One-year prospective study of pediatric cutaneous leishmaniasis: a neglected tropical disease in sub Himalayan region, India

Authors

  • Pancham Kumar Department of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
  • Ashok Garg Department of Pediatrics, MGMSC, Khaneri, Rampur, Shimla, Himachal Pradesh, India
  • Sandhya Kumari Department of Dermatology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India
  • Ajeet Negi Department of Dermatology, DDU, Shimla, Himachal Pradesh, India
  • G. R. Tegta Department of Dermatology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20182562

Keywords:

Cutaneous, Leishmaniasis, Pediatric, Sodium stibogluconate

Abstract

Background: Satluj Valley of Himachal Pradesh is a newly identified focus of Cutaneous Leishmaniasis (CL) and here disease is still in emerging phase. Although children are most commonly affected victims by CL but till date no such study has been done on childhood CL in this region.

Methods: All newly diagnosed cases of CL were registered and detailed clinico-epidemiological parameters of children between 0-18 years were recorded. Imprint smears for LD bodies and biopsies for histopathology were done in atypical cases to confirm clinical diagnosis.

Results: Over a period of one year 337 cases of CL were registered, out of them 115 children (0-18 years) were enrolled for this study. School going (6-18 years) population was predominantly affected age group. Males outnumbered the females with a ratio of 1.88. Face was most commonly affected site and most (65.21%) cases presented with single lesion. Nodules (40.87%), plaques (24.35%) and papules (7.39%) were commonly observed morphologies although mixed patterns and atypical forms were also found. Most (62.60%) cases presented within 1-3 months of lesion onset. All cases responded well to treatment with antimonials. Lesional pain, swelling, bleeding, pigmentation and scarring were minor post treatment side effects.

Conclusions: Pediatric CL is an emerging infection along the Satluj valley of Himachal Pradesh (HP). Although clinical diagnosis is simple, and all cases respond well to antimonials. But, availability of diagnostic tests is essential to diagnose atypical cases. Further annual record keeping, and reporting is recommended to know the exact disease burden so as to promote the effective treatment and preventive measures.

References

Klaus SN, Frankenburg S, Ingber A. Epidemiology of cutaneous leishmaniasis. Clin Dermatol 1999;17:257-60.

Handler MZ, Patel PA, Kapila R, Al-Qubati Y, Schwartz RA. Cutaneous and mucocutaneous leishmaniasis: Clinical Perspectives. 2015;73:897-908.

Abdalla NM, Abdelgani AM, Osman AA, Mohamed MN. Clinico-epidemiological study on focus of cutaneous leishmaniasis in Saudi Arabia. Int J Current Research. 2016; 8:31190-6.

Belal US, Abdel-Hafeez EJ, Naoi K, Norose K. Cutaneous leishmaniasis in the Nalut district, Libyan Arab Jamahiriya: a clinico-epidemiologic study and leishmania species identification. J Parasito. 2012;98:1251-6.

Raina S, Mahesha, Kaul R, Kaushal S, Satindera, Gupta D, et al. A new focus of visceral leishmaniasis in the Himalayas, India. Vector Borne Dis. 2009;46:303-6.

Aksoy M, Doni N, Ozkul HU, Yesilova Y, Ardic N, Yesilova A, et al. Pediatric cutaneous leishmaniasis in an endemic region in Turkey: A retrospective analysis of 8786 cases during 1998-2014. PLoS Negl Trop Dis. 2016;10:e0004835.

Palumbo E. Treatment strategies for mucocutaneous leishmaniasis. J Global Infect Dis. 2010;2:147-50.

Agrawal S, Khandelwal K, Bumb RA, Oghumu S, Salotra P, Satoskar AR. Short report: pediatric cutaneous leishmaniasis in an endemic region in India. Am J Trop Med Hyg. 2014;91: 901-4.

Talari SA, Talaei R, Shajari G, Vakili Z, Taghaviardakani A. Childhood cutaneous leishmaniasis: report of 117 cases from Iran. Korean J Parasitol. 2006;44: 355-60.

Gupta M. Cutaneous leishmaniasis in children: A case series. Indian J Paediatr Dermatol. 2018;19:37-9.

Bari AU. Childhood cutaneous leishmaniasis. J Clinical Diagnostic Research. 2008;2:973-8.

Gurel MS, Ulukanligil M, Ozbilge H. Cutaneous leishmaniasis in Sanliurfa: epidemiologic and clinical features of the last four years (1997-2000). Int J Dermatol. 2002;41:32-7.

Shoaib S, Tauheed S, Hafeez A. Cutaneous leishmaniasis: an emerging childhood infection. J Ayub Med Coll Abbottabad. 2007;19:40-1.

Zaraa I, Ishak F, Kort R, El Euch D, Mokni M, Chaker E, et al. Childhood and adult cutaneous leishmaniasis in Tunisia. Int J Dermatol. 2010;49:790-3.

Kharfi M, Benmously R, El Fekih N, Daoud M, Fitouri Z, Mokhtar I, et al. Childhood leishmaniasis: report of 106 cases. Dermatol Online J. 2004;10:6.

Qasmi S, Elguelbazouri N, Belgnaoui FZ, Marcil T, Bouhllab J, Senouci K, et al. Childhood cutaneous leishmaniasis: experience of a Moroccan unit of dermatology. Dermatol Online J. 2008;14:18.

Bari AU, Rahman SB. Many faces of cutaneous leishmaniasis. Indian J Dermatol Venereol Leprol. 2008;74:23-7.

Aara N, Khandelwal K, Bumb RA, Mehta RD, Bhikam C, Ghiya BC, et al. Clinco-Epidemiologic study of cutaneous leishmaniasis in Bikaner, Rajasthan, India. Am J Trop Med Hyg. 2013;89:111-5.

Rodrigues EH, Felinto de Brito ME, Mendonc¸a MG, Werkha¨user RP, Coutinho EM, Souza WV, et al. Evaluation of PCR for diagnosis of American cutaneous leishmaniasis in an area of endemicity in northeastern Brazil. J Clin Microbiol. 2002;40:3572-6.

Al-Hucheimi SN, Sultan BA, Al-Dhalimi MA. A comparative study of the diagnosis of Old World cutaneous leishmaniasis in Iraq by polymerase chain reaction and microbiologic and histopathologic methods. Int J Dermatol. 2009;48:404-8.

Vega-Lo´ pez F. Diagnosis of cutaneous leishmaniasis. Curr Opin Infect Dis. 2003;16:97-101.

WHO. Cutaneaous Leishmaniasis: An overview: Symposium. J Postgrad Med. 2003;49:50.

Sharma RC, Mahajan VK, Sharma NL, Sharma A. A new focus of cutaneous leishmaniasis in Himachal Pradesh (India). Indian J Dermatol Venereol Leprol. 2003;69:170-2.

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Published

2018-06-22

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Original Research Articles