Epidemiological, clinical and hematological profiles of visceral leishmaniasis among patients visiting Tefera Hailu Memorial Hospital, Northeast Ethiopia: a 4 year retrospective study

Abstract

Visceral leishmaniasis is a major, life-threatening parasitic disease that still remains a serious public health problem in Ethiopia. Understanding the epidemiological, clinical, and hematological profiles of visceral leishmaniasis patients is important for implementing evidence-based control strategies. It is also important for early treatment and to decrease the mortality rate from the disease. Therefore, this study was aimed at assessing the epidemiological, clinical, and hematological profiles of visceral leishmaniasis among patients visiting Tefera Hailu Memorial Hospital, Northeast Ethiopia. A retrospective study was conducted at Tefera Hailu Memorial Hospital from September 2017 to August 2021. Data were collected from the medical records of suspected patients who were tested by the rK39 rapid diagnostic by strictly following standard operating procedures. The data was summarized using Microsoft Excel and analyzed using SPSS 26 version software. Descriptive statistics were used to describe the epidemiological, clinical, and hematological profiles of visceral leishmaniasis patients. A p-value < 0.05 was considered statistically significant. The overall positivity rate for visceral leishmaniasis was 23.4% (132/564). The result of this study indicated a fluctuating yet declining trend in VL over the past 4 years. From a total of 132 VL confirmed cases, the numbers of cases were highest among males (78.0%), those 15–29 years of age (37.1%), and urban residents (89.4%). Furthermore, Abergele (11.0%), Sehala (6.0%), and Ziquala (5.0%) districts had the highest number of VL cases. The major clinical presentations of patients were fever (96.2%), splenomegaly (94.7%), and general weakness (80.3%). With regard to hematological profiles, the most common findings were anemia (86.4%), thrombocytopenia (81.8%), leucopenia (78.8%), neutropenia (74.2%), and pancytopenia (71.2%). In the study area, the VL positivity rate was high. Our findings also concluded that VL causes significant alterations in clinical and hematological parameters. Therefore, the zone health office and other concerned stakeholders should strengthen evidence-based control programs for VL.

Sero-prevalence of visceral leishmaniasis and associated risk factors among febrile patients attending Metema Hospital, West Gondar Zone, North West Ethiopia

“…Our findings revealed a higher prevalence of VL in the 21-30 age groups than in other age groups, similar to studies conducted in Ethiopia [8] and Brazil [9]. The higher prevalence of VL in adults might be due to the lack of immunity in adult migrants coming from non-endemic highland areas to the study area to work on seed weeding and harvest in large-scale agricultural activities in the study area.…”

“…For instance, a higher prevalence of VL was detected in children less than 15 years old in different studies in Ethiopia [3][4][5] due to the lack of acquired immunity in these age groups. However, a higher prevalence of VL was observed in adults older than 15 years in studies conducted in Ethiopia and Brazil [6][7][8][9]. The migration of non-immune adults could be the reason for the higher prevalence of VL in adults greater than 15 years old in these studies.…”

Elucidating the role played by bone marrow in visceral leishmaniasis

“…Anemia is a common hematological alteration in the peripheral blood seen in patients with VL, frequently from a normochromic normocytic type. The prevalence of anemia reportedly ranges from 83.8% to 97.4% in patients with VL ( Sarkari et al., 2016 ; Mulaw et al., 2018 ; Shiferaw et al., 2021 ; Debash et al., 2023 ). Children affected by this disease tend to experience more severe anemia ( Al-Jurayyan et al., 1995 ).…”

“…Another frequently observed alteration is thrombocytopenia, characterized by a significant prevalence of reduced platelet counts ranging from 40% to 91.2% in patients with VL ( Rahim et al., 1998 ; Queiroz et al., 2004 ; Chakrabarti et al., 2013 ; Chufal et al., 2016 ; Shiferaw et al., 2021 ; Debash et al., 2023 ). In an apparent contradiction, another study did not find correlations between thrombocytopenia and parasite index or leukopenia ( Hamid and Gobah, 2009 ).…”

Visceral Leishmaniasis Associated with HIV Coinfection in Pará, Brazil

“…It is estimated that around 350 million people worldwide live in areas at risk for leishmaniasis, having been diagnosed in 88 countries, of which 72 are developing. 9 Approximately 94%of the world’s cases of calazar are concentrated in the South Asian region, South and Central America. 10 In Brazil, the disease is endemic, there has been an expansion, becoming a growing public health problem in rapid geographical expansion.…”