Cutaneous leishmaniasis in British troops from Belize

Area of Science:

• Medical Parasitology
• Tropical Medicine
• Dermatology

Background:

• Cutaneous leishmaniasis is a significant health concern for military personnel deployed in endemic regions.
• British soldiers deployed in Belize were clinically diagnosed with cutaneous leishmaniasis.

Purpose of the Study:

• To analyze the clinical presentation and treatment outcomes of cutaneous leishmaniasis in British soldiers.
• To evaluate the efficacy of sodium stibogluconate in treating Leishmania infections in this cohort.

Main Methods:

• Retrospective analysis of medical records of 306 British soldiers with a clinical diagnosis of cutaneous leishmaniasis.
• Parasitological confirmation including Leishmania culture and histological identification of Leishman-Donovan bodies.
• Evaluation of two treatment regimens of sodium stibogluconate: 600-800 mg daily for 10 days vs. 600 mg twice daily for 14 days.

Main Results:

• Parasitological confirmation was achieved in 187 cases, with identification of Leishmania braziliensis braziliensis and Leishmania mexicana mexicana.
• Most patients (71%) presented with a single lesion on exposed extremities, with a mean ulcer diameter of 14.4 mm.
• Sodium stibogluconate demonstrated high efficacy, with ultimate healing rates of 93% and 100% for the lower and higher dose regimens, respectively.
• Dose-dependent transient leucopenia and elevated liver enzymes were observed during treatment.

Conclusions:

• Sodium stibogluconate is an effective treatment for cutaneous leishmaniasis in British soldiers returning from Belize.
• Treatment regimens, while varying in initial cure rates, ultimately lead to high rates of ulcer healing.
• Monitoring for side effects like leucopenia and liver enzyme changes is recommended during treatment.