Kala-azar (Leishmaniasis) - Disease spread by sand flie's byte

Leishmaniasis otherwise known as Kala-azar is a disease spread by sand fly. It is spread from the byte of sandfly and is parasitic in nature. It is a group of disease. Disease may be cutaneous or systemic. Cutaneous leishmaniasis affects mucous membrane and skin and in mucous membrane ulcers might develop. Systemic or visceral leishmaniasis affects the immune system of whole body and might cause death.

Causes

Leishmaniasis is spread by sand flies which is infected by biting an infected by biting any infected animal.

Symptoms

Children affected by the disease will show symptoms like vomiting, fever, weakness, cough, night sweat, change in skin tone, hair thinning, discomfort with abdomen, weight loss, diarrhea, fatigue etc. In adults fever might last for two weeks or two months. They will have weakness, fatigue, loss of appetite etc and along with the disease weakness increases. In those affected by cutaneous leishmaniasis there might be difficulty to breath, sores on skin, skin ulcer, nose bleeding, nose running, ulcers in mouth lips, nose etc.

Treatment

Spleen and bone marrow or skin biopsy and culture, immunofluorescent antibody test done indirectly, complete blood count, hemoglobin count, direct agultination assay, montenegro skin test, serum protein and albumin, immunoglobulins etc are done for detecting the disease.

Antimony containing compounds are the most important drugs used to treat the disease. Medicines usually given are Meglumine antimonate and Sodium stibogluconate. Amphotericin B , Pentamidine are also given. In case of visceral leishmaniasis removal of spleen might become necessary if it is drug resistant. If disfigurement occurs in cutaneous leishmaniasis plastic surgery might become necessary. Death occurs in a time span of two years due to other complications like other infections. Pentavalent antimony is the most common treatment or pentamindine is used as an alternative.

Usually two pentavalent antimonials (Pentostam and Glucantime) are used in treatment. In case they are not effective pentamidine and amphotericine B are given to patient. Allopurinol used in gout treatment is being tried as experiment. Similarly as part of experiments ambisome and ketaconazole are also given. Drugs are chosen according to the geographic location and infecting species. Drugs like Nastibogluconate or Meglumine antimonate are also given. Deoxycholate, Ishethionate, itraconazole, topical paromomycin etc are other drugs given to patient. Supportive measures like adequate nutrition, antibiotics etc are also needed.

Prevention

Sandfly bites must be prevented through insect repellent, appropriate clothing, window screening etc. There are no preventive vaccines for this disease.