Clinical Epidemiology, Diagnosis and Treatment of Visceral Leishmaniasis in the Pokot Endemic Area of Uganda and Kenya
Authors
Mueller, Yolanda KKolaczinski, Jan H
Koech, Timothy
Lokwang, Peter
Riongoita, Mark
Velilla, Elena
Brooker, Simon J
Chappuis, François
Affiliation
Epicentre, Paris, France; Faculty of Infectious and Tropical Disease, London School of Hygiene and Tropical Medicine, Keppel Street, London, United Kingdom; Médecins Sans Frontières, Operational Centre, Geneva, Switzerland; Geneva University Hospitals and University of Geneva, Geneva, Switzerland.Issue Date
2013-11-11
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Between 2000 and 2010, Médecins Sans Frontières diagnosed and treated 4,831 patients with visceral leishmaniasis (VL) in the Pokot region straddling the border between Uganda and Kenya. A retrospective analysis of routinely collected clinical data showed no marked seasonal or annual fluctuations. Males between 5 and 14 years of age were the most affected group. Marked splenomegaly and anemia were striking features. An Rk39 antigen-based rapid diagnostic test was evaluated and found sufficiently accurate to replace the direct agglutination test and spleen aspiration as the first-line diagnostic procedure. The case-fatality rate with sodium stibogluconate as first-line treatment was low. The VL relapses were rare and often diagnosed more than 6 months post-treatment. Post-kala-azar dermal leishmaniasis was rare but likely to be underdiagnosed. The epidemiological and clinical features of VL in the Pokot area differed markedly from VL in Sudan, the main endemic focus in Africa.PubMed ID
24218406Additional Links
http://www.ajtmh.orgLanguage
enISSN
1476-1645ae974a485f413a2113503eed53cd6c53
10.4269/ajtmh.13-0150
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