An assessment of interobserver agreement on lesion size, morphology and clinical phenotype in cutaneous leishmaniasis caused by Leishmania aethiopica in Ethiopia [version 2; peer review: 2 approved]

Introduction Cutaneous leishmaniasis (CL) remains a major public health challenge, especially in endemic regions like Ethiopia, where an estimated 40,000 new cases occur annually. Effective treatment evaluation for CL relies on consistent clinical assessments, yet variability in lesion descriptions...

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Main Authors: Stephen L. Walker, Saba Lambert, Endalamaw Gadisa, Fewzia Shikur Mohammed, Amel Beshir Mohammed, Shimelis Doni Nigusse, Feleke Tilahun Zewdu, Michael Marks
Format: Article
Language:English
Published: F1000 Research Ltd 2025-05-01
Series:NIHR Open Research
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Online Access:https://openresearch.nihr.ac.uk/articles/5-12/v2
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author Stephen L. Walker
Saba Lambert
Endalamaw Gadisa
Fewzia Shikur Mohammed
Amel Beshir Mohammed
Shimelis Doni Nigusse
Feleke Tilahun Zewdu
Michael Marks
author_facet Stephen L. Walker
Saba Lambert
Endalamaw Gadisa
Fewzia Shikur Mohammed
Amel Beshir Mohammed
Shimelis Doni Nigusse
Feleke Tilahun Zewdu
Michael Marks
author_sort Stephen L. Walker
collection DOAJ
description Introduction Cutaneous leishmaniasis (CL) remains a major public health challenge, especially in endemic regions like Ethiopia, where an estimated 40,000 new cases occur annually. Effective treatment evaluation for CL relies on consistent clinical assessments, yet variability in lesion descriptions can complicate reliable outcome measures. Methods We conducted an inter-reliability study of clinicians’ evaluations of CL lesion morphology and size at ALERT Hospital, Addis Ababa. Twelve clinicians independently examined 12 patients with parasitologically confirmed CL, each clinician assessing lesion morphology, size, and severity. Results We found high consistency in reporting major morphological categories (e.g., plaques) but significant variability in secondary features like dyspigmentation and scale, as well as mucosal involvement. Lesion size measurements showed limited variability, suggesting its reliability as a potential measure for future clinical trials. Disparities in severity assessments highlight the need for a standardized scoring system in CL. Discussion Our findings underscore the importance of training for consistent, high-quality clinical evaluations of CL and suggests that lesion size could be a reproducible outcome measure in treatment efficacy trials.
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spelling doaj-art-9087c3666b364b5f8a97a062de5a0e122025-08-20T02:32:22ZengF1000 Research LtdNIHR Open Research2633-44022025-05-01510.3310/nihropenres.13869.215196An assessment of interobserver agreement on lesion size, morphology and clinical phenotype in cutaneous leishmaniasis caused by Leishmania aethiopica in Ethiopia [version 2; peer review: 2 approved]Stephen L. Walker0Saba Lambert1https://orcid.org/0000-0003-4376-5495Endalamaw Gadisa2https://orcid.org/0000-0002-5179-6278Fewzia Shikur Mohammed3Amel Beshir Mohammed4Shimelis Doni Nigusse5https://orcid.org/0000-0003-0455-2518Feleke Tilahun Zewdu6Michael Marks7https://orcid.org/0000-0002-7585-4743Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UKALERT Hospital, Addis Ababa, EthiopiaDepartment of Malaria and Neglected Tropical Disease Research, Armauer Hansen Research Institute, Addis Ababa, EthiopiaALERT Hospital, Addis Ababa, EthiopiaALERT Hospital, Addis Ababa, EthiopiaALERT Hospital, Addis Ababa, EthiopiaBoru Meda Hospital, Boru Meda, EthiopiaDepartment of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UKIntroduction Cutaneous leishmaniasis (CL) remains a major public health challenge, especially in endemic regions like Ethiopia, where an estimated 40,000 new cases occur annually. Effective treatment evaluation for CL relies on consistent clinical assessments, yet variability in lesion descriptions can complicate reliable outcome measures. Methods We conducted an inter-reliability study of clinicians’ evaluations of CL lesion morphology and size at ALERT Hospital, Addis Ababa. Twelve clinicians independently examined 12 patients with parasitologically confirmed CL, each clinician assessing lesion morphology, size, and severity. Results We found high consistency in reporting major morphological categories (e.g., plaques) but significant variability in secondary features like dyspigmentation and scale, as well as mucosal involvement. Lesion size measurements showed limited variability, suggesting its reliability as a potential measure for future clinical trials. Disparities in severity assessments highlight the need for a standardized scoring system in CL. Discussion Our findings underscore the importance of training for consistent, high-quality clinical evaluations of CL and suggests that lesion size could be a reproducible outcome measure in treatment efficacy trials.https://openresearch.nihr.ac.uk/articles/5-12/v2cutaneous leishmaniasiseng
spellingShingle Stephen L. Walker
Saba Lambert
Endalamaw Gadisa
Fewzia Shikur Mohammed
Amel Beshir Mohammed
Shimelis Doni Nigusse
Feleke Tilahun Zewdu
Michael Marks
An assessment of interobserver agreement on lesion size, morphology and clinical phenotype in cutaneous leishmaniasis caused by Leishmania aethiopica in Ethiopia [version 2; peer review: 2 approved]
NIHR Open Research
cutaneous leishmaniasis
eng
title An assessment of interobserver agreement on lesion size, morphology and clinical phenotype in cutaneous leishmaniasis caused by Leishmania aethiopica in Ethiopia [version 2; peer review: 2 approved]
title_full An assessment of interobserver agreement on lesion size, morphology and clinical phenotype in cutaneous leishmaniasis caused by Leishmania aethiopica in Ethiopia [version 2; peer review: 2 approved]
title_fullStr An assessment of interobserver agreement on lesion size, morphology and clinical phenotype in cutaneous leishmaniasis caused by Leishmania aethiopica in Ethiopia [version 2; peer review: 2 approved]
title_full_unstemmed An assessment of interobserver agreement on lesion size, morphology and clinical phenotype in cutaneous leishmaniasis caused by Leishmania aethiopica in Ethiopia [version 2; peer review: 2 approved]
title_short An assessment of interobserver agreement on lesion size, morphology and clinical phenotype in cutaneous leishmaniasis caused by Leishmania aethiopica in Ethiopia [version 2; peer review: 2 approved]
title_sort assessment of interobserver agreement on lesion size morphology and clinical phenotype in cutaneous leishmaniasis caused by leishmania aethiopica in ethiopia version 2 peer review 2 approved
topic cutaneous leishmaniasis
eng
url https://openresearch.nihr.ac.uk/articles/5-12/v2
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