Clinical aspects of paediatric visceral leishmaniasis in North‐west Ethiopia. Issue 1 (20th October 2014)

• Record Type: Journal Article
• Authors: Diro, Ermias; Lynen, Lutgarde; Gebregziabiher, Berhane; Assefa, Abraham; Lakew, Wubishet; Belew, Zewdu; Hailu, Asrat; Boelaert, Marleen; van Griensven, Johan
• Is Part Of: Tropical medicine & international health. Volume 20:Issue 1(2015:Jan.)
• Page Start: 8
• Page End: 16
• Publication Date: 2014-10-20
• Subjects: Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.12407
• Languages: English
• ISSNs: 1360-2276

Abstract

<abstract abstract-type="main" id="tmi12407-abs-0001"> <title>Abstract</title> <sec id="tmi12407-sec-0001" sec-type="section"> <title>Objective</title> <p>Visceral leishmaniasis (VL) in north‐west Ethiopia is causing an overwhelming case load among adult migrant workers that masked the disease burden in children. This study describes the clinical profile and explores comorbidities in paediatric VL patients.</p> </sec> <sec id="tmi12407-sec-0002" sec-type="section"> <title>Methods</title> <p>A prospective study at two hospitals in this region (Gondar and Humera) was conducted in a year period, 2011–2012. The clinical manifestations and comorbidities such as malnutrition, intestinal parasitosis and vitamin D deficiency and HIV infection were assessed, and treatment outcomes noted.</p> </sec> <sec id="tmi12407-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 122 children with VL were detected during the study period with median age of 8.5 years (IQR 5–12 years); 23% were under 5 years. Eighty‐five (69.7%) cases were male. The clinical manifestations were similar to the adult patients. High rates of malnutrition, intestinal parasitosis (47.5%) and hypovitaminosis D (56.4%) were detected. The proportion of stunting and wasting was 63% and 22.2% in children aged under five years, and 50.5% and 75.9% in 5‐year and older children, respectively, using WHO standard growth curves. Only one child had HIV infection. In 95% of the cases, sodium stibogluconate (20 mg/kg/day for 30 days) was used for treatment. The treatment success rate at end of therapy was 98.3%, but the definitive outcome at 6 months could not be determined because of a high loss to follow‐up (80.2%).</p> </sec> <sec id="tmi12407-sec-0004" sec-type="section"> <title>Conclusion</title> <p>While HIV co‐infection was rare, malnutrition, intestinal parasitosis and vitamin D deficiency were frequent indicating the need for further research on their role in the pathophysiology. Meanwhile, systematic assessment and management of malnutrition and intestinal parasitosis in VL programmes is recommended.</p> </sec> </abstract>