Visceral leishmaniasis (kala-azar)—the Bihar (India) perspective

From a hospital-based surveillance carried out in Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India, the socio-economic, demographic and treatment response information of 737 patients admitted with visceral leishmaniasis (VL) during January 2001–December 2003, were analys...

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Bibliographic Details
Published in:The Journal of infection 2006-07, Vol.53 (1), p.60-64
Main Authors: Sinha, P.K., Ranjan, A., Singh, V.P., Das, V.N.R., Pandey, K., Kumar, N., Verma, N., Lal, C.S., Sur, D., Manna, B., Bhattacharya, S.K.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Animals
Antiprotozoal Agents - pharmacology
Antiprotozoal Agents - therapeutic use
Child
Child, Preschool
Clinical features
Demography
Drug Resistance
Epidemiology
Female
Hospitals
Humans
India - epidemiology
Leishmania donovani - drug effects
Leishmaniasis, Visceral - drug therapy
Leishmaniasis, Visceral - epidemiology
Leishmaniasis, Visceral - parasitology
Male
Middle Aged
Population Surveillance
Socioeconomic Factors
Treatment Outcome
Visceral leishmaniasis
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Summary:From a hospital-based surveillance carried out in Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India, the socio-economic, demographic and treatment response information of 737 patients admitted with visceral leishmaniasis (VL) during January 2001–December 2003, were analysed. The disease was two times higher in males than in females because of several factors including clothing pattern, sleeping habits and occupation. In Bihar, the second poorest state in India, poverty plays a major role in perpetuation of the disease, contributing to malnutrition, illiteracy (60%), and poor housing (82%). Further, presences of peri-domestic animal shelters around houses (63%) and vegetations (77%) facilitate breeding of sand fly vector. Clinical and laboratory characteristics were similar in the age groups 12 years. The increasing unresponsiveness of VL patients to conventional anti-leishmanial drugs, e.g. sodium antimony gluconate (SAG) and pentamidine, has definitely posed a major therapeutic challenge in combating the disease. Amphotericin B, though costly, is highly effective. Miltefosine is a highly promising new oral drug for VL.
ISSN:0163-4453
1532-2742
DOI:10.1016/j.jinf.2005.09.011