Clinical and Epidemiologic Features of Visceral Leishmaniasis in Children: A 6-year Study from an Iranian Referral Hospital

Abstract

Background: Visceral leishmaniasis (VL) is an emerging zoonosis disease that is endemic in the northwestern and southern part of Iran. This study aimed to evaluate the clinical characteristics and laboratory findings of the children with VL hospitalized at Children Medical Center Hospital (CMC), Tehran, Iran. Methods: A retrospective study was performed based on studied medical records of children with a final diagnosis of VL from 2011 to 2016. For each patient’s demographics, clinical laboratory findings and treatment were examined. Results: The clinical features of 17 children were examined and the most frequent symptoms were fever (94.1%, n=16), pallor, loss of appetite (76.5%, n=13), splenomegaly (82.4%, n=14) and hepatomegaly (58.8%, n=10). The most frequent laboratory abnormalities were hematological including anemia (94.1%, n=16), leukopenia (52.9%, n=9) and thrombocytopenia (70.5%, n=12). In order to detect anti-Leishmania antibodies, DAT was performed in 11 patients and 82% of them were positive (titers ≥ 1: 3200). In addition, rK39 was used in 9 cases and 7 children (78%) had positive results. Direct parasitology revealed the presence of amastigotes of Leishmania in bone marrow aspirate (BMA) stained by Giemsa stain in 9 patients (69%, among 13 children). Conclusion: Leishmaniasis is a regional disease therefore management and control of disease, particularly in an endemic area, as well as detection of new emerging foci are recommended.

Cutaneous Leishmaniasis Associated With the Level of Poverty of the Andean Rural Population: A Five-Year Single-Center Study

“…and annually >15% of cases happen in the Americas [25,26]. Pediatric leishmaniasis is highly prevalent in endemic areas and can present intermittent fever, anorexia, weight loss, hepatosplenomegaly, among others [27]. Infants and children present greater risks of contagion in rural communities since livestock activities of the parents leads to greater exposure of this group may occur due peri and intra-domiciliary transmission [28].…”

The diagnostic accuracy of direct agglutination test for serodiagnosis of human visceral leishmaniasis: a systematic review with meta-analysis

“…The first line regimen for primary VL treatment is pentavalent antimonial compounds such as meglumine antimoniate (Glucantime®) and Sodium stibogluconate(-Pentostam®) which can be used as a monotherapy (administered as intramuscular injections of 20 mg/ kg/ day for 28-30 days) or in combination with cryotherapy or other drugs such as paramomycin [1][2][3]. Other drugs such as amphotericin B deoxycholate, Liposomal amphotericin B (Ambisome®) and miltefosine (administrated orally) may be used for the treatment of VL particularly in patients with clinical or laboratory resistance to pentavalent drugs as well as contraindications caused by these drugs [1].…”

“…Visceral leishmaniasis (VL) is one of the most important neglected tropical diseases that is caused by Leishmania donovani and L. infantum/chagasi in both humans and canines [1][2][3]. The morbidity and mortality due to VL are estimated at 200,000 to 400,000 new cases a year and approximately 20,000 to 40,000 deaths occur annually [4].…”

The Diagnostic Accuracy of Direct Agglutination Test for Serodiagnosis of Human Visceral Leishmaniasis: A Systematic Review with Meta-analysis

“…The rst line regimen for primary VL treatment is pentavalent antimonial compounds such as meglumine antimoniate (Glucantime®) and Sodium stibogluconate(Pentostam®) which can be used as a monotherapy (administered as intramuscular injections of 20 mg/ kg/day for 28-30 days) or in combination with cryotherapy or other drugs such as paramomycin (1)(2)(3). Other drugs such as amphotericin B deoxycholate, Liposomal amphotericin B (Ambisome®) and miltefosine (administrated orally) may be used for the treatment of VL particularly in patients with clinical or laboratory resistance to pentavalent drugs as well as contraindications caused by these drugs (1).…”