Cutaneous Leishmaniasis: A Neglected Vector Borne Tropical Disease in Midwestern Region of Nepal

Ghimire, Pragya Gautam; Shrestha, Richa; Pandey, Sumit Kumar; Pokhrel, Kumar; Pande, Rajan

doi:10.3126/njdvl.v16i1.19405

Cited by 12 publications

(24 citation statements)

References 8 publications

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“…More than three-quarters of CL cases had one lesion. This finding confirms the findings of previous studies from Lahj, Hajjah, Taiz, and Nepal [6][7][8]16]. In agreement with the findings of other studies [6,7,12], two-thirds of cases had lesions on their faces, and this might be because the face is the most exposed part of the body.…”

Section: Principal Findingssupporting

confidence: 92%

Cutaneous Leishmaniasis Outbreak Investigation in Hajjah Governorate, Yemen, in 2018: Case-Control Study (Preprint)

Nassar¹,

Abdelrazzaq²,

Almahaqri³

et al. 2021

Preprint

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BACKGROUND On 23 July 2018, Hajjah governorate surveillance officer notified Ministry of Health about increased number of cutaneous leishmaniasis (CL) cases in Bani-Oshb, Kuhlan district, Hajjah governorate. On 24 July 2018, Yemen Field Epidemiology Training Program sent a team to perform investigation. OBJECTIVE To describe a CL outbreak in Hajjah governorate and determine its risk factors. METHODS A descriptive study followed by a case-control study were conducted. Cases were defined as any person who met the suspected or confirmed case definition of WHO and live in Bani-Oshb sub-district during the period August 2017 - July 2018. Controls were defined as any person living for at least one year in Bani-Oshb without new or old skin lesions. Crude or adjusted Odd Ratios (cOR or aOR) with 95% Confidence Interval (CI) was used to test the significance of the association. RESULTS Thirty cases with leishmaniasis were found in Bani-Oshb sub-district during the period August 2017 - July 2018. Twenty-three percent of patients were younger than 5 years, 57% aged 5-14 year, 57% were females and 77% of cases had one lesion. The attack rate was 7 per 1000 population in the age group < 15 year and 1 per 1000 population in the age group ≥15 year. On bi-variate analysis the following factors were significantly associated with CL: female gender (cOR 5.2, 95% CI 1.7–16.5), malnutrition (cOR 5.2, 95% CI 1.7–16.5), not using bed net (cOR 14.5, 95% CI 1.7–122.4), poor house lightening (cOR 6.4, 95% CI 2.1–19.7), poor house hygiene (cOR 11.2, 95% CI 3.1–40.7), and poor sanitation (cOR 14.5, 95% CI 1.7–122.4), living in houses without windows net (OR 5.2, 95% CI 1.3–21.2), plantation around the house (cOR 6.5, 95% CI 2.1–20.5), animals barn inside or close to the house (cOR 9.3, 95% CI 1.9–46.7), raising animals (cOR 8.1, 95% CI 1.6–40.7) and having animal’s dung in or near the house (cOR 6.8, 95% CI 1.7–27.7). The following risk factors remained significant after application of multivariate stepwise analysis: female gender (aOR 22.7, 95% CI 1.6–320.5), malnutrition (aOR 17.2, 95% CI 1.3–225.8), poor house hygiene (aOR 45.6, 95% CI 2.5–846.4), plantation around the house (aOR 43.8, 95% CI 1.9–1009.9), and raising animals (aOR 287.1, 95% CI 5.4–15205.6). CONCLUSIONS CL in Hajjah governorate was endemic and a wave of increase in cases was confirmed. Many individual, housing, and animal related factors had been shown to contribute to CL endemicity. Implementation of control measures directed towards altering the factors favoring contact between vectors, reservoirs, and susceptible humans are strongly recommended to control future outbreaks. Further studies focusing on species of parasite, vectors and reservoir are also recommended.

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Section: Principal Findingssupporting

confidence: 92%

Cutaneous Leishmaniasis Outbreak Investigation in Hajjah Governorate, Yemen, in 2018: Case-Control Study (Preprint)

Nassar¹,

Abdelrazzaq²,

Almahaqri³

et al. 2021

Preprint

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“…First reported case of CL in Nepal was in 2006 which were imported from gulf countries. But now, there is increasing number of reports of natives of CL from far-western and central part of Nepal [6][7][8][9]. Here we report three cases of CL.…”

Section: Introductionmentioning

confidence: 73%

“…Cutaneous leishmaniasis is an emerging public health problem in Nepal [4]. From 2006 AD of first reported case of CL to present context, there are increasing number of cases being reported from different parts of country [6][7][8][9]. Previously, majority patient had history of travel to gulf countries but recently a studies denies such history in majority of patients [9].The geographic distribution of our cases of CL evaluated reflects travel and immigration patterns; two of the patients were returnees from Saudi Arabia, however, one of them denies any travel outside Nepal, similar to case being reported.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous leishmaniasis in Nepal: an emerging public health concerns

Paudel¹,

Parajuli²,

Chudal³

2020

Our Dermatol Online

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Cutaneous leishmaniasis, a vector borne protozoan infection of skin manifests as chronic nodulo-ulcerative growth in skin. In Nepal, cutaneous leishmaniasis, the most common form, supposed to be rare is gradually rising as an emerging public health concern. These days, a number of imported and native patients are being reported from different parts of Nepal. Since, it's less endemic here; there is high chance of being treated as other diseases. Here, we report a series of cases of cutaneous leishmaniasis, who presented in the outpatient department of dermatology, TU Teaching Hospital in the year 2015-2016 and was treated with meltifosine.

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“…Few cases are even noted in Hilly regions of Nepal [1]. Moreover, studies have demonstrated that cutaneous Leishmaniasis is an under recognized presentation of Leishmaniasis with significant cases noted in individuals inhabiting in the Terai belt as well as hilly region [5, 6].…”

Section: Discussionmentioning

confidence: 99%

A case report of visceral leishmaniasis and malaria co-infection with pancytopenia and splenomegaly - a diagnostic challenge

Ghimire

Adhikari

et al. 2019

BMC Infect Dis

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Background Leishmaniasis and malaria are tropical diseases with more than half of the world population at risk of infection resulting in significant morbidity and mortality. Co-infection of Leishmaniasis and malaria pose a great challenge in the diagnosis as well as overall management. Case presentation In this case report, we present a rare case of a 5 years old child hailing from non-endemic region of Nepal with history of fever for a period of 3 months who was diagnosed as co-infection of malaria due to Plasmodium vivax and visceral Leishmaniasis with pancytopenia that subsequently improved after a course of treatment. Conclusions A high index of suspicion for a possibility of co-infection with Leishmaniasis and malaria should be borne in mind when an individual hailing from or having history of travel to endemic countries presents with prolonged fever.

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Cutaneous Leishmaniasis: A Neglected Vector Borne Tropical Disease in Midwestern Region of Nepal

Cited by 12 publications

References 8 publications

Cutaneous Leishmaniasis Outbreak Investigation in Hajjah Governorate, Yemen, in 2018: Case-Control Study (Preprint)

Cutaneous Leishmaniasis Outbreak Investigation in Hajjah Governorate, Yemen, in 2018: Case-Control Study (Preprint)

Cutaneous leishmaniasis in Nepal: an emerging public health concerns

A case report of visceral leishmaniasis and malaria co-infection with pancytopenia and splenomegaly - a diagnostic challenge

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