Pediatric Cutaneous Leishmaniasis in an Endemic Region in India

Abstract

Abstract. Cutaneous leishmaniasis (CL) is endemic in the Bikaner region situated in the Thar Desert of Rajasthan, India. This study describes clinicoepidemiological data of pediatric CL in pre-school children (0-5 years of age) from this region during 2001-2012. In total, 151 patients with 217 lesions were reported during the study period. The mean age of the study group was 3.29 ± 1.43 years (0.25-5 years), with many (41.7%) cases being in the age group of 2-4 years. Face was the most common site involved, and morphologically, the lesions were either plaque type or papulonodular. Smear for parasitologic examination was positive in 84 (70%) of 120 cases, and histopathologic examination confirmed CL in 10 (55.55%) of 18 cases. Parasite species identification conducted for 13 randomly selected patients by polymerase chain reaction identified Leishmania tropica as the causative species. Intralesional sodium stibogluconate was the most commonly used treatment and found to be well-tolerated. Other therapies that were effective included oral rifampicin, oral dapsone, radiofrequency heat therapy (RFHT), and combinations of the three therapies.

Clinico-Epidemiological Patterns of Cutaneous Leishmaniasis Patients Attending the Anuradhapura Teaching Hospital, Sri Lanka

“…Dry type CL lesions were common in this study group, in agreement with previous studies conducted in Sri Lanka [12], India [30], Libya [31], and in Syria [32]. However, females had more wet lesions than males.…”

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

“…11 Higher predilection in this age group can be explained by frequent outdoor activities (school going, outdoor playing activities) thus making them prone to bites by infected vectors. Authors found a male to female ratio of 1.88 similar to studies by Agrawal, Bari and Shoaib et al 8,11,13 The lesions were most frequently seen on the face and neck (86.09%) in accordance with studies by Aksoy et al and Agrawal et al 6,8 Face was the most commonly affected site in 80.87% cases in accordance with study by Zaraa et al 14 Although a single lesion was most commonly observed, multiple lesions (more than one) were not uncommon. Bari et al observed multiple lesions in 25% of cases, which was similar to the finding in present study (27.8%).…”

“…In children face being the most unprotected and exposed, is the commonest site for sand-fly bite. 8 Although CL is selflimiting and does not cause mortality, but it causes cosmetic disfiguration, persistence and spread into mucocutaneous form thus increases expenses on treatment and side effects of available drugs. 9 Therefore, treatment is recommended to prevent these complications especially in children.…”

Evaluation of clinical and demographic characteristics of Turkish and Syrian pediatric cutaneous leishmaniasis patients from Hatay, Turkey after the Syrian civil war

“…In India, a single lesion (72.2%) was most frequently detected in the 0-5 age group of patients. The authors reported that 19.9% of patients had two lesions and 7.9% of patients had multiple lesions [17]. In another study from Iran, only one lesion was detected in 82.3% of patients, two lesions were detected in 12.4% of patients, and ≥ 3 lesions were detected in 5.3% of patients [18].…”

“…Another interesting result of our study is that in 63.6% (n = 7) of patients with ulcer type the lesions occurred on extremities. When other studies were reviewed, it was observed that papules [14], plaques [16], plaques or papulonodules [17] or ulcers [10] were reported as the most common types of lesions.…”