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Case Series Study of Human Cutaneous Anthrax in Dermatology Department, Herat Regional Hospital, Herat City-Afghanistan Feb 2014 to October 2017

Mohammad Sh. Kakar, Bashir A. Barakzie, Shir A. Bagrami

Objective: The aim of this study is to evaluate the extent and burden of cutaneous anthrax in western part of Afghanistan.

Materials and methods: Total of 177 Admitted Cutaneous Anthrax (101 Female and 76 Male) were recruited in a retrospective study. The patients suspected having either visceral or inhaled anthrax in primary clinical impression and patients with mild diseases who were treated as out-patients, were excluded from the study. The data was generated from the registration book and patients’ files. EPI Info 7 software was used for analysis of data.

Results: The age of participants was between 6 months to 74 years with a mean of 20 years. The hospital average length of stay was 4.5. Face (mostly Eyelids) was the most common involved site (82% for over 5 Years old) however; it was 98% for fewer than 5. The hands (11%), neck (4%), trunks (2%) and other parts (1%) were affected respectively. 71% of the study population were residents of Herat districts, 19% from neighboring provinces, and only 10% from Herat city. 4 patients escaped without medical permission and considered as default. 2 deaths (1 Male and 1 Female) occurred for over 5 patients, all the other patients were discharged with good health, however, the squeal (crust, and mild edema) was still present in most cases during the discharge time. Ciprofloxacin was the drug of choice regardless the sex and age, Dexamethasone was used as an adjuvant therapy.

Conclusion: Although cutaneous anthrax is less prevalent now in other countries, it still highly affects Afghanistan population. Female higher prevalence rate necessitates comprehensive plan for community awareness focusing on the female group, collaboration and coordination among different stakeholders is mandatory to address this simple still fatal challenge.