scholarly journals Clinical and laboratory profiles of visceral leishmaniasis among adult patients admitted to Felege Hiwot Hospital, Bahir Dar, Ethiopia

2021 ◽  
Vol 9 ◽  
pp. 205031212110367
Author(s):  
Berhanu Tarekegn ◽  
Ayanaw Tamene
Keyword(s):  
Visceral Leishmaniasis ◽  
Leishmania Donovani ◽  
Clinical Presentation ◽  
Winter Season ◽  
Adult Patients ◽  
Sand Fly ◽  
Timely Initiation ◽  
Vector Borne Disease ◽  
Vector Borne ◽  
Endemic Areas

Background: Visceral leishmaniasis is a vector-borne disease caused by Leishmania donovani transmitted by sand fly species. It is the third most common vector-borne disease globally. Visceral leishmaniasis is endemic in Ethiopia with an estimated annual incidence ranging from 3700 to 7400 cases. This research aimed to assess the clinical presentations and laboratory profiles of visceral leishmaniasis for early diagnosis and timely initiation of management. Objective: To describe the clinical and laboratory manifestation and diagnostic modalities of visceral leishmaniasis among adult patients admitted to Felege Hiwot Hospital, from 1 September 2016 to 30 August 2019. Method: Institution-based retrospective cross-sectional study was conducted among 141 patients admitted to Felege Hiwot Hospital from 1 September 2016 to 30 August 2019. Descriptive statistics were used to describe the clinical presentation and laboratory profiles of patients with visceral leishmaniasis. Results: Among a total of 141 enrolled patients in the study, males were affected 13-fold. Most of them were travelers to endemic areas during the winter season for labor work. The mean duration of illness was 48 days. Common symptoms were fever (96.5%), weightless (82.5%), jaundice (18.4%), vomiting/diarrhea (13.5%), and bleeding episodes (11.3%). Splenomegaly was seen in 98.6%, ascites in 35.5%, and lymphadenopathy in 9.9%. Lymphadenopathy was seen significantly in HIV patients (40%). Anemia was seen in 95%, thrombocytopenia in 90.2%, leukopenia in 86.4%, and pancytopenia in 79.4%. Half of the patients had coinfection. Neutropenic sepsis was seen in 21.3%. The diagnosis was made by tissue aspiration in 65% of patients. Conclusion: The majority of patients who were diagnosed to have visceral leishmaniasis were young male adults who traveled to the endemic areas seasonally. Fever and splenomegaly were seen as the commonest clinical presentation. Lymphadenopathy occurred in high frequency among HIV co-infected patients. Anemia was the commonest hematologic finding.

An unusual case of post-kala-azar dermal leishmaniasis in a patient with HIV and visceral leishmaniasis co-infection

2019 ◽  
Vol 30 (12) ◽  
pp. 1221-1223
Author(s):  
Tamara Elliott ◽  
Jacqueline Simpson ◽  
Kikkeri N Naresh ◽  
Diana Lockwood ◽  
Angela C Bailey
Keyword(s):  
Human Immunodeficiency Virus ◽  
Visceral Leishmaniasis ◽  
Leishmania Infantum ◽  
Leishmania Donovani ◽  
Unusual Case ◽  
Vector Borne Disease ◽  
Kala Azar ◽  
Immunodeficiency Virus ◽  
Vector Borne

Visceral leishmaniasis (VL) is a vector-borne disease caused by Leishmania donovani complex. Post-kala-azar dermal leishmaniasis (PKDL) is a rash that can occur following treatment for VL due to L. donovani species. We describe an unusual case of PKDL occurring during treatment for Leishmania infantum VL in a patient with human immunodeficiency virus-co infection.

scholarly journals Rare splenic complications and specific serology: decisive diagnostic tools in two cases of visceral leishmaniasis

2012 ◽  
pp. 274-277
Author(s):  
Andrea Celestini ◽  
Federica Paglia ◽  
Orlando Dell’ Unto ◽  
Riccardo Guarisco ◽  
Claudio Puoti
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Bone Marrow Biopsy ◽  
Clinical Presentation ◽  
Splenic Rupture ◽  
Splenic Infarction ◽  
Diagnostic Tools ◽  
Minor Trauma ◽  
Vector Borne ◽  
A Minor

Introduction: Visceral leishmaniasis (VL) is a major endemic vector-borne disease in Southern Europe. We present two cases of VL, both characterized by splenic complications. Methods and results: Case 1: A 47-year-old female presented with effort angina, hepatosplenomegaly and pancytopenia. The clinical course was complicated by splenic infarction. Although bone marrow biopsy failed to show amastigotes, diagnosis was performed by a fast agglutinating screening test (FAST) and confirmed by a direct agglutinating test (DAT). The patient was treated successfully with AmBisome. Case 2: A 22-year-old male who had undergone a splenectomy to treat splenic rupture related to a minor trauma four months earlier presented with fever, nocturnal sweats and weight loss. The lack of pancytopenia was due to the absence of the spleen. The first biopsy did not identify parasites, but because the FAST had been positive, another bone marrow biopsy was performed, which demonstrated leishmaniasis. This patient was treated with the same schedule of AmBisome infusion. Discussion: 1) The clinical presentation of VL can be atypical, 2) splenic complications can characterize this disease, and 3) specific serology may be an important tool to reach a diagnosis.

scholarly journals Study of Visceral Leishmaniasis (Kala-azar) in Children of Nepal

2009 ◽  
Vol 29 (2) ◽  
pp. 67-73 ◽  
Author(s):  
Durga Datt Joshi
Keyword(s):  
Visceral Leishmaniasis ◽  
Leishmania Donovani ◽  
Research Work ◽  
Case Fatality ◽  
Zoonotic Disease ◽  
Morbidity And Mortality ◽  
Sand Fly ◽  
Epidemiological Surveillance ◽  
Mortality Data ◽  
Kala Azar

Introduction: Visceral leishmaniasis (VL) or Kala-azar is a potentially fatal vector-borne (sand fly phlebotomies spp) zoonotic disease caused by a protozoan parasite, Leishmania donovani. In Nepal, the disease is restricted to the Eastern Terai region which lies adjacent to the Bihar state of India. Although leishmaniasis is regarded as a significant health problem in Nepal by the Ministry of Health, there is no active case detection programme in the country. Objective: Objectives of this study were to determine the up-to-date morbidity and mortality trend for VL in children of Nepal. Method: The epidemiological surveillance team from the NZFHRC visited to eight zonal hospitals in Terai region during the month from September to December of each year 2003 to 2007. The morbidity and mortality data up to the year 2007 were collected every year. The team has also collected 66 blood serum samples of which 18 samples from children were collected for the diagnosis. Results: A total 25890 cases with 599 deaths were reported during the year 1980-2006. The case fatality rate (CFR) varied from 0.23% to 13.2%. Districtwise analysis showed that, during 2003, highest incidence was in Mahottari district (184/100,000), followed by Sarlahi (100/100,000) and Sunsari (96/100,000). The highest CFR was in Dhanusha (2.9%) followed by Bara (2.4%) and Saptari (2.0%). Majority (70.9%) of persons affected by VL were aged 15 years and above, followed by 10-14 years (13.9%), 5-9 years (11.9%) and 1-4 years (3.3%). VL cases recorded from different district of Nepal for the year 2004, 2005, 2006 and 2007 are recorded. CFR for the year 2004, 2005, 2006 and 2007 were 3.2%, 3.7%, 16.67% and 11.42% respectively. Conclusions: There should be regular surveillance research work to be carried out in endemic area. Mass public health education, to make the people aware about preventive aspects of the disease is important. The possibility of the existence of animal reservoirs as zoonotic disease should also be considered. This disease is very much serious in children below 15 years of age both in male and female, therefore it is essential to have paediatrician post at least in all VL six endemic districts. Key words: Epidemiology, Leishmaniasis, Kala-azar, Sandfly   doi: 10.3126/jnps.v29i2.2041 J. Nepal Paediatr. Soc. Vol 29, No. 2, pp.67-73

scholarly journals INVESTIGATION OF LEISHMANIASIS VECTORS IN EL-KADOBA VILLAGE, WHITE NILE STATE, SUDAN

2017 ◽  
Vol 5 (1) ◽  
pp. 430-441
Author(s):  
Belal Abdallah A. Adam ◽  
Moawia Mukhtar Hassan ◽  
Osman Mohammed Abd Elnour ◽  
Ahmed Hamid Awadallah
Keyword(s):  
Visceral Leishmaniasis ◽  
Leishmania Donovani ◽  
Morphological Characters ◽  
Sand Fly ◽  
Leishmania Infection ◽  
Sand Flies ◽  
Kala Azar ◽  
Ecological Aspects ◽  
Binocular Microscope ◽  
White Nile

Visceral leishmaniasis (VL; kala-azar) is one of the most important parasitic tropical diseases in Sudan   and the Sudan is considered to be one of the most important foci in the world. The visceral leishmaniasis has been described in Sudan since the beginning of the twentieth century. In Sudan, VL is caused by Leishmania donovani complex: MON 18, MON 30 and MON 82 zymodemes and  The proven vector is Phlebotomus (Larroussius) orientalis, in this study a survey was carried out to identify the principal vector of VL based on Leishmania infection, morphological characters and to determine some ecological aspects of the sand flies prevalent in the area . Ten species of sand flies were recorded, three Phlebotomus species and seven Sergentomyia species of these sandflies, P. rodhaini was collected only from Acacia seyal/Balanities aegyptiaca at the Island whereas S. hunti was collected from the Acacia nilotica forest only of the total collections, P. orientalis representing 3.80% (248 specimens) of the total collection and P. papatasi were 3.11% of the collection. Sand flies identification was done under a binocular microscope at 40x (magnification). The main features used for sand flies identification were the sperm theca of the female, the termination of the male and the pharyngeal and the ciboria toothed structures of both sexes. According to results of this study we recommended the following:  more studies are needed in the future to determine the transmission season, and infection rates of Leishmania parasites in human and the animal host in this area. Annually Entomological surveys must be done to determine density of Sand fly Vectors and Encourage the use of personal protection tools (ITNs), repellents, and improving of houses to avoid bite of sand fly.

scholarly journals Studies on the Feeding Habits ofLutzomyia (Lutzomyia) longipalpis(Lutz & Neiva, 1912) (Diptera: Psychodidae: Phlebotominae) Populations from Endemic Areas of American Visceral Leishmaniasis in Northeastern Brazil

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Margarete Martins dos Santos Afonso ◽  
Rosemere Duarte ◽  
José Carlos Miranda ◽  
Lindenbergh Caranha ◽  
Elizabeth Ferreira Rangel
Keyword(s):  
Visceral Leishmaniasis ◽  
Feeding Habits ◽  
Blood Feeding ◽  
Northeastern Brazil ◽  
Sand Fly ◽  
Lutzomyia Longipalpis ◽  
Elisa Technique ◽  
Endemic Areas ◽  
Feeding Sources

The aim of this study was to identify potential blood feeding sources ofL. (L.) longipalpisspecimens from populations in Northeastern Brazil, endemic areas of American Visceral Leishmaniasis (AVL) and its correlation with the transmission ofL. (L.) i. chagasi. The ELISA technique was applied using bird, dog, goat, opossum, equine, feline, human, sheep, and rodent antisera to analyze 609 females, resulting in an overall positivity of 60%. In all municipalities, females showed higher positivity for bird followed by dog antiserum and sand fly specimens were also positive for equine, feline, human, sheep, goat, opossum, and rodent antisera. The finding for 17 combinations of two or three types of blood in some females corroborates the opportunistic habit of this sand fly species. The results demonstrating the association betweenL. (L.) longipalpisand opossum suggest the need for further evaluation of the real role of this synanthropic mammal in the eco-epidemiology of AVL.

scholarly journals Comparative Study of Microscopy and Polymerase Chain Reaction for the Diagnosis of Suspected Visceral Leishmaniasis Patients in Nepal

2014 ◽  
Vol 11 (1) ◽  
pp. 14-17 ◽  
Author(s):  
K Pandey ◽  
AK Mallik ◽  
S Pyakurel ◽  
SB Pun ◽  
BD Pandey
Keyword(s):  
Bone Marrow ◽  
Polymerase Chain Reaction ◽  
Visceral Leishmaniasis ◽  
Leishmania Donovani ◽  
Polymerase Chain Reaction Amplification ◽  
Public Health Problem ◽  
Major Public Health Problem ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Endemic Areas

Background Visceral leishmaniasis is potentially fatal protozoan diseases caused by Leishmania donovani. Nepal is an endemic region in which visceral leishmaniasis causes a major public health problem in the lowland areas that border the endemic areas of Bihar state in India. Accurate diagnosis to inform treatment is a first step in achieving the goal of visceral leishmaniasis elimination from South East Asian regions by 2020. Objective The objective of the present study was to compare between the Microcopy and polymerase chain reaction for diagnosis of visceral leishmaniasis. Methods In the present study, 236 bone marrow aspirations were collected from suspected visceral leishmaniasis patients in Janakpur Zonal Hospital, Dhanusa district, Terai region of Nepal in between 2003-2007. We evaluated bone marrow samples by microscopic examination with subsequent testing of the same sample by polymerase chain reaction and sequence analysis. Results Giemsa’s solution stained bone marrow slides stored for over five years were used for polymerase chain reaction amplification. The result showed that 71% were polymerase chain reaction positive and 56% were microscopic positive. Out of 104 microscopic negative bone marrow samples, 15% of samples were positive by polymerase chain reaction. Conclusion Polymerase chain reaction could make a very good option for diagnosis by using less or non-invasive material from visceral leishmaniasis patients in endemic areas of Nepal. DOI: http://dx.doi.org/10.3126/kumj.v11i1.11016 Kathmandu University Medical Journal Vol.11(1) 2013: 14-17

scholarly journals Preclinical validation of a second generation leishmanization vaccine against vector transmitted fatal visceral leishmaniasis

2020 ◽  
Author(s):  
Subir Karmakar ◽  
Nevien Ismail ◽  
Fabiano Oliveira ◽  
James Oristian ◽  
Wen Wei Zhang ◽  
...  
Keyword(s):  
Immune Response ◽  
Visceral Leishmaniasis ◽  
Leishmania Donovani ◽  
Leishmania Major ◽  
Protective Efficacy ◽  
Sand Fly ◽  
Endemic Region ◽  
Cytokines And Chemokines ◽  
Human Leishmaniasis ◽  
Strong Candidate

AbstractVisceral Leishmaniasis (VL) is fatal if untreated. There is no licensed vaccine available against human leishmaniasis. We recently demonstrated protection in mice against L. major infection using a CRISPR genome edited attenuated Leishmania major strain (LmCen−/−). Here, as a pre-clinical step, we evaluated the protective efficacy of LmCen−/− against VL induced by sand fly transmitted Leishmania donovani in hamsters. Intradermal immunization of hamsters with LmCen−/− did not develop any lesion; while still priming a pro-inflammatory immune response. When challenged with L. donovani either by intradermal needle injection or by infected sand flies, LmCen−/−-immunized hamsters were protected, not showing spleen or liver pathology averting VL fatality compared to control animals. Spleen cells from LmCen−/− immunized and infected sand fly challenged hamsters produced significantly higher Th1-associated cytokines and chemokines including IFN-γ and TNF-α, and significantly reduced expression of the anti-inflammatory cytokines IL-10 and IL-21, compared to non-immunized challenged animals. We further developed a GLP-grade LmCen−/− which showed equal protection as laboratory-grade LmCen−/− parasites in hamsters. Importantly, GLP-grade LmCen−/− parasites also induced a proinflammatory immune response in the PBMCs isolated from healthy people living in non-endemic and endemic for VL as well as cured VL people living in endemic region. Together, this study demonstrates that the LmCen−/− parasites are safe and efficacious against VL and it is a strong candidate vaccine to be tested in a human clinical trial.

scholarly journals Epistaxis in Visceral Leishmaniasis: A hospital based study in Eastern Nepal

2012 ◽  
Vol 1 (1) ◽  
pp. 38-40
Author(s):  
B Sigdel ◽  
S Bhandary ◽  
P Karki ◽  
A Ghimire
Keyword(s):  
Bone Marrow ◽  
Visceral Leishmaniasis ◽  
Clinical Manifestation ◽  
Endemic Area ◽  
Leishmania Donovani ◽  
Age Group ◽  
Peripheral Smear ◽  
Cross Sectional ◽  
Severe Epistaxis ◽  
Endemic Areas

INTRODUCTION: Epistaxis is a common clinical manifestation in endemic areas of Visceral Leishmaniasis (VL). This study aims to see the prevalence of epistaxis in VL in Eastern Nepal. MATERIALS AND METHODS: This study was a prospective cross sectional hospital based study. Diagnosis was made by Rk-39 from peripheral smear & Leishmania donovani (LD) bodies from bone marrow. Before starting anti–kalaazar treatment, nasal examination findings were noted. RESULTS: Ninenteen out of 80 diagnosed case of VL patients had epistaxis (23.8%) with age group between 7-66 years. One patient had developed severe epistaxis and hemotoma and died. CONCLUSION: Epistaxis is a common ent finding in endemic area of VL, however this needs to be confirm with larger cohorts. DOI: http://dx.doi.org/10.3126/ijim.v1i1.6942Int J Infect Microbiol 2012;1(1):38-40

scholarly journals Evolutionary genomics of epidemic visceral leishmaniasis in the Indian subcontinent

eLife ◽  
2016 ◽  
Vol 5 ◽  
Author(s):  
Hideo Imamura ◽  
Tim Downing ◽  
Frederik Van den Broeck ◽  
Mandy J Sanders ◽  
Suman Rijal ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Leishmania Donovani ◽  
Indian Subcontinent ◽  
Evolutionary Genomics ◽  
Whole Genome ◽  
Parasitic Disease ◽  
Distinct Population ◽  
Genome Sequences ◽  
Vector Borne ◽  
Base Pair Insertion

Leishmania donovani causes visceral leishmaniasis (VL), the second most deadly vector-borne parasitic disease. A recent epidemic in the Indian subcontinent (ISC) caused up to 80% of global VL and over 30,000 deaths per year. Resistance against antimonial drugs has probably been a contributing factor in the persistence of this epidemic. Here we use whole genome sequences from 204 clinical isolates to track the evolution and epidemiology of L. donovani from the ISC. We identify independent radiations that have emerged since a bottleneck coincident with 1960s DDT spraying campaigns. A genetically distinct population frequently resistant to antimonials has a two base-pair insertion in the aquaglyceroporin gene LdAQP1 that prevents the transport of trivalent antimonials. We find evidence of genetic exchange between ISC populations, and show that the mutation in LdAQP1 has spread by recombination. Our results reveal the complexity of L. donovani evolution in the ISC in response to drug treatment.

scholarly journals Leishmania spp. seropositivity in Austrian soldiers returning from the Kosovo

2020 ◽  
Vol 132 (1-2) ◽  
pp. 47-49 ◽  
Author(s):  
Edwin Kniha ◽  
Julia Walochnik ◽  
Wolfgang Poeppl ◽  
Gerhard Mooseder ◽  
Adelheid G. Obwaller
Keyword(s):  
Visceral Leishmaniasis ◽  
Cutaneous Leishmaniasis ◽  
Risk Of Infection ◽  
Protective Measures ◽  
Vector Borne Disease ◽  
Clinical Forms ◽  
Mediterranean Countries ◽  
Leishmania Spp ◽  
Balkan Region ◽  
Vector Borne

SummaryLeishmaniasis is a severe vector-borne disease with two main clinical forms, visceral leishmaniasis and cutaneous leishmaniasis. Both forms of leishmaniasis are also endemic in Mediterranean countries including the Balkan region from where mainly visceral leishmaniasis is reported. Austrian soldiers returning from Kosovo were screened for anti-Leishmania antibodies to assess the risk of infection during operations. Anti-Leishmania antibodies were detected in more than 20% of the soldiers investigated, which indicates a considerable risk of infection during missions in this area and thus suggests the application of protective measures.

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