Kala-Azar: Causes, Symptoms, Diagnosis and Treatment

Ans. Kala-azar diagnosis and treatment are difficult for a variety of reasons. Treatment is time-consuming and pricey. The diagnosis is invasive, requiring organ needle aspiration and microscopic examination. In the event of infection, samples of bone marrow, spleen, and lymph node tissues are taken. Spleen aspiration has better diagnostic sensitivity, ranging from 95% to 98 per cent. However, there is a significant danger of bleeding during the surgery. Bone marrow testing has the lowest accuracy rate, ranging from 53% to 95%. Technical skills are required for organ aspirations and examinations, which are not available in rural locations. Outside of research laboratories, correct diagnosis methods are not used.

Ans. There are no vaccines or preventative medications available for visceral Leishmania. Prevention is the most effective way. Sandfly bites must be avoided at all costs. Precautions should be taken as follows:

1 – Outdoors – Sandflies are most active from nightfall to dawn, so avoid going outside during that time. Wear long pants, long-sleeved shirts, and socks when going outside. Tuck the shirt into the bottom of the pant. Insect repellent should be applied to any flesh that is exposed or unprotected under the ends of pants and sleeves.

2 - Indoors - Stay in settings that are well-screened or air-conditioned. The insecticide should be sprayed in living/sleeping areas to kill insects. Flies can be kept at bay by using a bed net soaked in spray.

Ans. Leishmaniasis is a parasitic disease that is found in parts of the tropics, subtropics, and southern Europe. Leishmaniasis is caused by infection with Leishmania parasites, which are spread by the bite of infected sand flies. There are several different forms of leishmaniasis in people. The most common forms are cutaneous leishmaniasis, which causes skin sores, and visceral leishmaniasis, which affects several internal organs (usually spleen, liver, and bone marrow).

Ans. Some people have a silent infection, without any symptoms or signs. People who develop clinical evidence of infection have one or more sores on their skin. The sores can change in size and appearance over time. The sores may start out as papules (bumps) or nodules (lumps) and may end up as ulcers (like a volcano, with a raised edge and central crater); skin ulcers may be covered by scab or crust. The sores usually are painless but can be painful. Some people have swollen glands near the sores (for example, under the arm, if the sores are on the arm or hand).

Ans. Some people have a silent infection, without any symptoms or signs. People who develop clinical evidence of infection usually have a fever, weight loss, enlargement (swelling) of the spleen and liver, and abnormal blood tests. People may have low blood counts, including a low red blood cell count (anaemia), a low white blood cell count (leukopenia), and a low platelet count (thrombocytopenia).

Ans. People of all ages are at risk for infection if they live or travel where leishmaniasis is found. Leishmaniasis usually is more common in rural than in urban areas, but it is found in the outskirts of some cities. The transmission risk is highest from dusk to dawn because this is when sand flies generally are the most active. Examples of people who may have an increased risk for infection (especially with the cutaneous form) include adventure travellers, ecotourists, Peace Corps volunteers, missionaries, soldiers, ornithologists (people who study birds), and other people who do research (or are active) outdoors at night/twilight.

Ans. Some people have a silent infection, without any symptoms or signs.

The skin sores of cutaneous leishmaniasis usually develop within a few weeks or months of the sandfly bite.

People with visceral leishmaniasis usually become sick within months (sometimes as long as years) of when they were bitten.

Ans. The main way is through the bite of infected female phlebotomine sandflies. Sandflies become infected by sucking blood from an infected animal or person. People might not realize that sand flies are present because:

• They do not make any noise;
• They are small: on average, they are only about one fourth the size of mosquitoes or even smaller; and
• Their bites might not be noticed (the bites can be painless or painful).

Sandflies usually are most active in twilight, evening, and night-time hours (from dusk to dawn). Although sand flies are less active during the hottest time of the day, they may bite if they are disturbed (for example, if a person brushes up against the trunk of a tree or some other site where sand flies are resting).

Some types (species) of Leishmania parasites also may be spread via contaminated needles (needle sharing) or blood transfusions. Congenital transmission (spread from a pregnant woman to her baby) has been reported.

Ans. The number of new cases may vary or change over time and are difficult to estimate. For cutaneous leishmaniasis, estimates of the number of new cases per year have ranged from approximately 700,000 to 1.2 million or more. For visceral leishmaniasis, the estimated number of new cases per year may have decreased to <100,000, but previous estimates ranged up to 400,000 or more cases.

Ans. The first steps are to check if you have been in a part of the world where leishmaniasis is found and if you have any symptoms or signs that might be from leishmaniasis.

Health care providers and can help with laboratory testing for leishmaniasis. Tissue specimens—for example, from skin sores (for cutaneous leishmaniasis) or from bone marrow (for visceral leishmaniasis)—can be examined for the parasite under a microscope, in special cultures, and by molecular tests.

Blood tests that detect antibodies (an immune response) to the parasite can be helpful for cases of visceral leishmaniasis; tests to look for the parasite itself (or its DNA) usually also are done.