Title
A neglected disease of humans: a new focus of visceral leishmaniasis in Bakool,Somalia A neglected disease of humans: a new focus of visceral leishmaniasis in Bakool,Somalia
Author
Faculty/Department
Institute of Development Policy and Management
Publication type
article
Publication
London ,
Subject
Human medicine
Source (journal)
Transactions of the Royal Society of Tropical Medicine and Hygiene
Transactions of the Royal Society of Tropical Medicine and Hygiene. - London
Volume/pages
97(2003) :6 , p. 667-671
ISSN
0035-9203
0035-9203
ISI
000202964100056
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Abstract
Visceral leishmaniasis (VL) was observed in children in Bakool region, Somalia, an area where VL hasnot been reported before. We describe the extent of the problem in this war- and famine-stricken area. A retrospective analysis was done of all cases admitted to a VL treatment centre between July 2000 and August 2001. Patients with longstanding fever, splenomegaly and a positive direct agglutination test (DAT; titre > 1:3200) were treated as suspected VL cases. A rapid epidemiological and entomological assessment was performed in the area. Species identification was attempted from blood samples by polymerase chain reaction-restriction fragment length polymorphism analysis of cysteine proteinase B genes. In 1 year, 230 serologically-positive cases were diagnosed as VL, and response to therapy was good in 91.6% of the 225 treated with sodium stibogluconate. Parasitological confirmation was attempted and obtained in 2 cases. Parasites were found to be most similar to Sudanese and Ethiopian reference strains of the Leishmania donovani complex. In a serological survey of 161 healthy displaced persons, 15% were positive by the leishmanin skin test and 3 (2%) were positive by the DAT. The sandfly captures showed Phlebotomus martini and P. vansomerenae. VL seems to be a longstanding and serious health problem in Bakool region. Food insecurity might have contributed to the emergence and detection of VL in this area.
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