Visceral Leishmaniasis in children in the Yemen.
OBJECTIVE
The clinical presentation and duration of therapy for visceral leishmaniasis varies in different countries. The sodium stibogluconate is costly, and a trial of short course therapy has not yet been studied in Hajjah governorate. The aim of this study was to evaluate the efficacy of a 20 days regimen of sodium stibogluconate and to ascertain the epidemiological, clinical and laboratory features of visceral leishmaniasis in children.


METHODS
This was a prospective hospital-based study in Hajjah Governorate, Republic of Yemen. Children of 12 years of age or less with a confirmed diagnosis were included. Sodium stibogluconate was given in a dose of 15mg/kg/dose daily for 20 days, then the patients were re-evaluated and the data required for achieving the other objective was collected.


RESULTS
Thirty-two patients fulfilled the inclusion criteria. The age ranged from 12 months to 144 months (67.7 +/- 35). Females formed 53% of this criteria. The duration of symptoms ranged from 2 weeks to 116 weeks. Fever, fatigability and abdominal distension were the most common symptoms. The hematological findings showed anemia in all patients, leukopenia in 81% and thrombocytopenia in 56%. Formol gel test was negative in 20 patients (63%). Malaria smear was positive in 11 patients (34%). Splenic aspiration was carried out in 25 patients (78%) and bone marrow aspiration in 7 patients (22%). Blood transfusion were required for 24 patients (73%). After 20 days treatment with pentostam, 20 patients (63%) came for follow-up and re-tested for parasitological cure. Half of those were still positive for leishmania donovan bodies. The mortality rate was 5%.


CONCLUSIONS
The clinical features were of the Mediterranean type. Twenty days treatment with sodium stibogluconate was not adequate.
Haidar
N A
NA
Department of Pediatrics, Saudi Hospital at Hajjh, Republic of Yemen. alo@y.net.ye
Diab
A B
AB
El-Sheik
A M
AM
D000967:Antimony Sodium Gluconate / Q000008:administration & dosage*; D000981:Antiprotozoal Agents / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007223:Infant; D007898:Leishmaniasis, Visceral / Q000188:drug therapy*; D008297:Male; D016896:Treatment Outcome; D015006:Yemen
D000981:Antiprotozoal Agents; D000967:Antimony Sodium Gluconate