Childhood visceral leishmaniasis.

Area of Science:

• Infectious Diseases
• Parasitology
• Pediatrics

Background:

• Visceral leishmaniasis (VL) is a severe parasitic disease caused by Leishmania donovani.
• Transmitted by sandfly vectors, VL disproportionately affects children, with nearly half of cases occurring in this demographic.
• Clinical symptoms in children often include prolonged fever, anorexia, hepatosplenomegaly, and anemia.

Purpose of the Study:

• To summarize the key aspects of childhood visceral leishmaniasis.
• To highlight diagnostic methods and current treatment options for pediatric VL.
• To address challenges in managing post-kala-azar dermal leishmaniasis (PKDL) in children.

Main Methods:

• Review of clinical manifestations and diagnostic approaches for pediatric VL.
• Analysis of current therapeutic strategies, including established and newer drugs.
• Discussion of challenges in managing PKDL in children and overall control measures.

Main Results:

• Childhood VL shares clinical features with adult cases, primarily prolonged fever, anorexia, and significant organ enlargement.
• Diagnosis relies on identifying Leishmania parasites via microscopy or culture from bone marrow or splenic aspirates.
• Effective treatments include Amphotericin B and the oral drug miltefosine, while sodium antimony gluconate remains a long-standing option.

Conclusions:

• VL in children requires prompt diagnosis and appropriate treatment to prevent severe outcomes.
• Managing PKDL in pediatric patients presents unique therapeutic challenges.
• Effective control strategies necessitate integrated approaches, including vector control and community engagement, in the absence of a vaccine.