Kala-azar in Al-Anbar Governorate, Western Iraq


Objectives : To study the clinical presentation, epidemiology, and the therapeutic response of visceral leishmaniasis (Kala-azar) in Al-Anbar Governorate, western Iraq.Methods : All cases suspected of Kala-azar admitted to AL-Ramadi Maternity and Children Hospital from the 1stof November 2001 to the 1stof April 2002 were investigated to look for Kala-azar disease. The diagnosis depended on the clinical presentation, immunofluorescent antibody test (IFAT) and the bone marrow examination (BM) test. The collected data includes the patient’s name, age, sex, residence, presence of water irrigation areas, sand flies (Hermes), dogs & Jackals, and the poultry farms in their residence areas. Data was analyzed and compared with other studies. Results : The majority (75%) of the cases were found under 2 years age, more in males than females, and in rural than urban areas. More than 68% of the recorded cases were from Al-Fallujah district peripheries. The major presenting clinical manifestations were; fever (100%), hepatosplenomegaly (100%), anemia (96.9%), abdominal distention and anorexia (84.4%). The IFAT test results were positive in 93.8% and the BM examination in 51.1% of the studied cases. All cases (except one) responded to Pentostam (Sodium Stibogluconate) treatment in a dose of 15mg/kg/day for 21 days.Conclusion : Kala-azar was found as a public health problem in Al-Fallujah and Al-Ramadi, the largest two districts of Al-Anbar governorate, affecting mainly the infants and children below 3 years age. The use of insecticides, Larvicides and reservoir control, the use of fine window sieves, and the medico-social education about the mode of transmission and role of sand flies, Jackals, dogs, slaughters and poultry farms in the transmission of the disease and their control are important measures for the reduction of the prevalence of this treatable morbid and mortal disease.


kala azar