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Clinical and laboratory study of kala-azar in children in Nepal
1Department of Paediatrics, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. bpkihs@npl.healthnet.org
Insights
Kala-azar, a serious parasitic disease, affects children in Nepal. This study highlights common symptoms like enlarged liver and spleen, and confirms sodium stibogluconate is an effective treatment.
Area of Science:
- Tropical Medicine
- Pediatrics
- Infectious Diseases
Background:
- Kala-azar (visceral leishmaniasis) is a neglected tropical disease with limited documented cases in children in Nepal.
- Eastern Nepal is an endemic region where pediatric kala-azar requires further investigation.
Purpose of the Study:
- To document the clinical presentation, diagnosis, and treatment outcomes of pediatric kala-azar cases.
- To emphasize the significance of recognizing and managing kala-azar in children within endemic areas of Nepal.
Main Methods:
- Retrospective case series of 20 children diagnosed with kala-azar at B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
- Clinical data collection included age, illness duration, physical examination findings, hematological parameters, and diagnostic methods.
- Diagnosis was confirmed by demonstrating Leishmania donovani (LD bodies) in bone marrow aspirates.
Main Results:
- The study included 20 children aged 2-14 years, with illness duration ranging from 12 days to 24 months.
- Hepatomegaly (95%) and splenomegaly (90%) were prevalent. Anemia (95%), leucopenia (60%), and thrombocytopenia (75%) were common hematological findings.
- Leishmania donovani (LD bodies) were identified in 80% of bone marrow aspirates. All patients responded well to sodium stibogluconate treatment with no observed mortality.
Conclusions:
- Kala-azar is an important pediatric health concern in endemic regions of eastern Nepal.
- Prompt diagnosis and treatment with sodium stibogluconate are crucial for favorable outcomes in children.
- Further research and public health awareness are needed to address pediatric kala-azar in Nepal.
Abstract:
Reports are scanty regarding kala-azar in children in Nepal. In this communication we document 20 children diagnosed to have kala-azar who were admitted and treated at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. The children were between 2 and 14 years old. The duration of illness varied between 12 days and 24 months with a majority (65 per cent) of children being ill for less than 6 months. Hepatomegaly and splenomegaly were seen in 95 and 90 per cent of cases respectively. Splenomegaly was not found in two (10 per cent) children. Anaemia, leucopenia, and thrombocytopenia were seen in 95, 60, and 75 per cent of children respectively. Amastigotes of Leishmania donovani (LD bodies) were demonstrated in Giemsa-stained smears of bone marrow aspirates in 16 (80 per cent) children. All the children responded to treatment with sodium stibogluconate. No mortality was observed. This study emphasizes the importance of kala-azar in children in endemic areas of eastern Nepal.
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