kala azar symptoms?leishmaniasis treatment?types of leishmaniasis?

Kala azar or Leishmaniasis

Kala-azar is a black sickness / black fever, chronic prarasitic disease caused Leishmania donovani. It is also known as visceral leishmaniasis (VL). Kala-azar is fetal if not treated in time. It is transmitted by the bite of infected sand fly but in rarely transmitted through blood transfusion, mother to child & organ transplantation.

Kala-azar is caused by more than 20 species of Leishmania, among them Visceral leishmaniasis is most severe form and Cutaneous leishmaniasis or Oriental sore is most common form. As compare to female, male more likely to suffer from Leishmaniasis.

Kala azar

 

Some species of Leishmania are:

1. Leishmania tropica: causes cutaneous leishmaniasis
2. Leishmania bragilensis: causes mucosal leishmaniasis
3. Leishmania chagasi: causes cutaneous leishmaniasis
4. Leishmania donovani: causes visceral leishmaniasis

Mucosal Leishmaniasis

Visceral Leishmaniasis

Cutaneous Leishmaniasis

The parasites of Kala-azar migrates to the visceral organs of human body i.e. liver, spleen,bone marrow (parasites habitat). If untreated, will almost always results to the host death.

Pathogenicity of Leishmaniasis

Epidemiology of Kala-azar:-

1. Agent: Leishmania donovani 

2. Host: All age but peak in 5-9 years

3. Vector: Sandfly (Phlebotomus argentipes)

4. Transmission: Female sandfly

5. Incubation period: 2-6 months

6. Disease of rural areas 
   

Kala-azar is more common during and after rainy season, kala-azar is free above 600 metre sea level.

The vector of Kala-azar is Sand fly (Phlebotomus argentipes). The infective stage for man is Promastigote & for sand fly is Amastigote.

 

Kala-azar is characterized by:

1. Fever: intermittent/black fever/Dum-dum fever/camel hump fever/biphagic fever
2. Hepato-spleenomegaly
3. Cachexia (decrease muscle volume), Weight loss
   
4. Darkening of skin, Anemia
5. Skin dry & hair brittle
6. Leucopenia

Complications :

1. Epistaxis
2. Pneumonia
3. Pulmonary tuberculosis
4. Post kala-azar dermal leishmaniasis (PKDL): If not treated within 6-12 months

   

   PKDL
   

   
   

Laboratory diagnosis of Kala-azar:

rK39 test kit

• Kala-azar is diagnosed by microscopic examination in NNN culture medium (Novy-Neal-Necole medium )

• Now available for rapid diagnosis of Kala-azar is recombinant K39 protein test. It is also useful for surveillance and screening

• Antimony test

• Montgomery test

Treatments can be done by:

Drug of choice for Leishmaniasis

Liposomal amphotericin B 0.75 mg/kg is the choice of drug for kala-azar. The side effects of this drug are:

1. Diarrhoea
2. Joints pain
3. Fever
4. Stomach pain
5. Burning micturition

Meltefosine is second line drug for L. donovani
Sodium stibogluconate also can be used

Prevention and control of Kala azar :

Early diagnosis and Prompt treatment of the cases to prevent the spreads of Leishmaniasis

Vector control: This may helps to reduce the numbers of Sandfly resulting in low numbers of disease transmission. The vectors are controlled by spraying insecticidal i.e. Alpha cyphermethrine or DDT 

There is not specific medicine to control Leishmania. people can protect themselves from infection by preventing the bites of sandfly.
Wearing of full covered long pants, long seeleved shirts & hats.

To study more on Kala azar watch this videos: