{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:12:57Z","timestamp":1791432777451,"version":"4.3.3"},"update-to":[{"DOI":"10.1371\/journal.pntd.0013246","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T00:00:00Z","timestamp":1754352000000}}],"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100018384","name":"Directorate General for European Programmes, Coordination and Development","doi-asserted-by":"publisher","award":["Framework Agreement 5 collaboration between the Institute of Tropical Medicine (Antwerp, Belgium) and Ethiopian Public Health Institute (Addis Ababa, Ethiopia)"],"award-info":[{"award-number":["Framework Agreement 5 collaboration between the Institute of Tropical Medicine (Antwerp, Belgium) and Ethiopian Public Health Institute (Addis Ababa, Ethiopia)"]}],"id":[{"id":"10.13039\/100018384","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Cutaneous leishmaniasis (CL) in Ethiopia has typically been linked to high-altitude regions but has recently emerged at an unusually low altitude of 500 meters in the Somali Region, raising public health concerns. Cutaneous leishmaniasis has not been previously identified in the region. There is a conflict in the starting area and only militias have been infected with very serious lesions.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/Principal findings<\/jats:title>\n<jats:p>Routine clinical and socio-demographic information was extracted from the patient chart using a case report form. Additionally, clinical and laboratory data were obtained from 30 patients suspected for CL. Skin scraping and fine needle aspirates were collected from the raised edges, nodular and centre of the lesions followed by DNA extraction using the DNeasy Blood and Tissue kit. There were a total of 1050 CL patients recruited, all of them were male militia members, immunologically na\u00efve and displaced into a conflict area with a likely sylvatic transmission cycle. We identified <jats:italic><jats:italic>Leishmania tropica<\/jats:italic><\/jats:italic> as the causative species, challenging the previous assumption that <jats:italic><jats:italic>L. aethiopica<\/jats:italic><\/jats:italic> was the primary agent of CL in Ethiopia. Notably, over 77% of patients had more than 10 lesions, a presentation atypical for <jats:italic><jats:italic>L. tropica<\/jats:italic><\/jats:italic> elsewhere. <jats:italic><jats:italic>Phlebotomus orientalis<\/jats:italic><\/jats:italic> and <jats:italic><jats:italic>P. sergenti<\/jats:italic><\/jats:italic>, vectors for visceral leishmaniasis and CL in North Africa respectively, were found in the outbreak area.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusions\/Significance<\/jats:title>\n<jats:p>Further research is needed to explore the eco-epidemiology of the outbreak and patient\u2019s treatment responses. Insights will help develop management strategies to control this newly emerging form of CL, prevent its spread to other regions and hybridization with <jats:italic><jats:italic>Leishmania<\/jats:italic><\/jats:italic> strains causing VL endemic in the area.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0013246","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T17:35:07Z","timestamp":1753205707000},"page":"e0013246","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":10,"title":["Outbreak of cutaneous leishmaniasis amongst militia members in a non-endemic district under conflict in the lowlands of Somali Region caused by Leishmania tropica, Eastern 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