Clinical and epidemiological aspects of visceral leishmaniasis in children (original) (raw)

Visceral leishmaniasis: clinical and epidemiological features of children in an endemic area

Jornal de Pediatria, 2004

Objective: To describe the clinical and epidemiological features of children with visceral leishmaniasis admitted to a pediatric referral hospital, and to describe treatment measures and the case fatality rate. Methods: Retrospective analysis of biological, demographic, clinical and laboratory data from children with visceral leishmaniasis admitted to Instituto Materno Infantil de Pernambuco (Recife, state of Pernambuco, northeastern Brazil) between 1996 and 2001. Results: 431 children were included in the study. Age ranged from 4 months to 13.7 years. 50.3% were female and 82.5% came from the interior of the state of Pernambuco. 70% of the patients lived in brick homes, and 70% were not served with piped water and sewage services. Average maternal schooling was 3 years. Clinical presentation included splenomegaly (97%), fever (95.6%) and malnourishment (44.5%). Associated infections were diagnosed in 10.9% of cases. The mean values for laboratory variables were: hemoglobin 6 g/dl, leukocyte count 3,516/mm³, and platelet count 118,641/mm³. The first line treatment used in 98% of the cases was glucantime. Amphotericin B was used in seven cases. The case fatality rate was 10.2%. The main immediate causes of death were associated infections, bleeding and liver failure. Conclusions: Health care workers should be trained for the early recognition and appropriate management of visceral leishmaniasis and its complications.

[Vitamin A serum level in children with visceral leishmaniasis]

Revista da Sociedade Brasileira de Medicina Tropical

Vitamin A is considered an anti-infectious disease vitamin, and its deficiency is associated with severe infections such as in measles. In developing countries the low concentrations of vitamin A are a public health problem. The aim of this study is to describe serum vitamin A concentrations among children with visceral leishmaniasis (VL). Blood sample was collected from 22 children with VL, and stored in a freezer, 9 siblings, with no clinical signs of the VL patients had their blood collected for a control group. Samples were assayed by high performance liquid chromatography. The median vitamin A concentration in the LV group was 21.38 microg/100ml and in the control group it was 31.39 microg/100. The mean in the LV was statistically lower than in the control group, using Student's t test, p<0.01.

Análise espacial, clínico-epidemiológica e laboratorial de crianças internadas com leishmaniose visceral no Pará/Amazônia Brasileira

Saúde Coletiva (Barueri)

A Leishmaniose Visceral (LV), é uma infecção sistêmica que afeta pessoas no mundo todo. É endêmica no Pará. Objetivo: Analisar as características espaciais, clínico-epidemiológicas, laboratoriais, tratamento e letalidade de crianças com LV em hospital de referência do Pará. Método: Estudo retrospectivo-analítico, transversal, com abordagem quantitativa dos prontuários de crianças com LV internados entre 2012 e 2016. Resultado: Os casos predominaram na zona rural (77,1%) e infecção primária (86,5%). Os menores de 6 anos e do sexo masculino foram os mais acometidos. A distribuição espacial dos casos foi heterogênea, predominando o Nordeste Paraense (80,2%). A confirmação laboratorial foi a mais utilizada (86,5%). N-metil glucamina foi a terapêutica de eleição (89,3% dos casos). Conclusão: Houve cura em mais de 90% dos casos. A letalidade associou-se à sangramentos, à plaquetopenia, à falha no tratamento inicial, ao tempo de tratamento e ao maior escore sistema de avaliação de risco de...

Leishmaniose visceral infantil: relato de caso

Revista de Medicina, 2016

leishmaniose visceral (LV) é uma infecção causada por protozoários tripanosomatídeos do gênero Leishmania, as espécies são: Leishmania donovani e Leishmania infantum (conhecido como Leishmania chagasi na América do Sul). A LV é uma doença parasitária grave, com elevada morbimortalidade em todo o mundo. É considerada a doença tropical mais negligenciada, em termos de desenvolvimento de novos medicamentos. Considerada um importante problema de saúde em todo o Brasil, principalmente na área endêmica de Paracatu-MG. Acomete principalmente crianças com menos de cinco anos de idade. A transmissão ocorre através da picada de fêmeas hematófagas dos vetores Lutzomyia longipalpis ou L. cruzi, infectados pela Leishmania (L.) chagasi. Os sinais clínicos da LV variam de acordo com a resposta imune do hospedeiro, podendo assumir formas assintomáticas, oligossintomáticas e a forma clássica; os principais sinais incluem febre, hepatoesplenomegalia, perda de peso e pancitopenia. Indivíduos não trata...

[Mortality due to visceral leishmaniasis: clinical and laboratory characteristics]

Revista da Sociedade Brasileira de Medicina Tropical

Visceral leishmaniasis is a systemic infectious disease of broad geographical distribution, characterized by high potential for lethality. With the purpose of contributing towards reducing mortality and helping healthcare professionals in clinical management of patients with this disease, this paper aimed to investigate the clinical and laboratory characteristics of cases with a fatal outcome in hospitals in Campo Grande, Mato Grosso do Sul, between 2003 and 2008. Fifty-five medical files on patients who died due to visceral leishmaniasis were analyzed. Among the 55 patients studied, 37 were from the municipality of Campo Grande; 41 (74.5%) were males; and age over 40 years predominated. The patients presented with fever in 89.1% of the cases. The duration of the illness from the onset of symptoms to hospitalization was 78.2 days on average. Leukopenia was seen in 85.5% of the patients. Comorbidities were present in 39 (70.9%) patients; malnutrition and alcoholism were the most freq...

Infecção por Leishmania (Leishmania) chagasi em crianças de uma área endêmica de leishmaniose visceral americana na Ilha de São Luis-MA, Brasil

Revista Da Sociedade Brasileira De Medicina Tropical, 2001

Resumo Realizou-se estudo prospectivo com 648 crianças de zero a cinco anos no município da Raposa-MA, de julho/97 a junho/98, com o objetivo de avaliar as características da infecção por L.(L.)chagasi e verificar se existe associação entre desnutrição e infecção assintomática. Utilizou-se questionário com dados socioeconômicos, ambientais e hábitos de vida; realizou-se Intradermorreação de Montenegro(IDRM) com antígeno de L. amazonensis e Enzyme Linked Immunosorbant Assay(ELISA) para detectar infecção, e exame antropométrico. A prevalência inicial, final e incidência da infecção foram 18,6%, 20,6% e 10,8% pelo IDRM, e 13,5%, 34,4% e 28% pelo ELISA, respectivamente. A prevalência da desnutrição crônica (altura/idade) foi 26%. Não houve associação estatisticamente significante entre desnutrição e infecção assintomática por L. (L.) chagasi. A forma assintomática da doença está presente nas áreas estudadas, necessitando de medidas de controle mais efetivas. Palavras-chaves: Infecção. L. (L.) chagasi. Prevalência. Incidência. Crianças.

Epidemiological aspects of visceral leishmaniasis in baft district, kerman province, southeast of iran

PubMed, 2011

Background: Visceral leishmaniasis (kala-azar) is an endemic disease in some areas of Iran. A cross- sectional study was conducted for sero-epidemiological survey of visceral leishmaniasis (VL) in Baft district from Kerman Province, southeast of Iran. Methods: Blood samples were collected from children up to 12 years old and 10% of adult population from Baft villages with a multi-stage randomized cluster sampling. In addition, blood samples were collected from 30 domestic dogs from the same areas. All the collected blood samples were tested by direct agglutination test (DAT) for the detection of anti-Leishmania antibodies in both human and dog using the cut-off value of ≥1:3200 and ≥1:320, respectively. Parasitological, molecular, and pathological were performed on infected dogs. Chi-square and Fisher exact tests were used to compare sero-prevalence values. Results: From 1476 collected human serum samples, 23 (1.55%) showed anti-Leishmania antibodies at titers of 1:800 and 1:1600 whereas 14 (0.95%) showed anti-Leishmania infantum antibodies at titers of ≥1:3200. No statistically significant difference was found between male (1.18%) and female (0.69%) sero-prevalence (P=0.330). Children of 5-8 years showed the highest sero-prevalence rate (3.22%). Seven out of 30 domestic dogs (23%) showed anti-Leishmania antibodies at titers ≥1:320. Leishmania infantum was identified in five infected dogs by nested - PCR assay. Conclusion: It seems that visceral leishmaniasis is being endemic in southern villages of Baft district, southeast of Iran.