antimony-sodium-gluconate and Intestinal-Diseases--Parasitic

Visceral leishmaniasis (VL) in north-west Ethiopia is causing an overwhelming case load among adult migrant workers that masked the disease burden in children. This study describes the clinical profile and explores comorbidities in paediatric VL patients.. A prospective study at two hospitals in this region (Gondar and Humera) was conducted in a year period, 2011-2012. The clinical manifestations and comorbidities such as malnutrition, intestinal parasitosis and vitamin D deficiency and HIV infection were assessed, and treatment outcomes noted.. A total of 122 children with VL were detected during the study period with median age of 8.5 years (IQR 5-12 years); 23% were under 5 years. Eighty-five (69.7%) cases were male. The clinical manifestations were similar to the adult patients. High rates of malnutrition, intestinal parasitosis (47.5%) and hypovitaminosis D (56.4%) were detected. The proportion of stunting and wasting was 63% and 22.2% in children aged under five years, and 50.5% and 75.9% in 5-year and older children, respectively, using WHO standard growth curves. Only one child had HIV infection. In 95% of the cases, sodium stibogluconate (20 mg/kg/day for 30 days) was used for treatment. The treatment success rate at end of therapy was 98.3%, but the definitive outcome at 6 months could not be determined because of a high loss to follow-up (80.2%).. While HIV co-infection was rare, malnutrition, intestinal parasitosis and vitamin D deficiency were frequent indicating the need for further research on their role in the pathophysiology. Meanwhile, systematic assessment and management of malnutrition and intestinal parasitosis in VL programmes is recommended.

Topics: Amebicides; Amphotericin B; Antimony Sodium Gluconate; Antiprotozoal Agents; Child; Child, Preschool; Comorbidity; Cross-Sectional Studies; Ethiopia; Female; HIV Infections; Humans; Intestinal Diseases, Parasitic; Leishmaniasis, Visceral; Male; Malnutrition; Paromomycin; Prospective Studies; Treatment Outcome; Vitamin D Deficiency

We report the case of a 30-years old HIV-infected woman who suffered from recurrent fever up to 41 degrees C, loss of appetite, loss of 8 kg body weight and swelling of the cervical and inguinal lymph nodes. The diagnostic work-up revealed infection with leishmania in gastric and duodenal biopsies. The parasites were also found in the inguinal lymph nodes and in the bone marrow of the patient. According to patient's history the infection was acquired on a holiday in southern spain. The patient was treated with pentavalent antimony in combination with interferon gamma. Visceral leishmaniosis in immuno-suppressed patients is discussed and therapeutic approaches are described.

Topics: Adult; AIDS-Related Opportunistic Infections; Antimony Sodium Gluconate; Biopsy; Combined Modality Therapy; Female; Gastric Mucosa; Humans; Interferon-gamma; Intestinal Diseases, Parasitic; Intestinal Mucosa; Leishmaniasis, Visceral

Topics: Anthelmintics; Antimony; Antimony Sodium Gluconate; Drug Therapy; Gluconates; Humans; Intestinal Diseases; Intestinal Diseases, Parasitic; Rectum; Schistosomiasis; Sodium; Statistics as Topic; Toxicology