One-year prospective study of pediatric cutaneous leishmaniasis: a neglected tropical disease in sub Himalayan region, India

Abstract

Background: Satluj Valley of Himachal Pradesh is a newly identified focus of Cutaneous Leishmaniasis (CL) and here disease is still in emerging phase. Although children are most commonly affected victims by CL but till date no such study has been done on childhood CL in this region.Methods: All newly diagnosed cases of CL were registered and detailed clinico-epidemiological parameters of children between 0-18 years were recorded. Imprint smears for LD bodies and biopsies for histopathology were done in atypical cases to confirm clinical diagnosis.Results: Over a period of one year 337 cases of CL were registered, out of them 115 children (0-18 years) were enrolled for this study. School going (6-18 years) population was predominantly affected age group. Males outnumbered the females with a ratio of 1.88. Face was most commonly affected site and most (65.21%) cases presented with single lesion. Nodules (40.87%), plaques (24.35%) and papules (7.39%) were commonly observed morphologies although mixed patterns and atypical forms were also found. Most (62.60%) cases presented within 1-3 months of lesion onset. All cases responded well to treatment with antimonials. Lesional pain, swelling, bleeding, pigmentation and scarring were minor post treatment side effects.Conclusions: Pediatric CL is an emerging infection along the Satluj valley of Himachal Pradesh (HP). Although clinical diagnosis is simple, and all cases respond well to antimonials. But, availability of diagnostic tests is essential to diagnose atypical cases. Further annual record keeping, and reporting is recommended to know the exact disease burden so as to promote the effective treatment and preventive measures.

Pediatric cutaneous leishmaniasis: A clinico-epidemiological study from North India

“…There was a female preponderance in our study. This is in contrast to the studies by Kumar,[ 16 ] Agrawal[ 19 ], and Bari et al . [ 20 ] where a male preponderance was reported.…”

“…The incidence of CL is higher among the pediatric population in endemic areas, accounting for 60%–70% of the cases. [ 16 17 ] Similar to earlier studies, the 7 to 12 year age group was most commonly affected in our study. This could be accounted for by the greater risk of sandfly bites consequent to the increased involvement in outdoor playing activities as well as lack of immunity to CL in this age group.…”

“…[ 19 ] and Kumar et al . [ 16 ] in their respective studies on PCL reported a tissue smear positivity in 70% and 62.5% cases, respectively, whereas the positivity rates on histopathology were found to be 50% in both studies. Similar findings were reported by Gupta M in his study on 10 children with CL.…”

PCR Based Detection of Cutaneous Leishmaniasis

“…This type of finding seen in other repots also (24,25). Due to outside activities and higher probability of exposure to the environmental factors young age groups are at higher risk of CL as reported commonly (26,27). We found highest frequency of the infection 51% in the range of 2-12 years followed by 22% in the age group 13-23 in ours study.…”