Child Leishmaniasis

Mediterranean-Central Asian visceral leishmaniasis (synonyms: children's leishmaniasis, children's kala-azar).

[1], [2], [3], [4], [5], [6],

Epidemiology of pediatric leishmaniasis

Pediatric leishmaniasis is a zoonotic disease. There are 3 types of foci of Mediterranean-Central Asian leishmaniasis:

1. natural foci in which the pathogen circulates among wild animals (jackals, foxes, rodents, including ground squirrels, etc.), which are reservoirs and a source of infestation in these outbreaks;
2. rural foci in which the pathogen circulates mainly among dogs - the main sources of invasion, as well as wild animals. Under certain conditions, wild animals in such outbreaks can serve as a significant reservoir and, consequently, a source of infection that is relevant to the population;
3. urban (synanthropic) foci, in which dogs are the main source of invasion, but the causative agent is also found in synanthropic rats.

In general, the dogs of rural and urban foci of leishmaniasis represent the most significant source of infection of L. Infantum people .

The carriers of leishmanias are different kinds of mosquitoes: Ph. Ariasi. Ph. Perniciosus, Ph. Smirnovi. Mostly children aged 1 to 5 years old are sick in North Africa and South-West Asia, as well as children aged 5-9 years in East Africa. In China, Central Asia and Southern Europe, all age groups are affected.

The incidence is sporadic, small epidemics can occur in cities. The season of infection is summer, and the incidence season is autumn of the same or spring next year. The foci are located between 45 ° N. W. And 15 ° S. Are registered in the countries of the Mediterranean, north-western regions of China, the Middle East. Sporadic cases are revealed in the states of Central Asia and Transcaucasia.

[7], [8], [9], [10], [11],

What causes childhood leishmaniasis?

Childish leishmaniasis is caused by L. Infantum.

Pathogenesis and pathological anatomical picture of pediatric leishmaniasis

The pathogenesis of pediatric leishmaniasis does not differ significantly from those of Indian leishmaniasis; a feature is the development in a number of patients of primary affect in the place of mosquito bite.

Symptoms of pediatric leishmaniasis

The incubation period of childhood leishmaniasis lasts from 20 days to 3-5 months. In the place of bite in children 1-1,5 years, less often in older children and adults, there is a primary affect in the form of a papule, sometimes covered with a scaly. It is important to correctly assess this symptom, since it appears long before the common manifestations of the disease.

Symptoms of pediatric leishmaniasis do not differ fundamentally from those of Indian leishmaniasis: a picture of systemic parasitic reticuloendotheliosis develops. The most significant features of Mediterranean-Central Asian visceral leishmaniasis are the absence of cutaneous leishmaniasis and the involvement of lymph nodes, both peripheral and mesenteric, peribronchial, etc., in the pathological process. As a result, peripheral lymphadenitis and, more rarely, mezadenitis, are possible in the clinical picture of Mediterranean-Central Asian visceral leishmaniasis. Increase peritrahealnyh and peribronhialnyh nodes can provoke a paroxysmal cough. Often develop pneumonia caused by a secondary infection.

The disease of childhood leishmaniasis can occur in acute, subacute and chronic forms.

The acute form is manifested mainly in young children and without treatment or with belated therapy ends with death.

Subacute form is difficult, often with the development of complications. Without specific treatment of pediatric leishmaniasis in 5-6 months, the death of the patient may occur.

Chronic form of pediatric leishmaniasis occurs mainly in older children, less often in adults. Characterized by a lighter flow and with timely treatment results in recovery.

Diagnosis of pediatric leishmaniasis

Diagnosis of pediatric leishmaniasis is based on an epidemiological history (stay in endemic areas) and symptoms. Laboratory confirmation of the diagnosis is similar to Indian visceral leishmaniasis. In 75% of these patients, leishmanias are found in the blood, 88% in the skin and almost always in the pleural fluid.

[12], [13], [14], [15], [16]

Treatment of pediatric leishmaniasis

Treatment of pediatric leishmaniasis is the same as in the case of Indian visceral leishmaniasis.

Pediatric leishmaniasis, as a rule, has a favorable prognosis, with the exception of mixed infection of visceral leishmaniasis and HIV.