International Journal of Infectious Diseases (Mar 2024)

Impact of traditional cutaneous scarification on anthrax lesions: A series of cases from Cubal, Angola

  • Joan Martínez-Campreciós,
  • Milagros Moreno,
  • Fernando Salvador,
  • Ester Del Barrio-Tofiño,
  • Arlete Nindia,
  • Maria Luisa Aznar,
  • Israel Molina

Journal volume & issue
Vol. 140
pp. 104 – 109

Abstract

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Objectives: Bacillus anthracis infection is a worldwide zoonosis that affects the most vulnerable population and has a high mortality rate without treatment, especially in non-cutaneous presentations. Cutaneous scarification is still common in some regions of the world for the treatment of certain diseases as part of traditional medicine. We describe a series of cutaneus anthrax from a rural setting in Angola where cutaneus scarification is common. Case presentation: This is a retrospective observational study describing a series of cutaneous anthrax cases from Cubal (Angola), many of whom were treated with skin scarification before admission. A total of 26 cases were diagnosed from January 2010 to December 2018. None of the cases were confirmed and eight (30.8%) were probable cases according to the Centers for the Disease Control and Prevention anthrax case definition. The median age was 11 (4.7-30.5) years, 17 (65.4%) had lesions on the head, face, or neck and 15 (57.7%) were treated with cutaneous scarification. Nine (34.6%) patients died. Traditional cutaneous scarification was significantly associated with cutaneous superinfection, respiratory, systemic involvement, and death. Conclusion: Our case series points to increased complications and worse outcome of cutaneous anthrax disease if treated with skin scarification.

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