous leishmaniasis in an endemic area of Iran based on environmental factors. Geospatial Health. 2017;12(2):578.
27. Firouraghi N, Mostafavi SM, Raouf-Rahmati A, et al. Spatial-time Visualization of Cutaneous Leishmaniasis in an Urban Area: Informing Health Policy and Practice. Res Square. 2020.
28. Zeinali M, Mohebali M, Shirzadi, MR, et al. Integration and evaluation of cutaneous leishmaniasis laboratory diagnosis in the primary health care laboratory network. East Mediterr Health J.2023;29(10):810-818.
29. Mohebali M, Edrissian GhH, Shirzadi MR, et al. Integrated visceral leishmaniasis surveillance system in primary care for children in Meshkin-Shahr district, north-western Islamic Republic of Iran. East Mediterr Health J. 2010;16(10):1050-1054.
| Files | ||
| Issue | Vol 19 No 3 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijpa.v19i3.16395 | |
| Keywords | ||
| Cutaneous leishmaniasis Leishmania aethiopica Case notification Ethiopia | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Gashaw B, Yizengaw E, Nibret E, Workineh A, Tilahun F. Case Notification of Cutaneous Leishmaniasis at Different Elevations in the North-Central Ethiopia from 2018 To 2022. Iran J Parasitol. 2024;19(3):349-357.
