Epidemiology of Cutaneous Leishmaniasis in Maranhão State, Brazil: Demographic and Socioeconomic Insights | Chapter 4 | An Overview of Disease and Health Research Vol. 7

 

Cutaneous Leishmaniasis (CL) represents a significant public health challenge, particularly in endemic regions such as Brazil. This chapter delves into the epidemiological landscape of CL within Maranhão State, Brazil, aiming to elucidate the intricate interplay of factors contributing to its persistent prevalence. Drawing upon a comprehensive analysis of epidemiological data, we explore the demographic characteristics of affected populations, the environmental determinants influencing disease transmission, and the broader socioeconomic contexts that shape vulnerability to this neglected tropical disease. The narrative highlights the specific challenges encountered in controlling CL in Maranhão and proposes forward-looking strategies for enhanced disease management and prevention. Through a detailed examination of risk factors, this chapter seeks to provide a didactic overview for researchers, public health practitioners, and policymakers, fostering a deeper understanding of CL and informing more targeted public health initiatives. These findings underscore the critical role of sociodemographic factors, such as age, gender, and educational attainment, in shaping the disease's burden, thereby reinforcing the imperative for integrated health education and preventive policies. From 2020 to 2024, 6,406 cases were registered, marked by a significant number between the years 2020 to 2023, with a substantial decrease in the year 2024, with only 676 cases. A higher prevalence was observed in the ages between 20 and 39 years, and in the ages between 40 and 59 years, with males disproportionately affected. Individuals with incomplete elementary education had a higher incidence of confirmed cases, highlighting that lower educational levels tend to be more vulnerable to infectious diseases due to a limited understanding of the forms of transmission, prevention, and symptoms. This often delays care-seeking, treatment initiation, and ongoing health monitoring. Therefore, there is a need for health education in rural areas with the aim of informing and raising awareness among the population about the disease.

 

 

Author(s) Details

Maria Eduarda Santos Ferreira
Faculty of Health Sciences Pitágoras de Codó, Codó, Brazil.

 

Fernanda da Silva Ferreira
Faculty of Health Sciences Pitágoras de Codó, Codó, Brazil.

 

Keylla da Silva Machado
Faculty of Health Sciences Pitágoras de Codó, Codó, Brazil.

 

Rodrigo Lopes Gomes Gonçalves
Faculty of Health Sciences Pitágoras de Codó, Codó, Brazil.

 

Ian Jhemes Oliveira Sousa
Faculty of Health Sciences Pitágoras de Codó, Codó, Brazil.

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v7/6541

Cutaneous Leishmaniasis and Quality of Life | Chapter 1 | Disease and Health Research: New Insights Vol. 4

Introduction: Cutaneous Leishmaniasis (CL) is a neglected tropical disease caused by Leishmania parasites. It is prevalent and affecting the quality of human life in more than 100 countries globally. The impact of CL as a public health problem has often been expressed in epidemiological and clinical prevalence and incidence figures. However, considering the impact of the disease beyond morbidity, mortality and changes in patient’s appearance would help to better understand the disease.

 

Aim: This study determined the effect of CL on quality of life.

 

Methods: The sociodemographic and clinical information related to the disease was collected using an interviewer-administered questionnaire. The questions were categorised under seven domains: symptoms & feelings, daily activities, work and school, leisure, personal relationships, and treatment. Each question was scored on a three-point scale: Very much (3), A lot (2), A little (1), Undecided (0), and Not at all (0). The sum of the scores lay between 0 and 48. A higher score shows a worse quality of life. The data were entered and analysed using Statistical Package for Social Science 23. Frequencies and proportions were used to describe the data. Differences were considered statistically significant at p < 0.05.

 

Results: The lives of the majority (60.7%) of CL patients were significantly affected by CL. The quality of life of patients was moderately impacted by CL in 25% of the CL patients. In 32.1% of the CL patients, the effect of CL on patients’ quality of life was very large. The quality of one CL patient’s life was extremely largely affected. The disease had a small effect on 32.1% of the CL patients. Personal relationship was the most affected domain followed by symptoms, feelings and treatment. Future study with large sample sizes including rural regions is required. The domain related to personal relationships was the most affected domain followed by symptoms and feelings, treatment and leisure. Patients with CL lesions might develop a broad spectrum of psychosocial sufferings.

 

Conclusion: The Dermatology Life Quality Index demonstrates that CL has a small to extremely very large negative effect on the quality of life of patients. This study informs future programs and interventions aimed at mitigating the adverse consequences of this disease on individuals' quality of life.

 

Author (s) Details

Endalew Yizengaw
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia and Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia.

 

Endalkachew Nibret
Institute of Biotechnology, Bahir Dar University, Bahir Dar, Ethiopia and Department of Biology, College of Science, Bahir Dar University, Bahir Dar, Ethiopia.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v4/1791

Host Resilience and Cellular Response in Cutaneous Leishmaniasis Treatment: A Pre-Post Study in Ethiopia | Chapter 4 | Disease and Health: Research Developments Vol. 4

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

Cutaneous Leishmaniasis and Elevation in the Ethiopian Context | Chapter 3 | Medical Science: Trends and Innovations Vol. 3

Introduction: Cutaneous leishmaniasis (CL) is a disease of the skin and hampers the daily activity of patients. It is commonly found in Tropics and sub-tropic regions. In Ethiopia, the dominant CL-causing parasitic variant is Leishmania (L) aethiopica with few cases of L. tropica and L. major. Recent evidence showed that L. donovani, usually causes Visceral leishmaniasis, also known to cause CL.  Although CL in Ethiopia is associated with high land areas, now a day’s substantial number of CL cases is being reported in low land areas of the country.  In the Amhara region, one of the CL-affected regions in Ethiopia, most CL cases want to see traditional and religious treatment options, so that the real burden of the disease is not well recorded.

Aim: This study analyzed a four-year trend of CL and determined risk levels and hotspots in North-central Ethiopia.

Methods: A retrospective study was conducted at Boru Meda Hospital (BMH) from March to April 2023. Detailed demographic, clinical and epidemiological data was retrieved from   WHO standardized patient diagnosis and treatment log book. The collected data was synchronized with the elevation, of where patient residence. This helps to map the specific CL hot spot sites. It gives clues and insight for further research on environmental factors to take actions of preventive measures. The burden of CL was estimated per100, 000 population. The data was analyzed with SPSS version 23 using the chi-square test (Fisher exact test) to assess association across groups, with significance set at P < 0.05.

Results: A total of 573 CL patients were 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%) were localized CL type.  About 39% of CL patients were repeat, treated previously for CL. A significant clustering of CL cases was observed at an elevation of 2301-3300 meters above sea level (χ2:17.5; P<0.001). The overall incidence of CL was 9.4/100,000 population.

Conclusion: Most CL cases were clustered at higher elevations but CL cases are still reported from lowland areas. No significant difference for CL clinical types was observed between elevation differences. CL continues to be a significant issue in North-central Ethiopia and has the potential to spread to new areas.

 

Author (s) Details

Bizuayehu Gashaw
Amhara National Regional State Health Bureau, Bahir Dar, Ethiopia and Department of Biology, College of Science, Bahir Dar University, P.O Box 79, Bahir Dar, Ethiopia.

 

Endalew Yizengaw
Department of Medical Laboratory Science, College of Medicine and Health Science, Bahir Dar University, P.O Box 79, Bahir Dar, Ethiopia and Institute of Biotechnology, Bahir Dar University, P.O Box 79, Bahir Dar, Ethiopia.

 

Endalkachew Nibret
Department of Biology, College of Science, Bahir Dar University, P.O Box 79, Bahir Dar, Ethiopia and Institute of Biotechnology, Bahir Dar University, P.O Box 79, Bahir Dar, Ethiopia.

 

Addisu Workineh
Amhara National Regional State Health Bureau, Bahir Dar, Ethiopia.

 

Feleke Tilahun
Boru Meda Hospital, Dessie, Ethiopia.

 

Please see the book here:- https://doi.org/10.9734/bpi/msti/v3/3619

Miltefosine Nanoparticles against Leishmaniasis: Past, Present and Future| Chapter 7 | Current Overview on Pharmaceutical Science Vol. 4

 Miltefosine (MF), an alkyl phospholipid grown initially to treat breast tumor, is a highly effective situation for leishmaniasis, a neglected hot disease that is the planet's second leading cause of parasitic end of life after malaria.MF has lot-limiting gastrointestinal side effects in sufferers, and its infiltration through lipophilic barriers is lowered. This paper supplies an overview of the drug MF, its physicochemical features, pharmacokinetics, mechanism of action, and the differing nanocarriers used. It comprehensively reviews ultimate recent published essay on different methods for increasing the bioavailability of MF for the treatment of leishmaniasis. In current years, nanomedicine has emerged at the prominence of nanotechnology, creating high beliefs in the biomedical field. Researchers are developing novel nanoparticles for diagnostic requests using image technology and treatment requests using drug delivery sciences. Mesoporous silica nanoparticles (MSN), a porous material, have sparked interest on account of their appealing physicochemical properties and favorable morphological features.

Author(s) Details:

Parag Ghosh,
School of Pharmacy, The Neotia University, Sarisa, West Bengal 743368, India.

Subhasish Mondal,
School of Pharmacy, The Neotia University, Sarisa, West Bengal 743368, India.

Anirbandeep Bose,
TAAB Biostudy Services, Kolkata, West Bengal, India.

Please see the link here: https://stm.bookpi.org/COPS-V4/article/view/9309