Evidence map›Paper›PMID 37886367›Full record

ArticleFrontiers in medicine2023

Community-based treatment of cutaneous leishmaniasis using cryotherapy and miltefosine in Southwest Ethiopia: the way forward?

Saskia van Henten, Myrthe Pareyn, Dagimawie Tadesse, Mekidim Kassa, Mehret Techane, Eyerusalem Kinfe, Nigatu Girma, Degnet Demeke, Mebratu Mesay, Mekibib Kassa and 6 more

Open access · goldAbstract read
In one paragraph

Article in Frontiers in medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.7field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 2 institutions in 2 countries.

Saskia van HentenDepartment of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.
Myrthe PareynDepartment of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.
Dagimawie TadesseDepartment of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Mekidim KassaDepartment of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Mehret TechaneDepartment of Dermatology, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Eyerusalem KinfeDepartment of Dermatology, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Nigatu GirmaDepartment of Biology, College of Natural and Computational Sciences, Arba Minch University, Arba Minch, Ethiopia.
Degnet DemekeDepartment of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Mebratu MesayDepartment of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Mekibib KassaLeishmaniasis Research and Treatment Center, University of Gondar Hospital, Gondar, Ethiopia.
Rodas TemesgenDepartment of Internal Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Misgun ShewangizawDepartment of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Fekadu MasseboDepartment of Biology, College of Natural and Computational Sciences, Arba Minch University, Arba Minch, Ethiopia.
Johan van GriensvenDepartment of Clinical Sciences, Institute of Tropical Medicine Antwerp, Antwerp, Belgium.
Teklu WegayehuDepartment of Biology, College of Natural and Computational Sciences, Arba Minch University, Arba Minch, Ethiopia.
Behailu MerdekiosDepartment of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Arba Minch University · ETInstituut voor Tropische Geneeskunde · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Cutaneous leishmaniasis (CL) is a common, yet massively underreported skin morbidity in Ethiopia. Most patients never seek treatment, as this is offered only in specialized treatment centers. Early diagnosis and treatment through decentralization is crucial to decrease transmission and to reach the NTD roadmap goals. However, little information is available on outcomes and challenges of community-based treatment initiatives. Methods: A community-based prospective cohort study was conducted in Ochollo. Patients with clinically or microscopy confirmed CL were included. Cryotherapy was (to be) given weekly with at least four sessions for uncomplicated lesions, and miltefosine was given for 4 weeks for complicated lesions. Miltefosine adherence was assessed by counting pill strips. Clinical and patient-reported outcomes (dermatological life quality index and patient-global assessment) were assessed at month 6 (M6). Results: A total of 107 patients were included, with a median age of 6 years. Two patients refused, and 15 could not be treated as they were too young (<4 years) for miltefosine. Giving cryotherapy to patients weekly was not feasible due to long wound healing times and required use of topical antibiotics. Only 52.4% of miltefosine patients finished >90% of their tablets by M1. Among 46 patients treated with cryotherapy, 24 (52.2%) were cured at M6, and 9 (19.6%) had substantial improvement. The cure rate was 16/39 (41.0%) for miltefosine with 28.2% (11/39) substantial improvement. Before treatment, more than half (57.8%) of patients reported that CL did not negatively impact their life, which significantly increased to 95.2% at M6. At this time, 61.7% of patients said their lesion was clear, which was 1% before treatment. Conclusion: Our study is the first to identify the challenges and opportunities of miltefosine and cryotherapy for community treatment of CL. Although overall cure rates were lower than expected, patient-reported outcomes were generally positive and quite some patients had good improvement.

Indexed as

decentralizationimpavidooperational researchpatient-reported outcomestreatment outcomes

Identifiers

PMID37886367
PMCPMC10598589
OpenAlexW4387476463

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.