The infection risk of visceral leishmaniasis among household members of active patients

Şakru, Nermin; Töz, Seray; Korkmaz, Metin; Kavakli, Tülay; Alkan, Mustafa; Özbel, Yusuf

doi:10.1016/j.parint.2005.10.008

Cited by 10 publications

(5 citation statements)

References 16 publications

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“…tropica (known as anthroponotic in many densely populated areas [ 66 – 68 ] indicated possible person-to-person transmission among households in Libya. The latter was identified as risk factor for CL and VL in many countries [ 33 , 69 ], hence screening of household members of CL patients should be considered for better surveillance of the disease. The life cycles of CL caused by different species of Leishmania in Libya need to be fully investigated since sandflies and rodents, or both, were frequently observed in the patient’s neighborhood.…”

Section: Discussionmentioning

confidence: 99%

Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya

et al. 2017

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BackgroundCutaneous leishmaniasis (CL) is a major public health problem in Libya. In this paper, we describe the eco-epidemiological parameters of CL during the armed conflict period from January 2011 till December 2012. Current spatiotemporal distributions of CL cases were explored and projected to the future using a correlative modelling approach. In addition the present results were compared with our previous data obtained for the time period 1995–2008.Methodology/Principal findingsWe investigated 312 CL patients who presented to the Dermatology Department at the Tripoli Central Hospital and came from 81 endemic areas distributed in 10 districts. The patients presented with typical localized lesions which appeared commonly on the face, arms and legs. Molecular identification of parasites by a PCR-RFLP approach targeting the ITS1 region of the rDNA was successful for 81 patients with two causative species identified: L. major and L. tropica comprised 59 (72.8%) and 22 (27.2%) cases, respectively. Around 77.3% of L. tropica CL and 57.7% of L. major CL caused single lesions. Five CL patients among our data set were seropositive for HIV. L. tropica was found mainly in three districts, Murqub (27.3%), Jabal al Gharbi (27.3%) and Misrata (13.7%) while L. major was found in two districts, in Jabal al Gharbi (61%) and Jafara (20.3%). Seasonal occurrence of CL cases showed that most cases (74.2%) admitted to the hospital between November and March, L. major cases from November till January (69.4%), and L. tropica cases mainly in January and February (41%). Two risk factors were identified for the two species; the presence of previously infected household members, and the presence of rodents and sandflies in patient’s neighborhoods. Spatiotemporal projections using correlative distribution models based on current case data and climatic conditions showed that coastal regions have a higher level of risk due to more favourable conditions for the transmitting vectors.ConclusionFuture projection of CL until 2060 showed a trend of increasing incidence of CL in the north-western part of Libya, a spread along the coastal region and a possible emergence of new endemics in the north-eastern districts of Libya. These results should be considered for control programs to prevent the emergence of new endemic areas taking also into consideration changes in socio-economical factors such as migration, conflicts, urbanization, land use and access to health care.

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Section: Discussionmentioning

confidence: 99%

Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya

et al. 2017

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“…Among the common characteristic organs affected in the infection are the liver, spleen, vessels, and bone marrow [4]. Furthermore, household members of individuals with previously confirmed visceral leishmaniasis have been found to have a higher frequency of the disease [5]. Hence, the household members of infected individuals should be included in the risk group for visceral leishmaniasis.…”

Section: Introduction/backgroundmentioning

confidence: 99%

Two Cases of Siblings with Variation in Response to Standard Treatment of Visceral Leishmaniasis in Kenyatta National Hospital

Allan¹,

Wakaba²,

Anjumanara³

et al. 2021

J Infect Dis Epidemiol

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Background: Visceral leishmaniasis is caused by a protozoan parasite of the genus Leishmania, transmitted by sandflies of the genus Phlebotomus. It is one of the neglected tropical infectious diseases, though it has been endemic in many countries around the world. High morbidity and mortality have been reported in Sub-Saharan Africa, including Kenya, attributed to misdiagnosis, late diagnosis, or medication lack. The cases we present, highlight the disease's characteristics and the variable individual to the conventional standard treatment.Cases: This case series highlights two siblings in a family of 17 children; a 9-year-old boy and his 4-year-old brother. They presented with a history of progressive abdominal swelling for about five months for the younger brother and four months for the older. These symptoms were accompanied by fevers, easy fatigability, bilateral lower limb swelling, and a pruritic skin rash. Both siblings had pedal edema, massive Splenomegaly, and pancytopenia with severe anemia. The diagnosis of VL was made via a positive rapid test for VL. After which, both siblings were started on treatment with sodium stibogluconate and Paromomycin for 17 days. The 9-year-old gained full recovery, but his brother did not. So, the 4-year-old boy was started on therapy with liposomal amphotericin for six days, after which he gained full recovery. The father was tested and found negative for VL, while the rest of the family were then asymptomatic but not tested. Conclusion:VL is treatable, especially if diagnosed and managed early enough. The serological tests' presence makes the diagnosis easy, and management started early, sufficient for better outcomes. Variation in response to treatment raises concern about whether we have a new species in this geographical area or drug-resistant organisms' development to the standard therapy. Importantly, screening family members in the same household and exposure is crucial, especially for children younger than five-years-old.

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“…Leishmaniasis is a vector-borne disease widespread in the Mediterranean basin, including countries such as Turkey, Greece, and Cyprus. [1][2][3][4] Leishmania infantum, Leishmania donovani, Leishmania major, and Leishmania tropica are the main species observed in this region, which are the etiologic agents of cutaneous leishmaniasis (CL), visceral leishmaniasis (VL), and canine leishmaniasis (CanL). [1][2][3] VL is a life-threatening systemic infection manifesting as a chronic febrile illness, marked by hepatosplenomegaly, pancytopenia, and hyperglobulinemia, and children are regarded to be at greater risk of infection.…”

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confidence: 99%

“…3,9,10 The climatological characteristics of Cyprus, that is, high humidity with warm and rainy winter and hot and dry summer, are comparable to other regions where cases of VL are found. 1,4,7,16,17 Several studies conducted in Cyprus since the 1940s indicate the presence of several Phlebotomus species. 2,3,[8][9][10] Furthermore, World Health Organization (WHO) data state L. infantum as the etiological agent of VL and Phlebotomus tobbi as the potential vector in Cyprus.…”

mentioning

confidence: 99%

“…1,19 It has been indicated that several VL cases have been undiagnosed, misdiagnosed, or unreported due to lack of access to medical facilities or limited diagnostic capabilities. 4 There was no possibility for serologic and molecular diagnosis of leishmaniasis in northern Cyprus when the cases were diagnosed. These cases indicated that the awareness of the clinician was crucial.…”

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confidence: 99%

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Pediatric Visceral Leishmaniasis Caused by Leishmania infantum in Northern Cyprus

Sayili

Taylan-Özkan

Schallig

2016

The American Society of Tropical Medicine and Hygiene

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Visceral leishmaniasis (VL) is a vector-borne disease widespread in the Mediterranean basin, including Cyprus. During the last decades no cases were notified from northern Cyprus, but herein three cases of VL (female: 2, male: 1, median age: 24.6 months) diagnosed during their hospital admission between January 2011 and December 2012 are reported. Diagnosis was based on clinical findings; 1 ≥ 1/64 titer positivity of immunofluorescence antibodies, Leishmania amastigotes in Giemsa-stained slides of bone marrow, as well as molecular identification confirmed that in all three the infecting pathogen was Leishmania infantum Fever, splenomegaly, and hepatomegaly were the typical clinical findings. First-line treatment with liposomal amphotericin B (AmBisome; intravenous, 3 mg/kg) on days 1-5, followed by the same on days 10 and 21 yielded a successful outcome with no relapse in all cases. These confirmed VL cases found within 2 years demonstrate the presence of VL on the island.

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The infection risk of visceral leishmaniasis among household members of active patients

Cited by 10 publications

References 16 publications

Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya

Spatiotemporal and molecular epidemiology of cutaneous leishmaniasis in Libya

Two Cases of Siblings with Variation in Response to Standard Treatment of Visceral Leishmaniasis in Kenyatta National Hospital

Pediatric Visceral Leishmaniasis Caused by Leishmania infantum in Northern Cyprus

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