Successful treatment of cutaneous leishmaniasis with intralesional sodium stibogluconate in internally displaced school age children in Iraq

Abstract

Cutaneous leishmaniasis (CL) is endemic in Iraq. After the last war in Iraq against Islamic State in Iraq and Syria (ISIS), the number of CL cases has peaked particularly in children. International guidelines do not provide an insight on how to choose treatment regimen of CL in children. The aim of this article was to study the efficacy of intralesional sodium stibogluconate (SSG) therapy for school age children with CL. In the period between June 2016 and June 2019, 288 internally displaced school age children (6-12 years old) from Ninewa city were recruited in the study. All patients received intralesional SSG twice a week for a maximum of 12 sessions. All patients were followed up for 12 weeks after the last treatment session. The mean age of recruited patients was 8.6 ± 2 years and 164/288 (56.9%) were male. 202/288 (70.1%) of the patients presented with single lesion. The total number of lesions was 417 of which 141/417 (33.8%) lesion were nodular and the rest were ulcerative lesions. The treatment success rate was (282/288) 97.91%. No significant association was found between age, gender, number of lesions, or duration of lesions and the treatment outcome. Mild local pain, mild bleeding at the site of injection, and itching at the site of injection were the most common side effects. Intralesional SSG infiltrate is effective and minimal side effects. Further studies including clinical trials are required to provide robust data on the efficacy and the safety.