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Published on: September 20, 2018

Epidemiological, clinical and therapeutic features of pediatric kala-azar

Kadivar Mohammad Rahim1, Moslehi Mohammad Ashkan

  • 1Department of Pediatrics, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.

The Southeast Asian Journal of Tropical Medicine and Public Health
|September 22, 2007
PubMed

Insights

Visceral leishmaniasis (Kala-azar) in Iranian children shows seasonal peaks and common symptoms like fever and enlarged spleen. Glucantim therapy is effective, but jaundice indicates a poor prognosis.

Area of Science:

  • Medical Research
  • Infectious Diseases
  • Pediatrics

Background:

  • Kala-azar, or visceral leishmaniasis, is a significant parasitic disease endemic in southern Iran.
  • Infants and children represent a vulnerable population affected by this condition.

Purpose of the Study:

  • To retrospectively evaluate clinical features, laboratory findings, and treatment outcomes of visceral leishmaniasis in pediatric patients in Fars Province, Iran.
  • To identify prognostic factors influencing patient outcomes.

Main Methods:

  • Retrospective analysis of 367 infants and children diagnosed with visceral leishmaniasis.
  • Data collection on clinical presentation, laboratory results, diagnostic tests (IFA, bone marrow smears/cultures), therapy (Glucantim), and patient outcomes (cure, relapse, mortality).

Main Results:

  • A seasonal variation in cases was noted, with a peak in late winter and spring.
  • Predominant clinical signs included chronic fever, pallor, weight loss, abdominal distention, and hepatosplenomegaly.
  • High cure rate (96.7%) with Glucantim was observed, but relapse (8.2%) and mortality (7.3%) occurred, with jaundice and deranged liver function tests being poor prognostic indicators.

Conclusions:

  • Visceral leishmaniasis in this pediatric cohort is characterized by specific clinical and laboratory findings.
  • Glucantim is an effective treatment, but vigilance for relapse and adverse prognostic signs like jaundice is crucial for patient management.

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