PESHAWAR: The World Health Organisation has warned of outbreak of Cutaneous Leishmaniasis in February and has called for scaling up awareness regarding preventive measures as well as ensuring proper medication of the infected people.

“In the wake of impending outbreak this year gain, we have started preparing for control in collaboration with the provincial government,” the WHO officials told Dawn.

They said that the world health agency was in contact with Ministry of National Health Services, Regulations and Coordination because the skin ailment was endemic in the entire country and a strategy was needed to prevent its violent outbreaks.

Asks govt to scale up awareness regarding preventive measures

Last year, Khyber Pakhtunkhwa recorded about 40,000 cases of leishmaniasis but owing to non-availability of injections in the local market, the patients banked on the medication provided by the WHO and MSF that treated 5,000 patients in a CL Centre established in Naseerullah Khan Babar Memorial Hospital, Peshawar in May 2018.

The MSF is setting up another centre in Bannu to facilitate patients from tribal districts. The WHO surveillance cell in emergency unit and disease control unit has initiated efforts to put brakes on the outbreaks throughout Pakistan, especially in Khyber Pakhtunkhwa and tribal district where the disease was endemic.

Officials said that the province witnessed leishmaniasis outbreaks in September to November last and now they feared that more people would be infected in February and March and then in July, the number of cases would surge if preventive measures were not taken.

“We have arranged some stock of injections to be handed over to the government to meet the emergency needs. There is shortage of injections globally,” WHO officials said.

They said that they intended to use the thermotherapy and cryotherapy machines provided last year to Khyber Pakhtunkhwa and tribal districts.

The WHO donated four machines to health department of Khyber Pakhtunkhwa but the data about their use and effectiveness was not made public. “These are used in selected cases of leishmaniasis using heat and liquid nitrogen thus reducing the use of injections,” said officials.

Last year, the WHO had given 57,000 injections to the health department. The injections were not registered in Pakistan due to which these were imported.

The WHO said that the injections were manufactured at small scale due to which those were not readily available in the international market.

“We have been calling on the government to register the injections in the country as the disease is prevalent in every district but the drug is not available. The government relies totally on WHO and MSF for treatment of leishmaniasis patients,” said officials.

They said that glucantime injection, the only choice of treatment for the ailment, was desperately needed to be made available in the market. They added that the disease was self-limiting but left lesions on the skin, which caused social problems for the people, especially women.

The UN health agency, last year, provided training to dermatologists in Peshawar on management of leishmaniasis cases and ways to inform the people as to how they could stay safe from sand fly bites. A global meeting on leishmaniasis has been planned in Istanbul, Turkey in March where the CL-endemic countries, including Pakistan, will be discussed and strategies will be devised for its prevention and treatment.

Published in Dawn, January 20th, 2020