Suraj Bhattarai Poster 2023
Dr Suraj Bhattarai
Global Institute for Interdisciplinary Studies, Nepal
Nepal: An urgent need to generate evidence through global collaboration
Poster Abstract
Background: Leishmaniasis is a NTD caused by Leishmania donovani, transmitted by infected female sand flies. Cutaneous leishmaniasis (CL) is the most common form of leishmaniasis in adults; 600,000 to one million new cases annually worldwide, 95% reported in Americas, Mediterranean Basin, Middle East, and Central Asia. CL lesions are seen on exposed body parts, mainly ulcers or scaly; if untreated, may lead to life-‐long scars, disability, cosmetic issues, stigma.
Method: Patients from hill and mountainous regions of Nepal presenting to different health facilities with unusual skin lesion were studied. Epidemiological, clinical, and treatment outcomes data from 20 CL cases are analysed. We present a representative case treated in Bheri Hospital.
Findings: A 4-‐year old female presented with nonhealing skin lesion on right cheek for 5 months; single, indurated with crusting, 2 cm lateral and inferior to angle of mouth. There was no pallor, icterus, hepatomegaly, splenomegaly or other skin lesions. Her younger sister (1-‐year age) was diagnosed visceral leishmaniasis seven months before presentation. Initial investigations showed rK39 rapid immunochromatographic test positive. Abdominal ultrasonography was normal. FNAC of skin lesion demonstrated para-‐nuclear kinetoplast, confirming CL. She was treated with 1 ml of reconstituted and diluted bleomycin (equivalent dose: 1 unit) injected intra-‐lesion. The lesion was found significantly regressed on 5-‐month follow up. Images to be disclosed during presentation.
Conclusion: High clinical suspicion of CL is needed in patients of all age groups presenting with non-healing skin lesion, taking into account epidemiological factors, high mobility of people, vector dynamics, and climate change. Although high altitude eco-‐regions are considered non-‐endemic for leishmaniasis, the current emergence of cases above 2000 meters in Nepal necessitates urgent actions to generate evidence through global collaboration.
Biography
Suraj is a physician-researcher from Nepal with interest in tropical medicine and global health. He obtained masters in Tropical medicine and International health from LSHTM. He has been involved in various research projects, for example, ‘mortality surveillance and global burden of disease’, ‘vulnerability assessment of climate sensitive diseases’, 'cutaneous leishmaniasis', and ‘pandemic preparedness’. Previously, he worked as a research doctor at Patan Hospital, Kathmandu getting involved in childhood bacterial infection studies sponsored by the University of Oxford. Suraj has contributed to many professional societies and research funding bodies, and advised health development programmes in Nepal. He is a member of the European Society of Pediatric Infectious Disease (ESPID), where he received ‘ESPID Distinguished Award 2020 for Science Communication' for raising public awareness on common to rare cases and evolving evidence on pediatric infectious diseases through the official social media platforms. He is a member of Global Young Academy and an awardee of the Inter-Academy Partnership Young Physician Leaders Programme. Suraj is expected to start LSHTM's Joint PhD programme with the School of Tropical Medicine and Global Health, Nagasaki University, with his Nepal-based research focused on point-of-care disease diagnosis.
