PESHAWAR: Medicine, entomology, dermatology and zoology experts are calling for clinical trials to find alternative treatments for cutaneous leishmaniasis (CL), a tropical skin disease that is the third most important vector-borne disease after malaria and sea fever.
Experts’ concerns have been raised by the limited number of patients due to decades of reliance on the antimony Meglumine, an imported drug used as a first-line treatment for CL, which requires injections every 21-30 days.
In many areas, due to the limited supply of drugs and the lack of properly trained medical personnel, the dose received by each patient is insufficient.
Recent reports of running out of glucantim vials in Khyber Pakhtunkhwa (KP) have drawn calls from experts.
“Most of the 180,000 vaccines brought by the KP Health Department through WHO after the outbreak of CL in the province in 2018 have expired by December 2023 and now there is a shortage of drugs to treat patients,” said the entomologist. Integrated Vector Control Program KP, Salauddin Marwat.
In the absence of first-line treatment, doctors choose alternative treatments such as cryotherapy, where a small amount of liquid nitrogen is applied to the affected skin at -196°C once or twice a week for up to six days. week and thermotherapy using valley heat.
The integrated vector control program has provided tools for two treatments in various leishmaniasis hotspots of KP such as D.I.Khan, Mohmand and Karak.
For proper treatment and glaucanthim injections, patients visit a center set up by the international medical aid agency Medicines Sans Frontier (MSF) in Khyber Pakhtunkhwa, Salauddin told APP.
“After the Ministry of Health analyzed data showing the occurrence of leishmaniasis in the region and its impact on the physical and mental health of patients, it is time for the Drug Regulatory Authority (DRAP) to take action to ensure access to the right, modern, effective and affordable drugs for treatment,” he said. , suggested Dr. Rafiq Hayat Malezai, District Health Officer of Mohmand district, a hot spot of leishmaniasis that recorded about 5,283 cases in 2023.
In 2023, an estimated 25,273 CL cases were reported in Khyber Pakhtunkhwa, an increase of 7,093 from the previous year.
Dr Rafiq said he had to investigate about 439 follow-up cases in the coming days but could not treat the patients due to shortage of medicine.
“Although we know that the spread of CL infection from the pocket to other parts of the country has increased in the past few years, we must seriously focus on its prevention and treatment by involving several departments such as health, epidemiology, entomology and microbiology.” said Doctor Dr. Muhammad Akram suggested. In CL.
Dr Akram also called for more research into the parasites that cause CL and the control of the sand fly vector involved in the spread of the disease.
He said that most of the drugs used to treat leishmaniasis are about 70 years old and are third generation that have not shown better results.
Akram continued: “Dependence on the World Health Organization must end by allowing certain pharmaceutical companies to produce or import glucantim or related drugs.”
In addition to cryo and thermotherapy, we consider Miltefosine, a broad-spectrum antimicrobial and antileishmanial drug, as an alternative to glucantime, which is available on the open market,” said Dr.
However, some dermatologists think that products that can be supplied with glucantim and related drugs are not safe and not pirated.
Dr. Hafza Usman, a dermatologist at the Kuwait University Hospital in Peshawar, said, “In many cases, drugs obtained from the open market, especially those known to be smuggled, do not produce the desired results and are found to be fake.”
On August 5, 2022, DRAP warned about fake vials of glucantim on the market, TILLOTTS Pharma AG, Switzerland. The company then contacted DRAP and confirmed that they did not block it
