KARACHI, March 15: Scientists at the H.E.J. Research Institute of Chemistry, Karachi University, have developed a herbal ointment for the treatment of cutaneous leishmaniasis, an infectious skin disease transmitted by the bite of certain species of sandfly. The disease, which is considered a serious public health concern in many countries, is now endemic in many parts of Pakistan.
The finding is the result of a five-year long research to be completed by the end of this year. The treatment, which has proved highly successful in clinical trials, is free from any side-effects and pain as well as cost-effective and efficient as compared to the conventional therapy. The Jinnah Postgraduate Medical Centre (JPMC) and Chandka Medical College (CMC) are collaborating in the research.
“The laboratory discovery is, indeed, a breakthrough. The study is the first of its kind on leishmaniasis in the region. More research is needed before the ointment is brought into the market,” said Dr Iqbal Chaudhry, Director H.E.J. Research Institute of Chemistry, adding that his team intended to work on visceral leishmaniasis, a dangerous form of the disease, after completing the present study, which focused on cutaneous leishmaniasis, the form most common in Pakistan.
Making a comparison with the conventional treatment, Professor Dr Azam J. Samdani, Head of the Dermatology Department, JPMC, said that though a number of therapeutic procedures were used in the case of this specific disease, no single regime had proved to be effective and satisfactory.
“The imported drugs are administered through injections so the process is also painful apart from having some side-effects. However, when herbal extracts were applied, the majority of the patients responded positively to the treatment. Follow-ups were also carried out for three months, which showed no sign of re-infection,” he said.
According to research officer Samreen, out of 70 patients suffering
from cutaneous leishmaniasis – 58 males and 12 females, age ranging from 7 to 65 years – 57 patients responded to treatment and 40 patients were completely cured by the infection within 10 weeks during initial trials.
The exclusions were pregnant, lactating females and people having a history of drug allergies or those who had gone through some local therapy during the last 30 days.
Balochistan and upper Sindh are vulnerable to cutaneous leishmaniasis while Azad Kashmir and the Northern Areas appear on the visceral leishmaniasis belt of the world. Larkana, Khuzdar, Dera Ismail Khan and the suburbs of Multan are also some hotspots. Epidemics occurred in the Federally Administered Tribal Areas (Fata), Larkana and Dadu in 2001 and 2002. About 11,000 cases were registered in Dadu and Larkana alone.
Dr Farooq Rehman Soomro of the CMC and the in-charge, Leprosy Centre, Larkana, had tried out the ointment on about 2,000 patients during the last four years and the success rate had remained 90 per cent. The 10 per cent failure, he explained, was due to multiple lesions which obstructed the penetration of the cream.
Government apathy
Expressing concern over the government’s indifference towards the disease, Dr Soomro said despite the fact that leishmaniasis was present in all the provinces in varying degrees and was listed among the World Health Organization’s list of top five priority diseases, the government allocated no budget for it.
“It’s only when an outbreak occurs that the government moves into action,” he remarked, adding that leishmaniasis had been present in Balochistan and other areas for centuries but spread widely after Afghan refugees’ migration into Pakistan following the Soviet invasion of Afghanistan in 1979.
“Before the Afghan war, there were hardly two to three patients a year. Today, about 300 patients are registered every month at the leprosy centre, Larkana, alone, which also serves as a leishmaniasis cell. Though patients come throughout the year, more cases are seen in summer,” he said.
However, Dr Samdani disagreed with this theory and said that there were other major factors that might have contributed in the spread of the disease, for instance environmental pollution and a deterioration in living conditions, coupled with lack of action on behalf of the authorities concerned to contain the spread of the disease when it was limited to a few areas.
Incidence in Karachi
About its incidence in Karachi, he said it was difficult to give the exact data since there was no official database and the cases of leishmaniasis also came to general practitioners. The cases usually came from Hub, Lasbela, Malir, Korangi and the interior of Sindh. He also warned that “if pockets in the suburbs of Karachi continued to flourish, the disease can spread to other areas.”
The doctors stressed the need for public awareness and having treatment at early stages since multiple lesions could lead to disfigurement that could only be rectified through reconstructive surgery, which was a costly affair.
The symptoms of leishmaniasis are skin sores, which erupt weeks to months after the person affected is bitten by sand flies. Other consequences, which can become manifest anywhere from a few months to years after infection, include fever, damage to the spleen and liver, and anaemia.
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