Increasing incidence of post-kala-azar dermal leishmaniasis in a population-based study in Bangladesh.
Post-kala-azar dermal leishmaniasis (PKDL) occurs after kala-azar treatment and acts as a durable infection reservoir. On the basis of active case finding among 22,699 respondents, 813 (3.6%) had had kala-azar since 2002, of whom 79 (9.7%) developed PKDL. Eight additional patients with PKDL had no history of kala-azar. Annual kala-azar incidence peaked at 85 cases per 10,000 person-years in 2004 and fell to 46 cases per 10,000 person-years in 2007, but PKDL incidence rose from 1 case per 10,000 person-years in 2002-2004 to 21 cases per 10,000 person-years in 2007. The rising PKDL incidence threatens the regional visceral leishmaniasis elimination initiative and underscores the urgent need for more effective PKDL diagnosis and treatment.
Rahman
Kazi Mizanur
KM
International Centre for Diarrhoeal Disease Research, Bangladesh.
Islam
Shamim
S
Rahman
Muhammad Waliur
MW
Kenah
Eben
E
Ghalib
Chowdhury Mohammad
CM
Galive
Chowdhury Mohammad
CM
Zahid
M M
MM
Maguire
James
J
Rahman
Mahmudur
M
Haque
Rashidul
R
Luby
Stephen P
SP
Bern
Caryn
C
D000293:Adolescent; D000328:Adult; D001459:Bangladesh / Q000453:epidemiology; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D015994:Incidence; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology* / Q000209:etiology; D007898:Leishmaniasis, Visceral / Q000150:complications / Q000453:epidemiology*; D008297:Male; D011795:Surveys and Questionnaires