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Visceral leishmaniasis in Omani children: a review
I B Elnour1, F O Akinbami, A Shakeel
1Department of Child Health, College of Medicine, Sultan Qaboos University Hospital, PO Box 35, Al Khod, Sultanate of Oman. ibelnur@omantel.net.om
Insights
This study highlights key features of pediatric visceral leishmaniasis in Oman, finding fever, anemia, and enlarged spleen common. Most children responded to treatment, but complications led to a 6% mortality rate.
Area of Science:
- Tropical Medicine
- Pediatric Infectious Diseases
- Parasitology
Background:
- Visceral leishmaniasis (VL) is a severe parasitic disease affecting children globally.
- Understanding the epidemiological and clinical spectrum of VL in specific regions is crucial for effective management.
- Oman has reported cases of VL, necessitating localized data for public health strategies.
Purpose of the Study:
- To investigate the epidemiological and clinical characteristics of pediatric visceral leishmaniasis in Oman.
- To identify common presenting symptoms and diagnostic findings in children with VL.
- To evaluate treatment outcomes and mortality associated with VL in this pediatric cohort.
Main Methods:
- Retrospective analysis of 33 children diagnosed with visceral leishmaniasis at Sultan Qaboos University Hospital (1993-1999).
- Review of patient records for epidemiological data, clinical presentation, and diagnostic methods.
- Histological confirmation of Leishmania amastigotes in bone marrow or splenic aspirates.
Main Results:
- All 33 pediatric patients presented with fever, anemia, and splenomegaly.
- Hepatomegaly (88%) and lymphadenopathy (39%) were frequently observed; all cases had iron deficiency anemia.
- Hypertriglyceridemia was noted as a novel observation. Treatment with sodium stibogluconate was effective in most cases (94%), with two deaths (6% mortality) due to complications.
Conclusions:
- Pediatric visceral leishmaniasis in Oman typically presents with fever, anemia, and splenomegaly.
- Iron deficiency anemia and hypertriglyceridemia are significant clinical findings in this cohort.
- Sodium stibogluconate is an effective treatment, but vigilance for complications and associated mortality is warranted.
Abstract:
A retrospective study was undertaken of 33 children with visceral leishmaniasis admitted to Sultan Qaboos University Hospital (SQUH), Oman between 1993 and 1999. The aim was to study the epidemiological and clinical characteristics of visceral leishmaniasis in children in Oman. All presented with fever, anaemia and splenomegaly. Hepatomegaly and lymphadenopathy were present in 88% and 39% of children, respectively. All had iron deficiency anaemia. Hypertriglyceridaemia is a new observation. Diagnosis in all cases was confirmed by histological demonstration of Leishmania amastigotes in bone marrrow (32 subjects) or splenic aspirate (one subject). All children were treated with sodium stibogluconate, 14 needed blood transfusion or blood products and all but two responded well. There were two deaths from associated complications (6% mortality).