A Killing Disease Epidemic Among Displaced Sudanese Population Identified as Visceral Leishmaniasis.
AffiliationMedecins Sans-Frontieres-Holland, Amersterdam, The Netherlands.
MetadataShow full item record
AbstractA 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.
- Leishmaniasis in Sudan. Visceral leishmaniasis.
- Authors: Zijlstra EE, el-Hassan AM
- Issue date: 2001 Apr
- Positive response to sodium antimony gluconate administration in visceral leishmaniasis seropositive patients.
- Authors: Chowdhury S, Haque F, al-Masum A, el Harith A, Karim E
- Issue date: 1991 Apr
- A comparison of the direct agglutination test and enzyme-linked immunosorbent assay in the sero-diagnosis of leishmaniasis in the Sudan.
- Authors: el Safi SH, Evans DA
- Issue date: 1989 May-Jun
- Use of a newly developed beta-mercaptoethanol enzyme-linked immunosorbent assay to diagnose visceral leishmaniasis in patients in eastern Sudan.
- Authors: Mansour D, Abass EM, El Mutasim M, Mahamoud A, El Harith A
- Issue date: 2007 Dec
- Identification of an area predominantly endemic for childhood and adolescent visceral leishmaniasis in central Sudan.
- Authors: Mahamoud A, Osman HA, Abass EM, El Agib A, Madi RR, Semiao-Santos SJ, El Harith A
- Issue date: 2018 Feb