Clinical Characteristics and Haematological Parameters Associated With Visceral Leishmaniasis in Bangladeshi...

Visceral leishmaniasis (VL) also known as kala-azar (KA) is the most severe form of leishmaniasis and can be fatal in the absence of treatment. KA is highly endemic in Mymensingh region of Bangladesh. Although estimating the true incidence of VL may be difficult. The objective of the study was to evaluate clinico-haematological parameters in different groups of leishmaniasis cases. It was a cross-sectional descriptive type of study and was conducted in a research centre of Mymensingh, Bangladesh from February 2016 to January 2017. A total of 90 cases who were rk-39 strip test positive from five divisions of Bangladesh admitted to Research Centre were included for clinical and haematological parameters. All the cases were categorized into five different groups depending on the clinical case definition and Real Time PCR (RT-PCR) was performed using buffy coat preparation. The age of the study subjects ranged from 3 to 80 years. Mymensingh was the highest affected division (60%) and primary kala azar (PKA) cases were more than half of the study subjects. Fever was the most common feature (100%) in PKA, relapse kala azar (R-KA) and treatment failure kala azar (TF-KA) followed by splenomegaly (70.2%) in PKA, loss of appetite (62.9%) in R-KA, and skin pigmentation was observed (100%) in PKDL cases. Anaemia was present in 62.7%, leucopenia in 57.6% and thrombocytopenia in 61.7% PKA cases. Pancytopenia was observed in a total of 33 cases from all groups. There were no significant changes in serum bilirubin, SGPT and serum creatinine level. RT-PCR was performed in all cases and found positive in 30 (63.8%) PKA, 16 (59.3%) R-KA, 2 (100%) TF-KA and 2 (50%) R-KA associated with PKDL cases. Overall, VL cases were positive in 62.5% (50/80) and no PKDL cases were detected by buffy-coat RT-PCR. In endemic areas, the magnitude of the problem and limited resources of a developing country like ours, clinical characteristics and hematological parameters may also play important role for diagnosis of the clinical cases.