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Clinical aspects of paediatric visceral leishmaniasis in N orth‐west E thiopia
Author(s) -
Diro Ermias,
Lynen Lutgarde,
Gebregziabiher Berhane,
Assefa Abraham,
Lakew Wubishet,
Belew Zewdu,
Hailu Asrat,
Boelaert Marleen,
Griensven Johan
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12407
Subject(s) - medicine , wasting , malnutrition , pediatrics , sodium stibogluconate , visceral leishmaniasis , prospective cohort study , leishmaniasis , immunology
Objective 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. Methods 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. Results 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%). Conclusion 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.