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

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

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

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v5.i1.2017.1938 ◽

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.

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Visceral Leishmaniasis (Kala-azar) in Nepalgunj Medical College

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v16i2.24887 ◽

2018 ◽

Vol 16 (2) ◽

pp. 66-68

Author(s):

Shyam Kumar B.K. ◽

S. D. Bassi ◽

S. Baral ◽

A. Shah ◽

A. Dhakal

Keyword(s):

Public Health ◽

Visceral Leishmaniasis ◽

Health Problem ◽

Research Work ◽

Public Health Problem ◽

Sand Fly ◽

Age Group ◽

Major Health Problem ◽

Medical College ◽

Kala Azar

Background: Visceral leishmaniasis (VL) or Kala-azar is a potentially fatal vector-borne (sand fly phlebotomies spp) zoonotic disease caused by a protozoan parasite, Leishmaniadonovani. Kala-azar remains a public health problem in Nepal. The patient presented with a history of high-grade fever, abdominal distension, anemia, and weight loss. The disease is preventable, but various environmental, socioeconomic, health care and health behavior related variables affect its transmission. Objective: Find out the incidence of Kala-azar infection in Nepalgunj medical college. Method: This Hospital based study. Data was collected from April 2018to August 2018. Blood sample collected and test rk39 performed in laboratory of Nepalgunj Medical College Kohalpur. Result: Among 75 patients 16 were diagnosed kala-azar, rk39 positive 14 males and 2 females respectively. It is 12% of total cases. Among 16cases male are 14 and 2 are females. 85.7% male and 12.3% female. Age group between 15-30 years (31.25%), 31-45 years (25%), 46-60 years(18.75%), 61-75 years (12.5%), 76-85 years (12.5%). young people's age group 15-30 years are commonly infected. Conclusion: Visceral leishmaniasis (kala-azar) cases are still major health problem in Nepal. There should be regular surveillance research work to be carried out in both epidemic and non-epidemic districts of the country. Mass public health education, to make the people aware about preventive aspects of the disease is important.

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

SAGE Open Medicine ◽

10.1177/20503121211036787 ◽

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.

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Visceral leishmaniasis (Kala-azar) in Qom Province, Iran: Report of two cases

F1000Research ◽

10.12688/f1000research.15805.1 ◽

2018 ◽

Vol 7 ◽

pp. 1371

Author(s):

Leyli Zanjirani Farahani ◽

Abedin Saghafipour ◽

Mehdi Mohebali ◽

Behnaz Akhoundi ◽

Hedayatollah Raufi

Keyword(s):

Visceral Leishmaniasis ◽

Rural Areas ◽

Control Strategies ◽

Sand Fly ◽

Recurrent Fever ◽

Kala Azar ◽

Periodic Monitoring ◽

History Of ◽

The Common

Visceral leishmaniasis (VL) is a fatal parasitic zoonotic worldwide disease, which transmits to humans by the infected Phlebotomine sand fly bite. The common form of VL in Iran is the Mediterranean type with the causative agent of Leishmania infantum, whose main reservoirs are stray and domesticated dogs. The disease has several endemic foci in Iran, mostly seen among children under the age of 10, living in rural areas and nomadic tribes. The first cases of Kala-Azar in Qom province, central Iran, were reported in the year 2001, from the villages of Ghahan district. After conducting VL control strategies in the area, no new cases of the disease had been reported until recently. The cases described here are two 2-year-old girls, living in the urban parts of Qom province, one of whom did not have a history of traveling to known endemic areas of the disease. The patients were admitted to hospital in 2016-2017, complaining from recurrent fever with unrecognized reason, associated with decreased appetite and weight loss. Disease follow-up demonstrated anemia and splenomegaly, which led to diagnosis of VL, and both patients are now fully recovered. VL was presumed to be controlled in Qom province but the present cases indicate that possible VL existence remains in the region. Therefore, urgent studies and periodic monitoring are needed to identify potential reservoirs of VL in the area.

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Recalibration of insecticide-measuring containers could prevent underdosing of insecticide during indoor residual spraying for visceral leishmaniasis (kala-azar) elimination in India

Transactions of the Royal Society of Tropical Medicine and Hygiene ◽

10.1093/trstmh/traa026 ◽

2020 ◽

Vol 114 (7) ◽

pp. 549-552

Author(s):

Suman Saurabh ◽

Ravindra Kumar Yadav

Keyword(s):

Visceral Leishmaniasis ◽

Vector Control ◽

Indoor Residual Spraying ◽

Sand Fly ◽

Kala Azar ◽

Elimination Programme

Abstract Background The visceral leishmaniasis (kala-azar) elimination programme in India relies on indoor residual spraying (IRS) for sand-fly vector control. Insecticide supplied by a new manufacturer was introduced for IRS in 2019. We aimed to explore whether this led to a change in insecticide quantity being used in the field. Methods We compared measurements of weights of 250 mL of insecticide powder of two different manufacturers using a certified and calibrated weighing instrument. Results The density of insecticide supplied in 2019 was 43.4% lower than that in 2018, thereby leading to underdosing during current IRS activity. Conclusions Insecticide-measuring containers should be recalibrated prior to every IRS round and also when an insecticide manufacturer changes, so that the insecticide dose is maintained within the recommended range.

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Comparison of KAtex, Bone Marrow Aspiration and DAT for the Diagnosis of Visceral Leishmaniasis

Bangladesh Journal of Infectious Diseases ◽

10.3329/bjid.v6i1.42660 ◽

2019 ◽

Vol 6 (1) ◽

pp. 12-15

Author(s):

Ishrat Sharmin ◽

AKM Quamruzzaman ◽

Rezina Parveen ◽

M Abdulah Yusuf ◽

Rashida Akter Khanam

Keyword(s):

Bone Marrow ◽

Visceral Leishmaniasis ◽

Leishmania Donovani ◽

Bone Marrow Aspiration ◽

Cross Sectional Study ◽

Cross Sectional ◽

Medical College ◽

Kala Azar ◽

History Of ◽

One Year

Background: Newly developed KAtex test can be used as a non invasive tool for diagnosis of Kala-azar. Objectives: The aim of the present study was to compare KAtex, Bone marrow aspiration and DAT to diagnose VL. Methodology: This cross-sectional study was carried out in the Department of Microbiology at Dhaka Medical College, Dhaka, Bangladesh in collaboration with the Department of Parasitology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh for a period of one year. Clinically suspected Kala-azar (VL) cases of different age and sex attending IEDCR, Dhaka from different Kala-azar endemic areas of Bangladesh were selected for this study. Patients having fever for more than 2 weeks, with or without splenomegaly, having history of loss of body weight following onset of fever were clinically suspected as Kala-azar cases. Microscopy and culture was performed in bone marrow (BM). KAtex was performed with urine sample. Agglutination of sensitized latex indicated presence of Leishmania donovani antigen in urine and thereby visceral leishmaniasis. No agglutination indicates absence of antigen in urine. DAT was done with serums of all cases. Result: Among 130 clinically suspected VL cases, 70 (53.85%) cases were BM positive and 60(46.15%) cases were BM negative. All the 70 BM positive cases were positive by KAtex and DAT. Among 60 BM negative cases, 15 were positive by KAtex and 23 were positive by DAT. The sensitivity of KAtex was 100.0% and specificity was 75.0%. The sensitivity of DAT was 100.0% and specificity is 61.6%. Conclusion: In conclusion, KAtex test is a good diagnostic tool for the detection of VL in comparison with DAT. Bangladesh Journal of Infectious Diseases, June 2019;6(1):12-15

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Evaluation of molecular assays to detect Leishmania donovani in Phlebotomus argentipes fed on post-kala-azar dermal leishmaniasis patients

Parasites & Vectors ◽

10.1186/s13071-021-04961-6 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Md Anik Ashfaq Khan ◽

Khaledul Faisal ◽

Rajashree Chowdhury ◽

Rupen Nath ◽

Prakash Ghosh ◽

...

Keyword(s):

Leishmania Donovani ◽

Control Strategies ◽

Reference Method ◽

Critical Factor ◽

Sand Fly ◽

Accurate Estimation ◽

Limiting Factor ◽

Sand Flies ◽

Real Time Quantitative Pcr ◽

Kala Azar

Abstract Background Post-kala-azar dermal leishmaniasis (PKDL) caused by Leishmania donovani (LD) is a skin disorder that often appears after treatment of visceral leishmaniasis (VL) patients. PKDL patients are potential reservoirs of LD parasites, which can initiate a new epidemic of anthroponotic VL. Therefore, host infectiousness to its sand fly vector is a critical factor for transmission, and its accurate estimation can facilitate control strategies. At present, conventional microscopy serves as the reference method to detect parasites in its vector. However, low sensitivity of microscopy can be a limiting factor. Methods In this study, real-time quantitative PCR (LD-qPCR) and recombinase polymerase amplification (LD-RPA) assays were evaluated against microscopy for the detection of LD DNA extracted from live sand flies five days after controlled feeding on PKDL cases. Results The sensitivity of LD-qPCR and LD-RPA assays were found to be 96.43 and 100%, respectively, against microscopy for the selected fed sand flies (n = 28), and an absolute specificity of both molecular tools for apparently unfed sand flies (n = 30). While the proportion of infectious cases among 47 PKDL patients was estimated as 46.81% as defined by microscopic detection of LD in at least one fed sand fly per case, LD-RPA assay evaluation of only the microscopy negative sand flies fed to those 47 PKDL cases estimated an even greater proportion of infectious cases (51.06%). In overall estimation of the infectious cases in retrospective manner, discordance in positivity rate was observed (p < 0.05) between LD-RPA (59.57%) assay and microscopy (46.81%), while LD-RPA had slightly better positivity rate than LD-qPCR (55.32%) as well. Conclusions Considering the sensitivity, cost, detection time, and field applicability, RPA assay can be considered as a promising single molecular detection tool for investigations pertaining to LD infections in sand flies and/or host infectiousness in PKDL, while it can also be useful in confirmation of microscopy negative sand fly samples. Graphical abstract

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Visceral Leishmaniasis in Non-Endemic Districts of Bangladesh: Knowledge gap, Attitude and Practice of Inhabitants and Professionals for Treatment, Prevention and Control

Bangladesh Journal of Zoology ◽

10.3329/bjz.v43i2.27391 ◽

2016 ◽

Vol 43 (2) ◽

pp. 189-199 ◽

Cited By ~ 1

Author(s):

Hamida Khanum ◽

Sultan Uz Zaman ◽

Sabina Yesmin ◽

Sharmin Musa ◽

Hasina Banu ◽

...

Keyword(s):

Visceral Leishmaniasis ◽

Prevention And Control ◽

Leishmania Donovani ◽

Long Period ◽

Correct Knowledge ◽

Kala Azar ◽

Attitude And Practice ◽

And Control ◽

Knowledge Attitude And Practice ◽

Specific Agent

Investigation on knowledge, attitude and practice (KAP) of inhabitants and professionals for treatment, prevention and control of visceral leishmaniasis carried out on 519 inhabitants and 92 professionals of 6 districts (Panchagarh, Thakurgaon, Dinajpur, Bogra, Pabna and Shirajgonj) of Bangladesh. About 79.2% inhabitants agreed that they have heard about kala-azar disease. Regarding the transmission of kala-azar, 22.7% respondents answered by mosquito, about 38.3% said long period and irregular fever, 7.5% inhabitants knew enlargement of spleen and liver as sign and symptom of kala-azar. Among the professionals, about 80.4% of them have the correct knowledge regarding the specific agent (Leishmania donovani) of kala-azar. Investigation on knowledge, attitude and practice (KAP) of inhabitants and professional, 89.1% and 69.6% believe that spleen and liver are affected in kala-azar, 39.1% to 51.1% professionals understand that lymph nodes, blood and skin are involved as tissues due to kala-azar. Among the professionals, about 80.4% of them have the correct knowledge regarding the specific agent (L. donovani) of kala-azar.Bangladesh J. Zool. 43(2): 189-199, 2015

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