The Signs and Symptoms of Visceral Leishmaniasis - Research Paper Example

Risk factors in the spread of Visceral Leishmaniasis in two highly endemic but ecologically different regions Introduction Kala-azar (Visceral Leishmaniasis) is a parasitic disease that has high-mortality rates especially in Africa and Asia. It is a major form of the Leishmania disease, which is a dangerous endemic disease in the world. The disease is caused by infections from protozoan parasites of the leishmania genus. The phlebotomine sandflies are the main transmitters of the disease among human beings. However, not all species of phlebotomine transmit Leishmaniasis. Research has shown that it is only thirty of all the phlebotomine species transmit VL. In most cases, the female sandfly spreads the parasite into animals or human beings. This is because the parasite develops inside the sandfly for some period mostly between four and twenty five days. The sandfly then sucks fresh blood from an animal or a human being, and hence, transmitting the parasites, which completes the parasite’s cycle of transmission. Signs and symptoms The signs and symptoms of Visceral Leishmaniasis depend on the individual concerned as well as the geographical area involved. Some individuals have silent infections while others display symptoms of the disease. However, in most cases, VL affects internal organs of the body, which include the liver and spleen (Farrell 67). Fever is the most common symptom among many victims. Abnormal blood tests, which are factors of swelling of the spleen and liver, are also common symptoms of the disease. Low blood count of all the components of the disease are among the abnormal blood tests displayed by patients of the disease (Warrell 78). However, the signs and symptoms also depend on the geographical area under concern. For instance, in Sudan, most of the patients of the disease suffer from HIV, which leads to severe cases of the disease. The similarity between symptoms in Sudan and India is that all patients have fever as well internal body organs. Diagnosis and treatment Diagnosis of VL depends on the geographical location of the patient to be examined. This is because the disease varies according to the geographical location of the individual concerned. Clinical officers must use samples from the bone marrow (serologic testing) to test the presence of VL in patients. Serologic testing is effective because the disease mainly affects the internal organs of the body. Test samples for diagnosis may also come from the liver, blood or the lymph nodes. However, clinical officers and other medical practitioners have different approaches of diagnosis for individuals with HIV infection (Siddig, Mohammed, Hashim, David and Eskild 104). It is important to note that the diagnosis of the disease depends on the area or geographical region under concern. Similarly, treatment depends on the severity of the case in the individual concerned. Children and other special groups receive different medication from those of other members of the society. Severe cases of VL are fatal in untreated. No vaccines or preventive drugs are available for the disease. The only preventive measure that individuals can pursue is through preventing bites from sandflies (Mabey 45). Epidemiology and risk factors Epidemiology is one of the areas that have differences concerning geographical locations. Sandflies are responsible for spreading the Leishmania parasites into animals and human beings, which suggests that ecological factors may contribute to the spread of VL disease. The presence of tropical forests, caves and other habitats for the phlebotomine sandflies contributes to the spread of the disease in certain geographical areas. Sudan therefore, provides an ideal site for the breeding of sandflies. In addition, the conditions of living in Sudan are more severe than in India. India has relatively low breeding sites because of large population. Many individuals do not notice sandfly bites because the sandflies are mainly active at night and are very small (smaller than tropical mosquitoes). In addition, sandflies do not make noise when moving and their bites are not painful. The disease is more prevalent in the rural areas than urban areas although it may also be prevalent in suburban habitats. The risk of transmission of the disease is higher at night than during the day because sandflies are most active during the night (Hart 345). The World Health Organization (WHO) has ranked Visceral Leishmaniasis (VL) among the top endemic diseases that need prioritized attention in the world. The mortality rates of the disease are especially high in developing nations, which have the characteristics of absolute levels of poverty and lack of proper sanitation (see World Health Organization). Control and treatment of the disease differs among geographical locations depending on their levels of development. For instance, in Sudan, treatment of the disease is very difficult because of lack of infrastructure. Patients have to travel for long distances to access health facilities, which increases the severity of the disease (Elmojtaba, Mugisha & Hashim 2570). In addition, most of the inhabitants of the rural areas in Sudan develop symptoms of the disease resulting from co-infection with malaria and HIV (Hoogstraal, Harry, and Donald 78). Poor methods of sanitation contribute to increased number of reported cases. Social and cultural issues also expose people to the disease. For instance, political instability, lack of proper nutrition and lack of finances has led to increased number of cases of Visceral Leishmaniasis (Perea, Ancelle, Moren, Nagelkerke and Sondorp 50). In India, for instance, the disease is prevalent although there are few reported cases in government hospitals. Most patients of the disease prefer private medical practitioners to public institutions because the economic conditions in the country are relatively better than Sudan (Bryceson 1933). The private medical facilities do not report all the cases of VL that they handle, which renders the statistics given by the government as ineffective. Just like in Sudan, treatment of the disease has some major limitations that curtail the government’s efforts to reduce prevalence of the disease (Bhaduri 23). In India, most patients have continuously ignored or resisted the drugs used to treat the disease, which were developed many years ago (Ponte-Sucre, Alicia, Emilia, and Maritza 235). India’s government has had various efforts to control the spread and effects of VL in the subcontinent. The VL elimination program is one of the programs that the government has ever started in an effort to curb the rising cases of the disease in India (Stauch, Sarkar, Picado, Ostyn, Sundar, Rijal, Boelaert, Dukardin & Duerr 08). This is unlike in Sudan where the government has had very little efforts to control the prevalence and impact of the disease. Therefore, it is clear that epidemiological factors of Visceral Leishmaniasis differs across geographical locations in terms of transmission, availability of treatment, conditions of patients and other areas of concern (Sree, Hari and Ravi 56). Works Cited Bhaduri, A N. Current Trends in Leishmania Research. New Delhi, India: Publications & Information Directorate, Council of Scientific & Industrial Research, 1993. Print. Bryceson, A. "Visceral Leishmaniasis In India." The Lancet 356.9245 (2000): 1933-1933. Print. 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Hoogstraal, Harry, and Donald Heyneman. Leishmaniasis in the Sudan Republic: Final Epidemiological Report. Baltimore, Md: s.n., 1969. Print. Jha, T K, and E Noiri. Kala Azar in South Asia: Current Status and Challenges Ahead. Dordrecht: Springer, 2011. Print. Mabey, David. Principles of Medicine in Africa. Cambridge: Cambridge University Press, 2013. Print. Manual for Kala-Azar Control in Bihar, 1979-80. Delhi: National Institute of Communicable Diseases, 1979. Print. Perea, W.a., T. Ancelle, A. Moren, M. Nagelkerke, and E. Sondorp. "Visceral Leishmaniasis In Southern Sudan." Transactions of the Royal Society of Tropical Medicine and Hygiene 85.1 (1991): 48-53. Print. Ponte-Sucre, Alicia, Emilia Diaz, and Maritza Padro?n-Nieves. Drug Resistance in Leishmania Parasites: Consequences, Molecular Mechanisms, and Possible Treatments. Wien: Springer-Verlag, 2013. Print. Siddig, Mohammed, Hashim Ghalib, David C. Shillington, and Eskild A. Petersen. "Visceral Leishmaniasis In The Sudan: Comparative Parasitological Methods Of Diagnosis." Transactions of the Royal Society of Tropical Medicine and Hygiene 82.1 (1988): 66-68. Print. Sree, Hari R. V, and Ravi Durvasula. Dynamic Models of Infectious Diseases: Volume 1. New York, NY: Springer, 2013. Internet resource. Stauch, A., Sarkar, R., Picado, A., Ostyn, B., Sundar, S., Rijal., S., Boelaert, M., Dukardin, J., & Duerr, H. “Visceral Leishmaniasis in the Indian Subcontinent: Modelling Epidemiology and Control.” Neglected Tropical Diseases 5.11 (2011). Print. Treatment Options for Kala-Azar (visceral Leishmaniasis) in Bihar, India. University Of Oslo, 2005. Internet resource. Warrell, D A. Oxford Textbook of Infectious and Tropical Diseases. Oxford: Oxford University Press, 2012. Print. World Health Organization. (2013). Retrieved on 12th September 2013 at http://www.who.int/topics/leishmaniasis/en/ Read More