Clinical and epidemiological aspects of Kala-Azar in hospitalized cases in Children’s Medical Center (1988-2004)
Abstract
Background: As some areas in Iran are endemic to Kala-azar disease, studying clinical and epidemiological aspects of this disease in children is of great importance. In this article we studied Clinical and epidemiological aspects of visceral Leshmaniasis (Kala-azar) in children, hospitalized patients in Children’s Medical Center during 1988-2004.
Methods: A retrospective study was done to investigate the case series of different ethnic groups patients. A total of 157 patients with kalaazar, admitted during a 16 year period (from 1988 to 2004), were enrolled in the study. Descriptive and analytic analysis of independent variables was performed using SPSS software (version 12)
Findings: In this survey from 157 children with diagnosis of Kalaazar, 66.2% were males. History of traveling to suspected areas was present in 69.1% of cases. Most cases were diagnosed and hospitalized in spring. Mean (±SD) age at the time of admission was 40.4±41.7 months. Father of 82 (55%) of the patients were farmers and workers. Leishmen body was positive in 77.3% of bone marrow examinations. Anemia, thrombocytopenia and leukopenia were present in about 80% of patients. Mean(±SD) ESR was 90.9 (± 32.5). Most patients had a positive IFA titer of 1/320.
The majority of patients were from Tehran, Ardabil, and Lorestan(55, 29, 16 patients from each city respectively). Most patients were referred to hospital in May. After spring ,the trend was downwards to winter. Symptoms usually appeared in 3.7 (4.5) months before the admission to the hospital. The mean (SD) hospitalization period was 20.817.9 days. Fever, Splenomegaly and hepatomegaly are the most evident clinical symptoms. Outcome of patients was good at discharge in 94.7% of cases but four cases (2.7%) died
Conclusions: More studies are needed in this field for destroying pollution center and controlling this disease in endemic area, particularly Ardabil from where most patients originated. Ecological studies of sources and routes of transmission of this disease are suggested in different provinces especially Lorestsn which was in the third rank among other provinces.
Methods: A retrospective study was done to investigate the case series of different ethnic groups patients. A total of 157 patients with kalaazar, admitted during a 16 year period (from 1988 to 2004), were enrolled in the study. Descriptive and analytic analysis of independent variables was performed using SPSS software (version 12)
Findings: In this survey from 157 children with diagnosis of Kalaazar, 66.2% were males. History of traveling to suspected areas was present in 69.1% of cases. Most cases were diagnosed and hospitalized in spring. Mean (±SD) age at the time of admission was 40.4±41.7 months. Father of 82 (55%) of the patients were farmers and workers. Leishmen body was positive in 77.3% of bone marrow examinations. Anemia, thrombocytopenia and leukopenia were present in about 80% of patients. Mean(±SD) ESR was 90.9 (± 32.5). Most patients had a positive IFA titer of 1/320.
The majority of patients were from Tehran, Ardabil, and Lorestan(55, 29, 16 patients from each city respectively). Most patients were referred to hospital in May. After spring ,the trend was downwards to winter. Symptoms usually appeared in 3.7 (4.5) months before the admission to the hospital. The mean (SD) hospitalization period was 20.817.9 days. Fever, Splenomegaly and hepatomegaly are the most evident clinical symptoms. Outcome of patients was good at discharge in 94.7% of cases but four cases (2.7%) died
Conclusions: More studies are needed in this field for destroying pollution center and controlling this disease in endemic area, particularly Ardabil from where most patients originated. Ecological studies of sources and routes of transmission of this disease are suggested in different provinces especially Lorestsn which was in the third rank among other provinces.
Keywords
Kalaazar, Zeonose, Leishman body,
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