Enhancing the effectiveness and accessibility of treatment for cutaneous leishmaniasis in Ethiopia

Cutaneous leishmaniasis (CL) is a neglected tropical disease (NTD) that presents a significant public health challenge in Ethiopia, with 20,000 to 50,000 cases annually and about 29 million people at risk. The primary causative agent, Leishmania aethiopica, is associated with chronic disease, frequent facial and mucosal involvement, and poor treatment outcomes. The standard treatment, pentavalent antimonials, is toxic, requires prolonged hospitalization, and has a high relapse rate without achieving a sterile cure. The majority of patients, including those with complicated CL, are located in remote regions with limited access to treatment centers. This geographical barrier creates substantial economic and social challenges for individuals attempting to access modern medical care.
To address these challenges, my PhD project aims to improve the accessibility and efficacy of CL treatment in Ethiopia through a series of work packages (WPs). The first WP will assess the diverse clinical practices used in treatment centers to identify gaps and opportunities for standardization. The second WP will evaluate the Ministry of Health’s decentralized treatment initiative, which seeks to expand services to primary health care facilities closer to affected communities. Properly managed decentralized care would improve access to care and enhance patients’ quality of life.
WP3 will explore different treatment delivery methods to determine the best approach for adherence and effectiveness using Miltefosine as a model, an oral alternative to intravenous Sodium Stibogluconate (SSG). WP4 will involve a clinical trial to investigate innovative therapeutic strategies, including the use of topical antibiotics as adjunctive therapy to standard treatments.
By investigating treatment adherence and outcomes, this research aims to optimize CL management and reduce the overall disease burden in Ethiopia.