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

Author(s): Mohamadreza Abdolsalehi, Babak Pourakbari, Shima Mahmoudi, Mina Moradzadeh, Hossein Keshavarz, Setareh Mamishi*

Journal Name: Infectious Disorders - Drug Targets
Formerly Current Drug Targets - Infectious Disorders

Volume 20 , Issue 4 , 2020


Become EABM
Become Reviewer
Call for Editor

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.

Keywords: Leishmaniasis, Children, Iran, epidemiologic, features, visceral.

[1]
Salahi-Moghaddam, A.; Mohebali, M.; Moshfae, A.; Habibi, M.; Zarei, Z. Ecological study and risk mapping of visceral leishmaniasis in an endemic area of Iran based on a geographical information systems approach. Geospat. Health, 2010, 5(1), 71-77.
[http://dx.doi.org/10.4081/gh.2010.188] [PMID: 21080322]
[2]
Miao, R.; Wang, Z.; Guo, Q.; Wen, Y.; Liao, Q.; Zhu, Y.; Shu, M.; Wan, C. Clinical and Epidemiologic Features of Visceral Leishmaniasis in Children in Southwestern China: A Retrospective Analysis From 2001 to 2015. Pediatr. Infect. Dis. J., 2017, 36(1), 9-12.
[http://dx.doi.org/10.1097/INF.0000000000001343] [PMID: 27749663]
[3]
Mohebali, M.; Edrissian, G.H.; Shirzadi, M.R.; Akhoundi, B.; Hajjaran, H.; Zarei, Z.; Molaei, S.; Sharifi, I.; Mamishi, S.; Mahmoudvand, H.; Torabi, V.; Moshfe, A.; Malmasi, A.; Motazedian, M.H.; Fakhar, M. An observational study on the current distribution of visceral leishmaniasis in different geographical zones of Iran and implication to health policy. Travel Med. Infect. Dis., 2011, 9(2), 67-74.
[http://dx.doi.org/10.1016/j.tmaid.2011.02.003] [PMID: 21419708]
[4]
Silva, K.R.; Mendonça, V.R.; Silva, K.M.; Nascimento, L.F.; Mendes-Sousa, A.F.; Pinho, F.A.; Barral-Netto, M.; Barral, A.M.; Cruz, M.D. Scoring clinical signs can help diagnose canine visceral leishmaniasis in a highly endemic area in Brazil. Mem. Inst. Oswaldo Cruz, 2017, 112(1), 53-63.
[http://dx.doi.org/10.1590/0074-02760160305] [PMID: 28076469]
[5]
Sarkari, B.; Hatam, G.; Ghatee, M. Epidemiological features of visceral leishmaniasis in fars province, southern iran. Iran. J. Public Health, 2012, 41(4), 94-99.
[PMID: 23113170]
[6]
Mohebali, M. Visceral leishmaniasis in Iran: review of the epidemiological and clinical features. Iran. J. Parasitol., 2013, 8(3), 348-358.
[PMID: 24454426]
[7]
EDRISIAN, GH.; Nadim , A.; Alborzi, A.; AREDEHALI , S. Visceral leishmaniasis the Iranian experience 1998.
[8]
Dujardin, J-C.; Campino, L. Caٌavate, C.; Dedet, J-P.; Gradoni, L.; Soteriadou, K.; Mazeris, A.; Ozbel, Y.; Boelaert, M. Spread of vector-borne diseases and neglect of Leishmaniasis, Europe. Emerg. Infect. Dis., 2008, 14(7), 1013-1018.
[http://dx.doi.org/10.3201/eid1407.071589] [PMID: 18598618]
[9]
Mohebali, M.; Edrissian, G.; Nadim, A.; Hajjaran, H.; Ak-houndi, B.; Hooshmand, B. Application of direct agglutination test (DAT) for the diagnosis and seroepide-miological studies of visceral leishmaniasis in Iran. Iran. J. Parasitol., 2006, 1(1), 15-25.
[10]
Hamzavi, Y.; Hamzeh, B.; Mohebali, M.; Akhoundi, B.; Ajhang, Kh.; Khademi, N.; Ghadiri, K.; Bashiri, H.; Pajhouhan, M. Human visceral leishmaniasis in kermanshah province, Western iran, during 2011-2012 Iran. J. Parasitol., 2012, 7(4), 49-56.
[PMID: 23323091]
[11]
Layegh, P.; Pezeshkpoor, F.; Soruri, A.H.; Naviafar, P.; Moghiman, T. Efficacy of cryotherapy versus intralesional meglumine antimoniate (glucantime) for treatment of cutaneous leishmaniasis in children. Am. J. Trop. Med. Hyg., 2009, 80(2), 172-175.
[http://dx.doi.org/10.4269/ajtmh.2009.80.172] [PMID: 19190206]
[12]
Sakkas, H.; Gartzonika, C.; Levidiotou, S. Laboratory diagnosis of human visceral leishmaniasis. J. Vector Borne Dis., 2016, 53(1), 8-16.
[PMID: 27004573]
[13]
Babakhan, L.; Mohebali, M.; Akhoundi, B.; Edrissian, G.H.; Keshavarz, H. Rapid detection of Leishmania infantum infection in dogs: a comparative study using fast agglutination screening test (FAST) and direct agglutination test (DAT) in Iran. Parasitol. Res., 2009, 105(3), 717-720.
[http://dx.doi.org/10.1007/s00436-009-1456-3] [PMID: 19452168]
[14]
Bhattacharya, S.K.; Sur, D.; Karbwang, J. Childhood visceral leishmaniasis. Indian J. Med. Res., 2006, 123(3), 353-356.
[PMID: 16778316]
[15]
Naufal Spir, P.R.; Prestes-Carneiro, L.E.; Fonseca, E.S.; Dayse, A.; Giuffrida, R.; D’Andrea, L.A.Z. Clinical characteristics and spatial distribution of Visceral leishmaniasis in children in Sمo Paulo state: an emerging focus of Visceral leishmaniasis in Brazil. Pathog. Glob. Health, 2017, 111(2), 91-97.
[http://dx.doi.org/10.1080/20477724.2017.1289666] [PMID: 28221822]
[16]
Tofighi Naeem, A.; Mahmoudi, S.; Saboui, F.; Hajjaran, H.; Pourakbari, B.; Mohebali, M.; Zarkesh, M.R.; Mamishi, S. Clinical features and laboratory findings of visceral leishman-iasis in children referred to Children Medical Center Hospital, Tehran, Iran during 2004-2011. Iran. J. Parasitol., 2014, 9(1), 1-5.
[PMID: 25642253]
[17]
Fanni, F.; Shahbaznejad, L.; Pourakbari, B.; Mahmoudi, S.; Mamishi, S. Clinical manifestations, laboratory findings, and therapeutic regimen in hospitalized children with brucellosis in an Iranian Referral Children Medical Centre. J. Health Popul. Nutr., 2013, 31(2), 218-222.
[http://dx.doi.org/10.3329/jhpn.v31i2.16386] [PMID: 23930340]
[18]
Edrissian, G. Malaria in Iran: Past and present situation Iran. J. Parasitol., 2006, 1(1), 1-14.
[19]
Jafari, S; Hajiabdolbaghi, M; Mohebali, M; Hajjaran, H; Hashemian, H Disseminated leishmaniasis caused by Leishmania tropica in HIV-positive patients in the Islamic Republic of Iran 2010.
[20]
Fakhar, M.; Motazedian, M.H.; Hatam, G.R.; Asgari, Q.; Kalantari, M.; Mohebali, M. Asymptomatic human carriers of Leishmania infantum: possible reservoirs for Mediterranean visceral leishmaniasis in southern Iran. Ann. Trop. Med. Parasitol., 2008, 102(7), 577-583.
[http://dx.doi.org/10.1179/136485908X337526] [PMID: 18817598]
[21]
Thakur, C.P. Epidemiological, clinical and therapeutic features of Bihar kala-azar (including post kala-azar dermal leishmaniasis). Trans. R. Soc. Trop. Med. Hyg., 1984, 78(3), 391-398.
[http://dx.doi.org/10.1016/0035-9203(84)90131-7] [PMID: 6087515]
[22]
Braga, A.S.; Toledo, Junior, A.C.; Rabello, A. Factors of poor prognosis of visceral leishmaniasis among children under 12 years of age. A retrospective monocentric study in Belo Horizonte, State of Minas Gerais, Brazil, 2001-2005. Rev. Soc. Bras. Med. Trop., 2013, 46(1), 55-59.
[http://dx.doi.org/10.1590/0037-868216432013] [PMID: 23563826]
[23]
Ashkan, M.M.; Rahim, K.M. Visceral leishmanisis in paediatrics: a study of 367 cases in southwest Iran. Trop. Doct., 2008, 38(3), 186-188.
[http://dx.doi.org/10.1258/td.2007.070259] [PMID: 18628558]
[24]
Mahmoudvand, H.; Mohebali, M.; Sharifi, I.; Keshavarz, H.; Hajjaran, H.; Akhoundi, B.; Jahanbakhsh, S.; Zarean, M.; Javadi, A. Epidemiological aspects of visceral leishmaniasis in baft district, kerman province, southeast of iran. Iran. J. Parasitol., 2011, 6(1), 1-11.
[PMID: 22347268]
[25]
Sundar, S.; Singh, R.K.; Maurya, R.; Kumar, B.; Chhabra, A.; Singh, V.; Rai, M. Serological diagnosis of Indian visceral leishmaniasis: direct agglutination test versus rK39 strip test. Trans. R. Soc. Trop. Med. Hyg., 2006, 100(6), 533-537.
[http://dx.doi.org/10.1016/j.trstmh.2005.08.018] [PMID: 16325874]
[26]
Mohebali, M.; Mamishi, S.; Desjeux, P. Evaluation of rapid “Dipstick RK39” test in diagnosis and serological survey of visceral Leishmaniasis in humans and dogs in Iran. Arch. Iran Med., 2003, 6(1), 29-31.
[27]
Sundar, S.; Agrawal, S.; Pai, K.; Chance, M.; Hommel, M. Detection of leishmanial antigen in the urine of patients with visceral leishmaniasis by a latex agglutination test. Am. J. Trop. Med. Hyg., 2005, 73(2), 269-271.
[http://dx.doi.org/10.4269/ajtmh.2005.73.269] [PMID: 16103587]
[28]
Gupta, A.K.; Singh, A.; Srivastava, S.; Shankar, P.; Singh, S. Visceral Leishmaniasis in Children: Diagnosis, Treatment, and Prevention. J. Pediatr. Infect. Dis., 2017, 12(04), 214-221.
[http://dx.doi.org/10.1055/s-0037-1603500]


Rights & PermissionsPrintExport Cite as

Article Details

VOLUME: 20
ISSUE: 4
Year: 2020
Page: [461 - 466]
Pages: 6
DOI: 10.2174/1871526519666190613123217
Price: $65

Article Metrics

PDF: 13
HTML: 1