Causes and risk factors
Leishmaniasis is caused due to the bite of the sandfly which is infected with the leishmania parasite. There are 20 such leishmania species that can cause infection. When the sandfly bites the human being it injects the infective stage, metacyclic promastigotes into the human body. The promastigotes transform into the amastigotes. They invade the cells multiple and affect the other cells of the boy. When the sandfly bite this infected human being along with blood the amastigotes enter into the body of the sandfly. The amastigotes again transform into the promastigotes, they divides into the gut and again reach the proboscis ready to infect, thus continuing the cycle. The infection is more prevalent in areas of poor hygiene and damp places where the sand fly can thrive. Low immunity and malnutrition increases the risk for infection.
Clinical presentation
There are three main types of Leishmaniasis -mucocutaneous, visceral and cutenous.
Visceral form of Leishmaniasis is also known as kala azar and is severe and life threatening infection. The vital organs of the body are affected and the infection is characterized by fever, weight loss, swelling of liver and spleen. The number of red blood cells decrease along with low WBC and platelet count. Enlargement of lymph nodes is seen. This form is particularly caused by Lesihmanian Donovani and Lesihmanian infantum. Post kala azar dermal Leishmaniasis is also commonly seen. It is characterized by development of skin lesion which is patiruclarly seen on face. Nodules, pustules or macules or papular eruptions are seen. Mucosal type along with generalized complaints destruction of the mucosa particularly of the nose, mouth and throat takes place. Cutaneous Leishmaniasis is the most common type. Complaints are seen for weeks to months after the sand fly bite. Changes in skin takes place over a period of time. The eruptions start with a normal bump formation and ends up in ulceration. These ulcers are usually painless. In some cases pain may also be seen. It can also lead to disfigurement, stigma, permanent scar formation and disability.
Investigations
Diagnosis is confirmed on the basis of the symptoms narrated by the patient and on the basis of physical examination carried out by the doctor. Blood cultures along with serological test (rapid diagnostic test) helps in confirmation of the disease.Aldehyde chopra test can also be done. Microscopic examination of the tissues along with blood test for antibodies can also be done. Certain other routine test can also be advised.
Treatment
Administration of oral medications is the first line of treatment. Medications namely Antimony containing compounds and antibiotics are administered Ointments for soothing the ulcer complaints are advised. Usually the sores do not need any medication and they heal over a long period of time leaving behind scars. In severe cases the person is hospitalized and appropriate treatment is given. Along with this certain preventive measures needs to be implemented. In some areas of the world (Middle East and Russia), live-attenuated Lieshmania major promastigotes have been used to immunize against cutaneous leishmaniasis. Avoid outdoor activities especially from dusk to dawn, wearing of long sleeved clothes, use of repellents etc are certain preventive measure one can adopt.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up the symptom. Taking into consideration the symptoms in holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.
Facts and Figures:
As per WHO over 90% of visceral leishmaniasis cases occur in six countries: Bangladesh, Brazil, Ethiopia, India, South Sudan and Sudan while 90% of mucocutaneous leishmaniasis cases occurs in the Plurinational State of Bolivia, Brazil and Peru.
Research by Lancaster University published in the open access journal Parasites and Vectors suggest that the leishmania parasite which causes Leishmaniasis in human being acts as a probiotic protecting them from bacterial diseases.
