Cutaneous leishmaniasis in south-western Ethiopia: Ocholo revisited

Abstract

The borough of Ocholo, on the western side of the Ethiopian Rift Valley, is an endemic focus for Leishmania aethiopica infection and has been surveyed thrice between 1987 and 1990. In 1989, 3022 inhabitants (> 95% of the population) were interviewed and examined. The overall prevalence of localized cutaneous leishmaniasis (LCL) was 3.6-4.0%, with a peak value of 8.5% in the 0-10 years old age group. In half of the patients the active disease was estimated to last for 9.6 +/- 6 months; in 10%, it exceeded 3 years. Scars of LCL were present in 34.3% of the residents. Leishmanin skin tests were positive in 54% of 120 school-children without signs of the disease. Therefore, in Ocholo a minimum of 71.6% of the population has been exposed to L. aethiopica infection. Two cases of the diffuse form of cutaneous leishmaniasis were observed. In this highland biotope, Phlebotomus pedifer was found to be the major, and possibly the only, vector for L. aethiopica.

Risk map for cutaneous leishmaniasis in Ethiopia based on environmental factors as revealed by geographical information systems and statistics

“…The southern parts of the country (Fig. 4d), predicted as having many high-risk areas for CL, have also been described previously (Ashford et al, 1973;Mengistu et al, 1992;Gadisa et al, 2007;Negera et al, 2008).…”

“…The many different, vernacular names for CL in the various communities of Ethiopia Ashford et al, 1973;Mengistu et al, 1992) serve as evidence for its long existence there, yet the actual burden is not known and its environmental determinants are poorly understood. Bryceson et al (1969) reported 14 active CL cases and 12 patients with old scars from western Wollega and Dembi Dollo (previously in Wollega province, now in Oromia regional state), while Lemma et al (1969) documented a 22.5% positive leishmanin skin test (LST) in the town of Dessie and a 44.2% positive rate in the town of Karakore (both previously in Wollo province, now in Amhara regional state).…”

Epidemiologic characterization of American cutaneous leishmaniasis in an endemic region of eastern Venezuela.

“…This may be related to the occurrence of subclinical infections associated with repeated low-dose exposure, a situation frequently seen in endemic regions. 1,16,17 The territory of Bergantin is situated on the southeast side of the Turimiquire mountain range, in proximity to the territory of Naricual, where endemic foci of visceral and cutaneous leishmaniasis that are not characterized coexist. The main objective of this investigation was the study of the epidemiology of ACL in Bergantin, but the proximity to Naricual induced us to investigate the LST responses to antigens purified from amastigotes of parasite species associated mostly with the cutaneous and the visceral forms of the disease.…”

Dermatopathology Practice in Ethiopia

“…Some regions of the country are endemic, and the overall prevalence of localized cutaneous leishmaniasis reaches 4%. 7 Cutaneous leishmaniasis is mainly caused by Leishmania aethiopica, particularly in the highlands, and rarely by L. major. Leishmaniasis affects all age groups but is more common in children less than the age of 10 years.…”

“…Leishmaniasis affects all age groups but is more common in children less than the age of 10 years. 7 In localized cutaneous leishmaniasis, lesions grow on exposed areas of the skin as ulcers, which expand and spread (Figure 1). In mucocutaneous leishmaniasis, ulceration and swelling occur in the oral and nasal mucosa, and if left untreated, the infection can cause significant tissue destruction (Figures 2 and 3).…”