Visceral Leishmaniasis in children in the Yemen
Haidar, N.A.; Diab, A.B.; El-Sheik, A.M.
Saudi Medical Journal 22(6): 516-519
2001
ISSN/ISBN: 0379-5284 PMID: 11426243 Document Number: 527677
The clinical presentation and duration of therapy for visceral leishmaniasis varies in different countries. Sodium stibogluconate is costly, and a prospective hospital-based trial of short course therapy was carried out in Hajjah Governorate, Republic of Yemen, between January and June 1999 to evaluate the efficacy of a 20-day regimen of sodium stibogluconate and to ascertain the epidemiological, clinical and laboratory features of visceral leishmaniasis in children. Children aged 12 years or less with a confirmed diagnosis were included in the study. Sodium stibogluconate was given at a dose of 15 mg/kg/day for 20 days, after which the patients were re-evaluated. 32 patients fulfilled the inclusion criteria. Their age ranged from 12 to 144 months (67.7+or-35) and 53% were female. The duration of symptoms ranged from 2 to 116 weeks. Fever, fatigue and abdominal distension were the most common symptoms. Haematological findings showd anaemia in all patients, leukopenia in 81% and thromocytopenia in 56%. The formol gel test was negative in 20 patients (63%); malaria smear was positive in 11 patients (34%); splenic aspiration was carried out in 25 patients (78%) and bone marrow aspiration in 7 patients (22%). Blood transfusions were required for 24 patients (73%). After 20 days treatment with pentostam, 20 patients (63%) were tested for parasitological cure. Half were still positive for Leishmania donovani. The mortality rate was 5%. The clinical features were of the Mediterranean type. It was concluded that 20 days treatment with sodium stibogluconate was not sufficient.