Visceral leishmaniasis in children

Visceral leishmaniasis is a chronic disease in Africa and Asia, children under 5 years are affecting with L.infantum and older children and young adult with L.donovani Purpose of this study describes the characteristics of epidemiologic and clinicopathophysiologic and response to treatment of patient that affected in East Azarbaijan compared with other endemic areas in the world. This study was a descriptive survey that was carried out in 3 years. 40 patients with diagnosis of visceral leishmaniasis admitted to theTabriz children hospital between 2000-2002. Their diagnosis were documented with clinical examination and laboratory findings. Prevalence of mean age was 22.5 month. Fever and splenomegaly were present in all cases. Hepatomegaly in 29 cases (72.5%) and icter in 8 cases (20%) were present. In 90% of patients hemoglubin was <10mg/dl and thrombocytopenia in 75% were seen. In all patients bone marrow study was done and in 92.5% was positive. DAT test in 72% cases was positive. 3 patients with portal hypertension (icter, hepatosplenomegaly) were referred. All patients were treated with Meglomin antimony (Glucantim). Only 1 case death due to no response to different medications and frequently relapses were occurred. Visceral leishmaniasis in breast feeding age appear by liver involvement. In East Azarbaijan area visceral leishmaniasis, successfully, treated by glucantim. The expensive medications such as amphotericin B must be used only in relapsing and resistant cases.