Introduction: Leishmania, a protozoan parasite, employs various strategies, including the secretion of surface proteins, to evade the host's immune response, which can lead to severe clinical manifestations, particularly in immunocompromised individuals. In Ethiopia, cutaneous leishmaniasis (CL) presents distinct clinical features, often influenced by different factors. The primary immune responses to Leishmania infections involve neutrophils, macrophages, and dendritic cells, which play crucial roles in both the recognition and elimination of the parasite. Recent research has highlighted the importance of the cytokine environment in modulating these immune responses, as different cytokines can either enhance or hinder the effectiveness of the immune system against Leishmania.
Sodium Stibogluconate (SSG) remains a frontline treatment for
cutaneous leishmaniasis in Ethiopia; however, its efficacy can vary due to
factors such as parasite resistance and host genetic variability. Studies have
suggested that combination therapies, including SSG with immunomodulatory
agents, may enhance treatment outcomes by improving the host's immune response
while targeting the parasite more effectively.
Aim: This study aims to evaluate the host cellular profile of
cutaneous Leishmaniasis patients following SSG treatment. Assessing changes in
immune cell populations, hematological parameters, and overall host resilience
against anti-leishmania treatment, thereby contributing to a more comprehensive
understanding of therapeutic strategies in CL management.
Methods: A longitudinal Pre-Post study design was conducted at
Adiss Alem Primary Hospital in Bahir Dar, Ethiopia, spanning from September
2022 to August 2024. Data analysis, interpretation and synthesis were done for
three month period between September to November 2024 G.C. Blood samples were
collected from participants and analyzed using the CC20 Plus automated
hematology machine, ensuring prompt investigation to maintain sample integrity.
Participants received an initial dosage of SSG at 20 mg/kg/day for
a duration of 28 days. To assess the treatment's impact, blood analyses were
conducted at three distinct time points: prior to the initiation of SSG
treatment, after two weeks of therapy, and at the conclusion of the 28-day treatment
period. This longitudinal approach allowed for a comprehensive evaluation of
hematological changes over the course of the treatment.
Statistical analysis was performed using one-way ANOVA to compare
the mean values of relevant blood parameters across the three-time points. A
significance level was set at p < 0.05, corresponding to a 95% confidence
interval, to ensure that the findings were statistically robust. This
methodological framework aimed to provide valuable insights into the cellular
and hematological effects of SSG treatment in CL patients, contributing to the
understanding of treatment efficacy in endemic regions.
Results: In a comprehensive
two-year study involving 96 individuals diagnosed with cutaneous leishmaniasis
(CL), a notable predominance of male patients was observed. The treatment
regimen utilizing sodium stibogluconate demonstrated significant hematological
effects, leading to marked reductions in white blood cell counts, lymphocyte
levels, and hemoglobin concentrations, all with a p-value of less than 0.05,
indicating statistical significance. While the treatment negatively diminished
these parameters, it is important to note that several other hematological
indicators showed signs of recovery on treatment.
Conclusion: Careful monitoring of hematological parameters during
CL treatment is needed, as sodium stibogluconate may contribute to notable
changes in the blood profiles of affected individuals. To ensure homeostasis
and immune function in CL patients on SSG treatment, supplementary medications
should be included. Exploring alternative treatments for CL management is
crucial.
Close monitoring of hematological parameters during treatment for
cutaneous leishmaniasis (CL) is essential, particularly because sodium
stibogluconate (SSG) can induce significant alterations in blood profiles among
affected individuals. Patients receiving SSG may experience changes such as
leukopenia, thrombocytopenia, or anemia, which can compromise their immune
function and overall health. Therefore, it is imperative to incorporate
supplementary medications that can help support homeostasis and bolster immune
responses during the course of treatment. Furthermore, exploring alternative
treatment options for CL management is crucial, as it may provide safer and
more effective solutions that minimize hematological side effects. Research
into newer therapies, including immunotherapies and novel pharmacological
agents, is essential to improve treatment protocols and offer patients a
comprehensive approach to managing this challenging condition. This highlights
the complex interplay of therapeutic effects and the body's response to the
disease and treatment.
Author
(s) Details
Bizuayehu Gashaw
Department of Biology, College of Science, Bahir Dar University, Bahir Dar,
Ethiopia.
Endalew Yizengaw
Department of Medical Laboratory Science, Bahir Dar University, Bahir Dar,
Ethiopia.
Zelalem Mehari
Department of Epidemiology and Biostatistics, Bahir Dar University, Bahir
Dar, Ethiopia.
Banchwossen Sebsibe
Department of Dermatology, Felege Hiwot Hospital, Bahir Dar, Amhara Region,
Ethiopia.
Feiza Seid
Department of Dermatology and Venereology, Bahir Dar University, Bahir Dar,
Ethiopia
Tsedalu Alemu
Addis Alem Primary Hospital, Leishmaniasis Treatment Center, Bahir Dar,
Ethiopia.
Endalkachew Nibret
Department of Biology, College of Science, Bahir Dar University, Bahir Dar,
Ethiopia.
Please see the book here:- https://doi.org/10.9734/bpi/dhrd/v4/3805
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