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Epidemiological aspects of kala-azar in Meshkin-Shahr, Iran: human infection
G Soleimanzadeh1, G H Edrissian, A M Movahhed-Danesh
1Paediatric Ward, District Hospital, Meshkin-Shahr, Islamic Republic of Iran.
Abstract:
During the last decade, kala-azar, which used to be a sporadic disease, became endemic in parts of East-Azerbaijan province in north-west Iran. Many of the 1051 cases observed between 1985 and 1990 were in the district of Meshkin-Shahr (800 cases). The diagnosis was based on symptoms and signs of the disease plus a positive serological test (indirect immunofluorescence assay or direct agglutination test) and, in some cases, the finding of parasites in bone marrow smears. About 90% of the cases were children under 5 years of age. The disease incidence in 1990 was almost ten times that in 1985. New cases are diagnosed throughout the year, but mostly from January till April. Cases were treated with meglumine antimoniate with very satisfactory results; deaths were few among the treated children.
Insights
Kala-azar became endemic in East-Azerbaijan, Iran, with most cases in children under 5. Treatment with meglumine antimoniate yielded satisfactory results, with few deaths.
Area of Science:
- Medical Parasitology
- Epidemiology
Background:
- Kala-azar (visceral leishmaniasis) transitioned from sporadic to endemic in East-Azerbaijan, Iran.
- A significant increase in cases was observed between 1985 and 1990.
Purpose of the Study:
- To describe the epidemiology and clinical characteristics of a kala-azar outbreak.
- To evaluate the treatment efficacy of meglumine antimoniate.
Main Methods:
- Case identification based on clinical signs, serological tests (indirect immunofluorescence assay, direct agglutination test), and parasite detection in bone marrow smears.
- Retrospective analysis of 1051 cases from 1985-1990.
Main Results:
- Meshkin-Shahr district reported 800 cases, predominantly in children under 5 years old (90%).
- Disease incidence increased nearly tenfold from 1985 to 1990.
- Peak diagnosis occurred between January and April.
Conclusions:
- Kala-azar poses a significant public health concern in East-Azerbaijan, particularly for young children.
- Meglumine antimoniate is an effective treatment for kala-azar, with a low mortality rate.