Visceral leishmaniasis (kala azar) in Karachi.
نویسندگان
چکیده
Visceral leishmaniasis (VL) or Kala-azar (KA) is a communicable disease caused by Leishmania donovani named after the discoverers, Leishman and Donovan both of whom reported on the organism simulataneously, Leishman from London in May, 1903 and Donovan in July, 1903. Except for Australia, it is endemic in many places in China, Africa, Southern Europe, South America, Russia and India where it is endemic in Assam, Bengal, Bihar, Madras and the eastern parts of the Uttar Pradesh and far as Lucknow. In Mediterranean areas, China and Brazil, the dog is considered to be the reservoir of infection for man. Canine leishmaniasis does not exist in India where human kala-azar is endemic, hence in India man is the main or only source of infection. In Sudan and East Africa, it is primarily a rodent infection and in Russia, the jackals are the reservoir of infection. The incubation period generally varies from 3-6 months but the longest incubation period of 10 years and 24 years is reported by Wright and Noor respectively. 4 Although the characteristics of the disease are similar throughout the world, certain local peculiarities in its behaviour justify the classification of VL into African (KA), Mediterranean or infective (KA) and Indian (KA). The onset of the disease may be insidious or abrupt. Fever typically nocturnal and occasionally double quotadian is almost universal and is accompanied by tachycardia without signs of toxemia. Daily fever progresses to recurrent febrile waves. Non-tender splenomegalyis invariablypresentwhilehepa-tomegalyis not a constant feature. Pancyto-penia is characteristic, hypoalbuminaemia and hyperammaglobulinaemia are often present. Leishmaniasis can occur at any age but mostly it is a disease of childhood and adolescence. Once infection occurs, lifelong immunity develops. 6 In the present territories of Pakistan there was no record of VL until 1960 when Abmed et al. 7 and Burneyet al. reported 30 cases of VL from Northern areas of Pakistan (Baltistan) who also identified the vector sandfly of the genus Phlebotomus in the same areas and a case with long incubation period of 24 years was also reported from Multan by Noor et al. 4 Although sporadic cases of cutaneous leishmaniasis (unpublished) are found in this area, no case of VL has been reported so far in Karachi, the present two cases may well be the first to be reported from this part of the country.
منابع مشابه
DNA polymorphism assay distinguishes isolates of Leishmania donovani that cause kala-azar from those that cause post-kala-azar dermal Leishmaniasis in humans.
Leishmania donovani in India causes visceral infection (kala-azar) and dermal infection (post-kala-azar dermal leishmaniasis). We report here the identification of polymorphism in a well-defined genetic locus among the Leishmania parasites causing the visceral and dermal manifestations, in a comparison of 15 post-kala-azar dermal leishmaniasis and 12 kala-azar patient isolates.
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ورودعنوان ژورنال:
- JPMA. The Journal of the Pakistan Medical Association
دوره 39 9 شماره
صفحات -
تاریخ انتشار 1989