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    Jan 17, 2021
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    A Killing Disease Epidemic Among Displaced Sudanese Population Identified as Visceral Leishmaniasis.

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    Authors
    de Beer, P
    el Harith, A
    Deng, L
    Semiao-Santos, S J
    Chantal, B
    van Grootheest, M
    Affiliation
    Medecins Sans-Frontieres-Holland, Amersterdam, The Netherlands.
    Issue Date
    1991-03
    
    Metadata
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    Journal
    The American Journal of Tropical Medicine and Hygiene
    Abstract
    A fatal disease epidemic affected the Bentiu area in southern Sudan and led to a mass migration of the Nuer tribe searching for treatment. The initially available information revealed a high mortality rate due to a possible occurrence of tuberculosis, malaria, enteric fever or visceral leishmaniasis (VL). Serological screening of 53 of the most severely affected patients in an enzyme-linked immunosorbent assay (ELISA) or an improved direct agglutination test (DAT) revealed positivity for VL. In 39 of those patients, diagnosis was confirmed by identification of Leishmania donovani amastigotes in lymph node or bone-marrow aspirates. In a total of 2714 patients observed, 1195 (44.0%) had clinical symptoms suggesting VL: DAT positive titers (1:3200-greater than or equal to 1:12800) were obtained in 654 (24.1%), of whom 325 were confirmed parasitologically. Forty-two VL cases died before or during treatment, giving a mortality rate of 6.4%. Among the intercurrent infections diagnosed in the VL population (654), respiratory involvements (31.7%) and malaria (10.7%) were most prevalent. With the exception of four (0.6%), all other VL patients (509) responded readily to sodium stibogluconate. The factors initiating the outbreak are discussed. Malnutrition and nomadic movements to potential VL endemic areas appeared to be the most important. HIV infection as a possible predisposition seemed remote considering the clinical and epidemiological similarity to VL occurring in East Africa, adequate humoral response in DAT, and immediate positive response to specific anti-Leishmania chemotherapy.
    Publisher
    Published by: American Society of Tropical Medicine and Hygiene
    URI
    http://hdl.handle.net/10144/17669
    PubMed ID
    1852133
    Additional Links
    http://www.ajtmh.org
    Language
    en
    ISSN
    0002-9637
    Collections
    Leishmaniasis/Kala Azar

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