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Visceral leishmanisis in paediatrics: a study of 367 cases in southwest Iran

Moslehi Mohammad Ashkan1, Kadivar Mohammad Rahim

  • 1Department of Pediatrics, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran. moslehim@sums.ac.ir

Tropical Doctor
|July 17, 2008
PubMed

Insights

Kala-azar, or visceral leishmaniasis, is common in Iranian children. Glucantim therapy is effective, but jaundice indicates a poor prognosis for visceral leishmaniasis patients.

Area of Science:

  • Tropical medicine
  • Infectious diseases
  • Parasitology

Background:

  • Visceral leishmaniasis (Kala-azar) is a significant public health concern in southern Iran.
  • This study retrospectively analyzes cases of visceral leishmaniasis in infants and children in Fars Province.

Observation:

  • Seasonal variations in VL cases were noted, with peaks in late winter and spring.
  • Predominant clinical signs included chronic fever, pallor, weight loss, abdominal distention, and hepatosplenomegaly.
  • Common laboratory findings were anemia, leukopenia, thrombocytopenia, hypoalbuminemia, and hypergammaglobulinemia.

Findings:

  • All patients tested positive via immunofluorescence antibody test and Leishmania donovani confirmation (bone marrow smear/culture).
  • Glucantim therapy achieved a high cure rate (96.7%), with a relapse rate of 8.2% and mortality of 7.3%.
  • Jaundice and significantly deranged liver function tests were identified as indicators of a poor prognosis.

Implications:

  • Effective treatment strategies for visceral leishmaniasis are available, but vigilance for prognostic indicators is crucial.
  • Understanding seasonal patterns and clinical manifestations aids in early diagnosis and management of VL in endemic regions.
  • Further research into risk factors for relapse and mortality in pediatric VL is warranted.

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