Epidemiologic surveillance of visceral leishmaniasis in Sicily, Italy

Am J Trop Med Hyg. 1997 Jul;57(1):75-8. doi: 10.4269/ajtmh.1997.57.75.

Abstract

Visceral leishmaniasis (VL) is endemic in Sicily. Although it is a notifiable disease, there is evidence that the actual number of cases is higher than that reported. In 1987, a regional reference center for active surveillance of VL was established and it recorded a total of 284 cases through 1995, a mean of 31.5 cases/year and about four-fold more than previously reported. Of the 284 cases, 150 (53%) were children (< or = 14 years of age), and of the 134 adults, 39 (29%) were coinfected with human immunodeficiency virus (HIV). The commonest viscerotropic zymodeme of Leishmania infantum, MON 1, was identified in 40 (93%) of 43 HIV-negative and eight (57%) of 14 HIV-positive patients. Among 280 patients evaluated (i.e., all HIV-negative and 35 of 39 HIV-positive subjects), 254 (91%) were treated with meglumine antimoniate alone or in combination with other drugs; 23 (8%) received allopurinol or amphotericin B, either conventional or in liposomal form; and three terminally ill patients were not treated. Among the 245 HIV-negative patients, 236 (96%) were successfully cured, while nine (4%) (seven adults) died during the course of antimonial treatment. None of the 35 HIV-positive patients was definitively cured, although mortality was apparently associated with other opportunistic infections.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Allopurinol / therapeutic use
  • Amphotericin B / therapeutic use
  • Animals
  • Antiprotozoal Agents / administration & dosage
  • Antiprotozoal Agents / therapeutic use
  • Child
  • Child, Preschool
  • Cohort Studies
  • Drug Therapy, Combination
  • Female
  • HIV Infections / complications
  • HIV Infections / epidemiology
  • Humans
  • Infant
  • Leishmania infantum / isolation & purification*
  • Leishmaniasis, Visceral / complications
  • Leishmaniasis, Visceral / diagnosis
  • Leishmaniasis, Visceral / drug therapy
  • Leishmaniasis, Visceral / epidemiology*
  • Male
  • Meglumine / administration & dosage
  • Meglumine / therapeutic use
  • Meglumine Antimoniate
  • Middle Aged
  • Organometallic Compounds / administration & dosage
  • Organometallic Compounds / therapeutic use
  • Recurrence
  • Sex Distribution
  • Sicily / epidemiology

Substances

  • Antiprotozoal Agents
  • Organometallic Compounds
  • Allopurinol
  • Meglumine
  • Meglumine Antimoniate
  • Amphotericin B