Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 9;49(1):72.
doi: 10.1186/s41182-021-00359-3.

Emergence of cutaneous leishmaniasis in Nepal

Kishor Pandey  1 , Anup Bastola  2 , Gong Haiyan  3 , Uttam Raj Pyakurel  4 , Basu Dev Pandey  4 , Shyam Prakash Dumre  5
Affiliations

Emergence of cutaneous leishmaniasis in Nepal

Kishor Pandey et al. Trop Med Health. .

Abstract

Background: Cutaneous leishmaniasis (CL) is endemic in 70 countries worldwide. Nepal is considered non-endemic for CL and hence the control program is targeted to visceral leishmaniasis (VL) only. Here, we report the emergence of CL cases in different parts of Nepal.

Methods: We analyzed the CL and VL cases reported to Epidemiology and Diseases Control Division (EDCD), Ministry of Health and Population, Nepal through District Health Information System 2 (DHIS-2) and Early Warning and Reporting System (EWRS) during the past 4 years (2016-2019). Any laboratory-confirmed case was included in the study. Demographic and clinical details of each patient were transcribed into Excel sheets, verified with the case report forms and analyzed.

Results: VL has been reported in Nepal since 1980, but CL was reported very recently. From 2016 to 2019, 42 CL cases were reported from 26 different hospitals to EDCD which had been diagnosed on the basis of clinical presentation, and laboratory findings (demonstration of amastigotes in Giemsa-stained smears and rK39 test results). Majority of the patients (31.0%, 13/42) visited to the hospital within 1-6 months of onset of lesions. Facial region (38.1%, 16/42) was the common place where lesions were found ompared to other exposed parts of the body. CL was successfully treated with miltefosine for 28 days. The majority of CL patients did not have history of travel outside the endemic areas and there was no report of sandfly from these areas.

Conclusion: These evidences highlight that the Government of Nepal need to pay more efforts on CL and include it in differential diagnosis by clinicians, and plan for an active surveillance when the country is targeting leishmaniasis elimination by the year 2025 with the decreasing number of VL cases.

Keywords: Cutaneous leishmaniasis; Elimination; Emergence; Nepal; Visceral leishmaniasis.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Outline of the leishmaniasis data collection process in Nepal. PHCC Primary Health Care Center, CL cutaneous leishmaniasis, EWARS Early Warning and Reporting System
Fig. 2
Fig. 2
Year wise number of cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) cases in Nepal, 2016–2019
Fig. 3
Fig. 3
Map of Nepal showing visceral leishmaniasis (VL) endemic, endemic doubtful and non-districts districts with reported CL cases. Red color shows the VL-endemic districts (n = 18), green color shows non-endemic districts (n = 9) while the rest are endemic doubtful districts (n = 50). Numbers indicate CL cases distribution by district (n = 26) in the present study. Asterisk shows newly added endemic districts (n = 6)
Fig. 4
Fig. 4
Trend of leishmaniasis cases reported during 2016-2019 in Nepal. a Map of Nepal showing provinces of Nepal with different colors. Red and purple asterisks show 12 endemic and recently added 6 endemic districts for VL in Nepal. b The graph shows provincial breakdown of cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) cases in Nepal
See this image and copyright information in PMC

References

    1. World Health Organization. WHO report on global surveillance of epidemic-prone infectious diseases—leishmaniasis epidemic and pandemic alert and response (EPR). 2020. https://www.who.int/news-room/fact-sheets/detail/leishmaniasis
    1. Okwor I, Uzonna J. Social and economic burden of human leishmaniasis. Am J Trop Med Hyg. 2016;94(3):489–93. doi: 10.4269/ajtmh.15-0408. - DOI - PMC - PubMed
    1. Reithinger R, Dujardin JC, Louzir H, Pirmez C, Alexander B, Brooker S. Cutaneous leishmaniasis. Lancet Infect Dis. 2007;7(9):581–96. doi: 10.1016/S1473-3099(07)70209-8. - DOI - PubMed
    1. Bailey MS, Lockwood DNJ. Cutaneous leishmaniasis. Clin Dermatol. 2007 doi: 10.1016/j.clindermatol.2006.05.008. - DOI - PubMed
    1. WHO Global leishmaniasis surveillance, 2017–2018, and first report on 5 additional indicators. Wkly Epidemiol Rec. 2020. https://www.who.int/publications/i/item/who-wer9525.

LinkOut - more resources