Background: Cutaneous leishmaniasis (CL) is one of the endemic and neglected diseases known to exist in Ethiopian highlands. However, a neglected tropical disease overshadowed by lack of effective anti-leishmaniasis agent in Ethiopia. Thus, high number of population is faced for various degree of socio-economical and psychosocial morbidity. Hence, this study was initiated and conducted from July-February, 2017/18 to assess the patterns and effectiveness of different types of anti-leishmaniasis agents in Boru Meda Hospital, Dessie District.

Background Cutaneous leishmaniasis (CL) is generally caused by Leishmania aethiopica in Ethiopia, and is relatively hard to treat. Sodium stibogluconate (SSG) is the only routinely and widely available antileishmanial treatment, and can be used systemically for severe lesions and locally for smaller lesions. There is limited data on the effectiveness of intralesional (IL) SSG for localized CL in Ethiopia and therefore good data is necessary to improve our understanding of the effectiveness of the treatment. Methodology/Principal findings A pragmatic (before and after Quazi experimental) study was done to assess the effectiveness of intralesional SSG among localized CL patients at Boru Meda general hospital, Northeast Ethiopia. Patients who were assigned to intralesional SSG by the treating physician were eligible for this study. Study subjects were recruited between January and August 2021. Infiltration of intralesional SSG was given weekly to a maximum of six doses. However, when a patient’s lesions were already cured before getting 6 doses, treatment was not conintued, and patient were only asked to come for lesion assessment. Skin slit smears (SSS) were taken each week until they became negative. Outcomes were assessed at day 90, with patients who had 100% reepithelization (for ulcerative lesions) and/or flattening (for indurated lesions) defined as cured. Multi-level logistic regression was done to assess factors associated with cure. A total of 83 patients were enrolled, and final outcomes were available for 72 (86.75%). From these 72, 43 (59.7%, 95% confidence interval 0.44–0.69) were cured at day 90. Adverse effects were common with 69/72 patients (95.8%) reporting injection site pain. Factors associated with cure were age (OR 1.07 95% CI: 1.07–1.27), being male (OR 1.79, 95% CI: 1.10–2.25), size of the lesion (OR 0.79, 95% CI: 0.078–0.94) and skin slit smear (SSS) result +1 grading (OR 1.53, 95% CI: 1.24–1.73) and +2 grading (OR 1.51, 95% CI: 1.41–3.89) compared to the SSS grade +6. Conclusion Our findings revealed that intralesional sodium stibogluconate resulted in a cure rate of around 60%, with almost all patients experiencing injection site pain. This emphasizes the need for local treatment options which are more patient-friendly and have better cure rates.

Introduction: Following the recommendation of the Global Leprosy Strategy, Ethiopia targeted to reduce the incidence of new leprosy cases, and the proportion with severe disability (grade 2) from 13.6% in 2016 to < 1% in 2020. This study assessed the clinical profile of new leprosy cases and the sequelae of previously treated ones 20 years after leprosy was eliminated as a public health problem in the country. Methodology: Hospital based cross sectional study was conducted  by reviewing the medical records of all leprosy patients seen at the dermatology clinic of Boru Meda Hospital from August to December 2018.The  data were captured using a standard data collection form. Results: Over the study period, 57 (27.4%) new cases and 151 (72.6%) previously treated cases were seen.The median age was 44 years (interquartile range 32-57). Among the newly diagnosed cases, two were under the age of 15 years , 51 (89.5%) were multibacillary and 34 (59.6%) had grade 2 disability. This included visual impairment in 10 (17.5%) and neurological complications in 44 (77.2%). Of the 151 previously treated cases, 104 (68.9%) presented with disabilities, including 97 (64.2%) with grade 2. Amongst previously treated cases, 130 (86.1%) had neurological complications. In addition, 53 (35.1%) had vision impairment. Conclusions: This study showed evidence of ongoing leprosy transmission and delayed diagnosis in the country. This calls for operational research to determine the underlying reasons and provide ways forward. At the same time, the high burden of disabilities in previously treated cases should be addressed.

Introduction: The majority of neglected tropical diseases (NTDs) have established primary skin manifestations or associated clinical feature. Skin NTDs often result in physical impairment and disfigurement, which can lead to disability. Skin diseases have been proposed as an entry point for integrated NTDs control. However, the magnitude and overlap of skin NTDs is poorly understood. Methodology: An institution-based cross-sectional study was done using medical records of dermatology patients between July 2017 and June 2018 in a dermatology service in Northeast Ethiopia. A total of 661 patient records were selected using simple random sampling. Results: A total of 656 complete records were included in analysis. Skin NTDs constituted 17.2% (n = 113) of the overall of skin diseases. Of skin NTDS, cutaneous leishmaniasis (n = 40; 35.4%), leprosy (n = 38; 33.6%), and scabies (n = 31; 27.4%) were the most common. Additionally, there were four cases of mycetoma. Of the non NTDs, poverty-related infections such as superficial fungal (n = 118; 21.1%) and bacterial (n = 33; 5.2%) infections were also frequent. Tinea capitis was the most common superficial fungal infections. Impetigo and cellulitis were the predominant bacterial infections. Conclusions: Skin NTDsand other poverty related skin infections were common at the dermatology service. Dermatological services could act as a good entry point for integrated management of skin NTDs. Future studies should assess how different preventive strategies like contact tracing, early diagnosis and mass drug administration can be integrated.

Background: Skin diseases are the fourth most common cause of human illness which results in enormous non-fatal burden in daily life activities. They are caused by chemical, physical and biological factors. Visual assessment in combination with clinical information is the common diagnostic procedure for diseases. However, these procedures are manual, time-consuming, and require experience and excellent visual perception. Objectives: In this study, an automated system is proposed for the diagnosis of five common skin diseases by using data from clinical images and patient information using deep learning pre-trained mobilenet-v2 model. Methods: Clinical images were acquired using different smartphone cameras and patient's information were collected during patient registration. Different data preprocessing and augmentation techniques were applied to boost the performance of the model prior to training. Results: A multiclass classification accuracy of 97.5%, sensitivity of 97.7% and precision of 97.7% has been achieved using the proposed technique for the common five skin disease. The results demonstrate that, the developed system provides excellent diagnosis performance for the five skin diseases. Conclusion:The system has been designed as a smartphone application and it has the potential to be used as a decision support system in low resource settings, where both the expert dermatologist and the means are limited. | INTRODUCTIONSkin is the largest organ of the body which provides protection, regulates the body fluids and temperature, and enables sense of the external environment. 1 Skin diseases are the most common cause of all human illnesses which affects almost 900 million people in the world at any time. 2 According to the global burden of disease project, skin disease is the fourth leading cause of non-fatal disease burden throughout the world. 3 An estimated 21%-87% of children in Africa are affected by skin diseases. 4 Skin disease can cause financial, socio-economic, and psychological burden to the community and place a strain on health professionals. [5][6][7][8][9][10][11][12] Moreover, skin diseases may cause a sense of depression, frustration, isolation, and even suicidal ideation. 13 The pattern of skin diseases varies due to environmental factors, hygienic standards, social customs, and genetics. In developing countries, infection and infestation are more common. 4 There are more than 3000 known skin diseases worldwide. 14 According to a preliminary study conducted for this research, acne vulgaris, atopic dermatitis, lichen planus, onychomycosisThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Background Although Ethiopia eliminated leprosy as public health problem 20 years ago, still more than 3000 new cases are reported annually. Leprosy related disability affects patients' day to day physical activities and their participation in social activities. Assessing the degree of activity limitation and social participation is recommended to show disability and assess the efficacy of rehabilitation efforts. Methodology and principal finding A hospital based cross sectional study was conducted among a total of 305 leprosy patients. Data were collected by face to face interview using Screening of Activity Limitation and Safety Awareness (SALSA) scale and participation scale. The analysis was done with SPSS version 25. Descriptive statistics was done and then binary logistic regression was used to identify factors associated with activity limitation as well as participation limitation. Most patients (219, 71.8%) had activity limitation; 41 (13.4%) with severe and 25 (8.2%) with extreme limitations. More than half of patients (168, 55.1%) were suffering from participation restriction; with 43 (14.1%) having severe restriction and 30 (9.8%) extreme restriction. Older age, low educational status, distance from treatment center, time of treatment and higher Eye, Hand, Foot disability score were associated with activity limitation. Similarly, older age, low educational status and being unmarried were significantly associated with participation restriction. Conclusion This study revealed that activity limitation and participation restriction are common among leprosy patients. Earlier diagnosis and improved rehabilitative services may help to decrease activity limitation, whereas community rehabilitation may improve social PLOS NEGLECTED TROPICAL DISEASES

Introduction: Irrational use of topical corticosteroid (TC) is quite common in Ethiopia due to the unrestricted availability and use of topical steroids (TS) not only by general public but also by physicians and chemists. This practice is highly prevalent and sought after, owing to the quick relief of symptoms in different dermatological conditions and its nature of enhancing beauty for a certain period. Objective: This study aims to evaluate and analyze the prevalence of misuse of topical steroids, causes behind the misuse and consequences after the use of topical steroids among females in a dermatology outpatient department (OPD) at Ayder Referral Hospital, Ethiopia. Materials and Methods: A cross-sectional observational questionnaire based study was conducted from April to August 2015. Patients were questioned and assessed for misuse of topical steroids in terms of indication, dose, frequency, duration, effects after use and source of recommendation of topical steroids among female clients. Results: During the study period, 104 (27.1%) patients presented with inappropriate use of topical steroids among patients (n=384) who were attended the OPD of dermatology unit at Ayder Referral Hospital, the only hospital providing treatment, care and preventive measures for dermatological cases, with a response rate of 97%. A total of 72 patients were presented with adverse effects of topical steroids resulting from the misuse of these drugs for various purposes. Misuse of topical steroids was found to be most prevalent in the age group of 21-30 years (51.15%) followed by age group between 11-20 years (21.15%), who were severely affected due to its inappropriate use. Whereas, melasma (40.38%) and rosacea (35.6%) were the most common reasons of steroid abuse, followed by facial acne (26%), use as sunscreen 44 (42.3%), non-specific dermatosis 35 (33.7%) and skin lightening (10.58%). Patients using topical corticosteroids as over-the-counter (OTC) after recommendation made by friends and family (44.8%) was found to be a factor of influence on the misuse of topical steroids followed by pharmacist and drug store vendors as over the counter patterns of use (31.7%). The least were recommended by clinicians (10.57%) for the treatment of acne, melasma/hyper-pigmentation and to improve the appearance during weddings and other ceremonies. Dermovate and dermalar (70.18%) were the most commonly used topical steroid preparations, causing the patients to often develop fungal infections such as tinea incognito (26.4%), followed by facial acne (25.6%), telangiectasia and rosacea (41%) being the most common side effects experienced. Conclusion: Misuse of topical steroids was found to be very common owing to prescriptions by dermatologists, the major reason being recommendations by healthcare professionals, pharmacists, family and friends. Abuse of these steroids causes fungal, bacterial infections and rosacea which leads to many other secondary complications.

Background Skin diseases are the fourth most common cause of human illness which results enormous non-fatal burden in daily life activities. They are caused by chemical, physical and biological factors. Visual assessment in combination with clinical information is the common diagnosis procedure for the diseases. However, these procedures are manual, time consuming, and require experience and excellent visual perception. Methods In this study, an automated system is proposed for diagnosis of five common skin diseases by using data from clinical images and patient information using deep learning pretrained mobilenet-v2 model. Clinical images were acquired using different smartphone cameras and patient’s information were collected during patient registration. Different data preprocessing and augmentation techniques were applied to boost the performance of the model prior to training. Results A multiclass classification accuracy of 97.5%, sensitivity of 97.7% and precision of 97.7% has been achieved using the proposed technique for the common five skin disease. The results demonstrate that, the developed system provides excellent diagnosis performance for the five skin diseases. Conclusion The system has been designed as a smartphone application and it has a potential to be used as a decision support system in low resource settings, where both the expert dermatologist and the means is limited.