[leish-l] leishmaniasis - afghanistan

[Fred R. Opperdoes]

At 19:06 -0400 9/9/03, ProMED Digest wrote:
>Date: Tue, 9 Sep 2003 17:58:36 -0400 (EDT)
>From: ProMED-mail <promed at promed.isid.harvard.edu>
>Subject: PRO/EDR> Leishmaniasis - Afghanistan
>
>LEISHMANIASIS - AFGHANISTAN
>********************************
>A ProMED-mail post
><http://www.promedmail.org>
>ProMED-mail, a program of the
>International Society for Infectious Diseases
><http://www.isid.org>
>
>
>Date: 9 Sep 2003
>From: Richard Reithinger <rreithinger at yahoo.co.uk>
>Source: HealthNet International (HNI) [edited]
>
>
>High prevalence of Leishmaniasis in Afghanistan
>- -------------------------------------------
>The Dutch non-governmental organization HealthNet International (HNI) has
>carried out a cutaneous leishmaniasis (CL) prevalence survey in the city of
>Faizabad, Badakshan province, Afghanistan, which showed that 152/1832 (8.3
>percent) of  surveyed people had CL lesions.
>
>Based on Faizabad population estimates of 65 000 people and observed CL
>prevalence, it is estimated that there are approximately 5400 CL cases in
>Faizabad. It was also shown that 142/1832  (7.8 percent) of surveyed people
>had CL scars. The low prevalence of CL scars, compared with the high
>prevalence of disease, shows that CL has been introduced into Faizabad only
>recently; indeed, records by the local Ministry of Health show that the
>disease was virtually unknown [<50 annual cases] in Badakshan in 2000.
>
>Though no attempts were made to identify the species of circulating
>Leishmania, it appears that current epidemic is due to _L. tropica_,
>because of the clustering of cases and because both sexes are equally
>affected. In Afghanistan, the majority of CL cases are caused by _L.
>tropica_, which is transmitted anthroponoticically by the sandfly
>_Phlebotomus sergenti_. Though non-fatal, CL can have devastating effects
>on local communities due to its clinical symptoms, i.e., large and/or
>multiple disfiguring lesions, which can lead to social ostracism of
>affected individuals.
>
>Recent data on the burden of CL in Afghanistan has only been available for
>Kabul city, where studies carried out by the non-governmental organization
>HealthNet International (HNI) have reported an estimated 67 500 cases. HNI
>has now set up 3 leishmaniasis clinics in Faizabad (i) to increase the
>total number of patients diagnosed and treated; (ii) to reduce the risk to
>susceptible individuals through the distribution of insecticide-impregnated
>bed-nets; (iii) to train and supervise the Ministry of Health staff in
>diagnosis, treatment and prevention; and (iv) to implement health education
>campaigns, both for patients attending the clinics as well as the community
>at large.
>
>- --
>Richard Reithinger, PhD
>Technical Consultant
>Malaria & Leishmaniasis Control Programme Afghanistan
>HealthNet International
>11 - A Circular Lane, PO Box 889,
>University Town, Peshawar, Pakistan.
><http://www.healthnetinternational.org>
>
>[The report confirms the previous reports of a large epidemic of
>Leishmaniasis in Afghanistan, which came to light after the fall of the
>Taliban regime. In 2002, the WHO estimated 200 000 cases of cutaneous
>Leishmaniasis in Kabul alone:
><http://www.who.int/disease-outbreak-news/n2002/may/22may2002.html>
>
>Whether the estimate of 35 000 cases in the present report represents a
>true decline in prevalence -- or just the uncertainty of the estimates --
>remains to be seen. - Mod.EP]
>
>[see also:
>2002
>- ----
>Leishmaniasis - Afghanistan (07) 20020703.4662
>Leishmaniasis - Afghanistan (06) 20020629.4633
>Leishmaniasis - Afghanistan (05) 20020515.4212
>Leishmaniasis - Afghanistan (04) 20020523.4304
>Leishmaniasis - Afghanistan (03) 20020512.4178
>Leishmaniasis - Afghanistan (02) 20020511.4161
>Leishmaniasis - Afghanistan (Kabul): alert 20020508.4134
>1996
>- ----
>Infectious diseases - Afghanistan  19960802.1377]
>.......................mpp/ep/pg/mpp
>
>------------------------------