Imported and autochthonous kala-azar in France.
OBJECTIVE
To study the epidemiological, clinical, and biological features of imported and autochthonous kala-azar in France.


METHODS
Prospective survey of all patients in France with kala-azar diagnosed over the two years 1986-7. Information was obtained from parasitology laboratories in regional hospitals and all hospital laboratories and haematology departments capable of diagnosing leishmaniasis in the south of France.


METHODS
107 public hospitals in France.


METHODS
89 patients with kala-azar.


METHODS
All patients were treated with drugs. In the first instance meglumine antimonate was given to all but two patients.


METHODS
Prevalence of the various clinical and biological features of kala-azar; proportion of patients with HIV infection.


RESULTS
Half (44) of the patients were children under 8 years old. Seventy patients acquired the disease in France. Imported kala-azar was acquired mainly in Mediterranean countries (9/18 cases). Only 46 (52%) of the patients had all three of the classic associated clinical features of fever, splenomegaly, and hepatomegaly. Anaemia was the commonest biological sign, and the association of the four usual biological signs--anaemia, leucopenia, thrombocytopenia, and hypergammaglobulinaemia--was present in only 14 (33%) of the children under 8 and 26 (60%) adults. Fourteen of the patients over 8 years old were infected with HIV.


CONCLUSIONS
Doctors must be aware of kala-azar in Mediterranean areas, especially as patients often present without the characteristic features and the disease affects young children preferentially.
Jeannel
D
D
National Centre for Imported Diseases, Institute of Health and Development, Paris.
Tuppin
P
P
Brucker
G
G
Danis
M
M
Gentilini
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D014195:Travel
D000981:Antiprotozoal Agents