Visceral leishmaniasis: Clinical and demographic features in an African population

Abstract

Objective: To describe the clinical and demographic features of patients with visceral leishmaniasis (VL), from Sudan, Africa. Methodology: A descriptive study was conducted during 5 years period on confirmed VL patients. These patients are, originally, from White Nile Province (WNP) region, a previously non-endemic VL focus which is located in southern part of Sudan. They were referred during the period 2006-2010 for management at Tropical Diseases Hospital (TDH) in the capital Khartoum. The patients data were retrieved from the hospital electronic software system, and were studied. Results: A total of 71 patients with VL were reviewed. The main clinical features were: fever 68 (95.8%), splenomegaly 66 (93%), weight loss 61 (85.9%), pallor 59 (83.1%), hepatomegaly 52 (73.2%). The most notable haematology finding was the mean Hb value (7.6 g/dL) on admission to hospital. Gender showed males at higher risk for VL as compared to females with a ratio of 3:1 (53 vs 18). VL was largely a disease of children with 42 (59.1%) aged < 15 year, and around quarter (23.9%) under 5 years. Conclusion: The clinical features of Sudanese VL in WNP region is, generally, similar to the pattern seen globally in endemic foci. The majority of the study population are paediatric indigenous VL patients, suggesting that adults were immune, and indicating change of disease pattern from previous sporadic to present endemic. This finding emphasizes the need for research to better understand VL in non-endemic areas with the objective of developing effective and sustainable control strategies.

Improved kala-azar case management through implementation of health facility-based sentinel sites surveillance system in Bihar, India

“…This difference was found statistically significant (p<0.05). Similar findings were obtained by earlier studies conducted elsewhere [ 27 – 32 ]. However, large spleen (4–6 cm) size was also noticed for only negligible proportion under this study.…”

Clinical and laboratory profiles of visceral leishmaniasis among adult patients admitted to Felege Hiwot Hospital, Bahir Dar, Ethiopia

“…In this study, hematologic manifestations were high compared to previous studies done in North West Ethiopia and Greece. 18,19 This is likely due to late presentation which leads to bone marrow suppression by the amastigote and inflammation and splenic sequestration from huge splenomegaly.…”

“…[13][14][15][16] VL affects mainly of hematopoietic system manifested with leukopenia (96.6%), anemia (94.9%), thrombocytopenia (90.5%), and pancytopenia. [17][18][19][20][21][22][23][24] VL is diagnosed using serologic tests (either direct agglutination test (DAT) or recombinant kinesin protein (RK-39) dipstick) and confirmed parasitologically by the microscopic demonstration of amastigotes of Leishmania donovani bodies in Giemsa-stained tissue aspirates of the spleen, bone marrow, or lymph node. 15 In resource-limited areas or inconclusive results, VL can be diagnosed by case definition.…”

Visceral leishmaniasis in a Brazilian endemic area: an overview of occurrence, HIV coinfection and lethality

“…The clinical manifestations of VL observed in the present study are concordant with those reported by other studies 41 , 48 . Fever, weakness, hepatomegaly, weight loss and splenomegaly were frequent among VL cases and comprise the classic clinical features of the disease, generally found at the patients admission 49 . Curiously, anemia and pancytopenia (blood dyscrasias) were not detected at high frequencies, although pallor was often reported.…”