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PAKISTAN/2019/One year of cutaneous leishmaniasis services in Peshawar


Cutaneous leishmaniasis (CL) – a skin infection caused by a parasite transmitted by the bite of a phlebotomine sandfly – is a public health burden in Pakistan, where it is considered to be a neglected tropical disease. Although not life threatening, CL can cause severe physical disfigurement resulting in stigma and discrimination. The first-line treatment for CL is meglumine antimoniate. The drug is not yet produced in Pakistan, so the health authorities rely largely on imports by international organisations such as the WHO and MSF. Patients often receive inadequate treatment due to insufficient stocks at public hospitals and a lack of specialised medical professionals.
About 28,000 cases of cutaneous leishmaniasis have been reported in Khyber Pakhtunkhwa since November 2018, most of them from merged districts previously known as the federally administrated tribal areas close to the border with Afghanistan. A recent outbreak in the province’s southern districts, particularly in South Waziristan, resulted in many people seeking treatment in the neighbouring district of Bannu, or even the provincial capital, Peshawar which is about a four hours’ drive away.
MSF opened a CL treatment centre in Peshawar in May 2018 and, following an assessment in Bannu in April 2019, is preparing to open another treatment centre at the district headquarters hospital there, to address the dire needs in southern Khyber Pakhtunkhwa. In its first year, the treatment centre in Peshawar has provided CL treatment to more than 2,300 people. It offers specialised diagnostic and treatment facilities, ensures patients have a steady supply of safe and effective medication, and increases awareness in the area about treatment and prevention. It is working at full capacity, with ever increasing patient numbers demonstrating the high needs in the area. MSF has also started outreach activities to raise awareness about the disease and how to prevent it.
MSF also has CL programmes in Quetta and Kuchlak, both in Balochistan province. In 2018, MSF treated over 5,000 people suffering from CL across the country. MSF is one of the main providers of CL treatment services in Pakistan and in 2019 also starting clinical study into alternative treatment methods.
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