Visceral leishmaniasis complicated by secondary bacterial infections in Iraqi Kala-Azar

Kala-azar is a vector borne parasitic disease endemic in Iraq. This disease is complicated by secondary bacterial infections which may lead to death. The study was carried out to detect the bacterial infections associated with kala-azar and the effective treatment. Collection of blood, urine, stool and ear exudate specimens from 63 proved kala-azar patients. The bacterial isolates from the specimens were subjected to antibiotics sensitivity test. 63 [46.7%] of 135 hospitalized children with visceral leishmaniasis, developing 102 episodes of infections. The sites of these infections were urinary tract 46 [45.1%], lower respiratory tract 37[36.3%], gastrointestinal 10[9.8%] and middle ear 9[8.9%]. Both Gram negative and Gram positive bacteria were isolated. Most of the isolated bacteria belong to the family Enterobacteriaceae. The antibiotics gentamicin, amikacin and co-trimoxazole were the most effective. Bacterial infections were common among hospitalized children with kala-azar. The commonest were Gram negative bacteria of the family Enterobacteriaceae

Evaluation and comparison of immunchromatography and immunofluorescent techniques in diagnosis and epidemiological studies in Iraqi Kala-Azar

Infantile kala-azar is an endemic protozoal disease prevalent among children in Iraq. A rapid diagnostic laboratory tests are required for immediate treatment. A prospective study was conducted in two pediatric hospitals in Baghdad during the period from Oct. 2005 to Sept. 2006 to evaluate the efficiency of immunochromatography strip test [IC] with rK39 antigen compared to indirect fluorescent antibody test [IFAT] for serodiagriosis of visceral leishmaniasis [VL] to investigate its use for epidemiological studies in Iraqi kala-azar. The study included 54 proved cases for Leishmania donovani [L.D.] bodies in bone marrow, 108 clinically diagnosed cases, 38 with diseases other than VL [tuberculosis, acute amoebic dysentery, urinary schistosomiasis, brucellosis, toxoplasmosis and malaria] and 24 healthy controls. In addition of 3000 patients presented with fever, anaemia and hepatosplenomegaly. The highest sensitivity of the sera was obtained by IC [92.6%] and by IFAT [96. 3%], and the highest specificity by IC [100%] and by IFAT [86.8%]. In the epidemiological study with rK39 strip test 66.1% positive reactions were obtained in patients with fever, anaemia and hepatosplenomegaly. IC strip test with rK39 antigen was more easy to perform but less sensitive than IFAT and the former was more specific than the latter