Visceral leishmaniasis: Clinical and demographic features in an African population

OBJECTIVE To describe the clinical and demographic features of patients with visceral leishmaniasis (VL), from Sudan, Africa. METHODOLOGY A descriptive study was conducted during 5 years period on confirmed VL patients. These patients are, originally, from White Nile Province (WNP) region, a previously non-endemic VL focus which is located in southern part of Sudan. They were referred during the period 2006-2010 for management at Tropical Diseases Hospital (TDH) in the capital Khartoum. The patients data were retrieved from the hospital electronic software system, and were studied. RESULTS A total of 71 patients with VL were reviewed. The main clinical features were: fever 68 (95.8%), splenomegaly 66 (93%), weight loss 61 (85.9%), pallor 59 (83.1%), hepatomegaly 52 (73.2%). The most notable haematology finding was the mean Hb value (7.6 g/dL) on admission to hospital. Gender showed males at higher risk for VL as compared to females with a ratio of 3:1 (53 vs 18). VL was largely a disease of children with 42 (59.1%) aged < 15 year, and around quarter (23.9%) under 5 years. CONCLUSION The clinical features of Sudanese VL in WNP region is, generally, similar to the pattern seen globally in endemic foci. The majority of the study population are paediatric indigenous VL patients, suggesting that adults were immune, and indicating change of disease pattern from previous sporadic to present endemic. This finding emphasizes the need for research to better understand VL in non-endemic areas with the objective of developing effective and sustainable control strategies.