Spatial Epidemiology of Clinical Forms of Cutaneous Leishmaniasis and Treatment Practice: Evidence from Leishmaniasis Research and Treatment Center, Northwest Ethiopia.

Background: We aimed to conduct a comprehensive analysis of cutaneous leishmaniasis's (CL) clinical polymorphism by examining the relationship between clinical forms, duration of illness, and their spatiotemporal distribution.

Methods: A retrospective study at University of Gondar Hospital analyzed cutaneous leishmaniasis patients treated from 2022 to 2024. Demographic and epidemiologic data were collected, with parasite detection via microscopic and clinical examination.

Results: Overall, 454 CL cases from 49 districts were diagnosed, predominantly affecting males aged ≤30, with a mean age of 25.31 yr (SD ±18.3). Significant differences were noted in age and sex (P<0.05). Approximately 70% had lesions ≥4 cm. Most CL cases had 2+ parasite loads. Sodium stibogluconate (SSG) remained the primary treatment choice for patients. The spatial distribution of CL cases covered a larger geographical area, although the cases (>20) were concentrated in Central Gondar. The mucosal CL shared a similar geographical pattern with the recurrent CL type. Notably, 48% had chronic presentations and lived with the disease for ≥12 months. In diffuse CL (DCL) a longer delay was seen and its clinical presentation was associated with longitudinal time series. Acute patients exhibited a higher parasitic load than chronic ones (38% vs. 24%), respectively.

Conclusion: CL significantly affected school-aged children. The symmetrical distribution of cases in districts studied could increase the attention of clinicians and enhance management strategies. Extended disease durations necessitated specialized treatments for clinical transitions.