Traditional medicine practices for Cutaneous Leishmaniasis in Kalu District, South Wollo, Ethiopia

Cutaneous leishmaniasis is a neglected tropical disease of public health importance in Ethiopia, with an estimated 40,000 new cases per year. Access to allopathic diagnostic and treatment facilities is limited. Traditional healthcare is an accessible option in many communities, but there is limited evidence on the types of traditional treatments utilized for cutaneous leishmaniasis in Ethiopia.

To explore the traditional treatment practices used for cutaneous leishmaniasis in Kalu district, South Wollo, Ethiopia.

We conducted an ethnographic study from April to August 2023 in Kalu district, Amhara region. Interviews with ten cutaneous leishmaniasis affected individuals, five traditional healers, and three local opinion leaders were conducted to understand their experiences, treatment choices, and perceptions. In addition, observations at three traditional healers were used to document traditional treatment procedures, materials used, and healer-client interactions. The interviews were transcribed verbatim in Amharic and translated to English and thematically analyzed alongside observation notes.

Cutaneous leishmaniasis affected individuals reported using traditional treatments to manage cutaneous leishmaniasis. The factors influencing this choice were lack of awareness about the availability of allopathic treatments, limited access to healthcare facilities, the long duration and high cost of allopathic treatment, trust in traditional healers, and recommendations from community members. Plant-based remedies were commonly applied to lesions, while other treatments included honey, dried bat meat, application of heated metallic objects, and spiritual practices. Traditional healers recommended various behavioral modifications as part of the therapeutic process to facilitate healing, which included dietary restrictions, limiting farm work and cooking, celibacy, and social isolation.

In Kalu, traditional medicines are the primary source of treatment for cutaneous leishmaniasis. With limited access to allopathic care, cost of services, and trust in local healers, traditional healing of cutaneous leishmaniasis is widely recognized. While further research may help to evaluate the safety and effectiveness of traditional healing practices, there is a need to find ways of engaging healers to support interventions tackling skin diseases.