Study of visceral leishmaniasis (kala-azar) in children of Iraq


Background: Leishmaniasis is a parasitic disease caused by a Leishmaniaspecies, transmitted to humans through bites of female sand fly and isendemic in Iraq.Aims: To study the epidemiological, clinical, diagnostic and therapeuticaspects of visceral leishmaniasis in Iraqi children.Patients and Methods: This was a retrospective study done on patientswith Kala-azar admitted to Welfare Child Hospital-Medical City fromOctober 2004 to September 2005. The diagnosis was based onserological test and/or bone marrow exam. For each patient thefollowing data were reviewed: age, sex, time of admission, signs,symptoms, laboratory investigations and treatments.Results: A total of 50 visceral leishmaniasis cases were included. Allpatients were in the age range 0-10 years. Most cases occur in winter70%. Fever was recorded in 100%, splenomegaly in 92%, hepatomegaly in80%, and pallor in 70% of cases. Concomitant conditions were frequent:34% of cases had cough; jaundice was present in 26%; diarrhea in 18%;vomiting in 12% whereas lymphadenopathy was present only in 1% ofcases. Sodium stibogluconate (pentostam) was most often prescribedmedication (86% of cases) while miltefosine was less prescribed (14% ofcases).Conclusions: in Iraq, kala-azar should be suspected in any patient withprolonged fever and/or hepatosplenomegaly with pancytopeniawhereas in case of presence of lymphadenopathy the kala-azar would bethe last possible differential diagnosis. Also Pentostam remains the mostcommon prescribed medication for kala-azar in our country.