[Leish-l] FW: PRO/AH/EDR> Leishmaniasis, visceral - South Sudan (JO, UN)

Tue Apr 10 17:49:31 BRT 2012

From: ProMED-mail <promed at promed.isid.harvard.edu>

Date: 2011/11/11
Subject: PRO/AH/EDR> Leishmaniasis, visceral - South Sudan (JO, UN)
To: promed-ahead-edr at promedmail.org

LEISHMANIASIS, VISCERAL - SOUTH SUDAN (JONGLEI, UPPER NILE)

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A ProMED-mail post

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Date: Thu 10 Nov 2011

Source: NaTHNaC [edited]

<http://www.nathnac.org/pro/clinical_updates/leishmaniasis_ssudan_041111.htm>

Visceral leishmaniasis in the Republic of South Sudan

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In September 2009, an outbreak of visceral leishmaniasis was reported

in the states of Upper Nile and Jonglei which are now part of the

newly formed country of the Republic of South Sudan. Since this time

the outbreak has continued with increased numbers of cases and has

spread to the states of Eastern Equatoria and Unity [1].

As of 28 October 2011, more than 18 000 cases and 720 deaths have been

reported since the outbreak began. A total of 7827 cases have been

reported in 2011 which is an increase over 2010 case numbers [1,2].

The World Health Organization (WHO) estimates that the number of

deaths is likely to be under-reported due to the lack of a cohesive

infrastructure and the prevalence of remote communities [2]. This is

further complicated by thousands of people returning from northern

Sudan to settle in endemic areas of the Republic of South Sudan.

Insecurity in the affected states restricts access to health care and

treatment, and malnutrition, poor housing, mosquito net shortages, and

environmental changes escalate the problem [1]. There is concern that

thousands of lives will be at risk during the peak transmission season

through December [1].

WHO is supporting the Republic of South Sudan's health authorities

through provision of drugs, laboratory diagnosis, training of health

staff, and by developing an integrated management strategy to guide

vector control [1].

In order to ensure that treatment sites receive essential supplies

during the rainy season, when roads are impassable, boats are being

made available to facilitate movement of medical supplies [1].

Visceral leishmaniasis

----------------------

Visceral leishmaniasis is caused by parasitic protozoa of the genus

Leishmania. The parasite is transmitted via the bite of infected

sandflies. In advanced infection, symptoms include: fever, weight

loss, enlargement of the liver and spleen, anaemia if not treated.

Visceral leishmaniasis has a mortality rate of 95 percent [1].

Advice for travelers

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Travelers to and persons returning to live in the Republic of South

Sudan should follow good insect bite avoidance, particularly between

dusk and dawn. Sandflies are small enough to pass through standard

mosquito nets. However, mosquito nets impregnated with permethrin are

usually effective. There no vaccine against any type of

leishmaniasis.

References

----------

1. World Health Organization Republic of South Sudan. Thousands of

South Sudan people suffer from kala azar epidemic as cases rise. World

Health Organization 28 October 2011. [Accessed 4 November 2011].

Available at:

<http://www.who.int/hac/crises/sdn/releases/28october2011/en/>

2. United Nations News Centre. Deadly outbreak of kala-azar continues

in South Sudan, UN agency says. 28 October 2010, [Accessed 4 November

2011]. Available at:

<http://www.un.org/apps/news/story.asp?NewsID=40232&Cr=South+Sudan&Cr1>

--

Communicated by:

ProMED-mail from HealthMap alerts

<promed at promedmail.org>

[Sudan, including Southern Sudan, is endemic of leishmaniasis.

Leishmaniasis is spread by sandflies. The main reservoir is dogs and

the main vectors are _Phlebotomus papatasi_ and _P. orientalis_

(Dereure J et al. Visceral leishmaniasis in eastern Sudan: parasite

identification in humans and dogs; host-parasite relationships.

Microbes Infect. 2003;5:1103-8).

Leishmaniasis is a chronic infection with a high mortality in

untreated cases. Malnutrition is a main contributing factor to

clinical disease. Leishmaniasis is also a HIV related disease, but HIV

infection rates are low in South Sudan (Rai RK et al. Prioritizing

Maternal and Child Health in Independent South Sudan. Matern Child

Health J. 2011 Sep 30. [Epub ahead of print]). HealthMap location:

<http://healthmap.org/r/1qzq> - Mod.EP]

[see also:

2009

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Leishmaniasis - Sudan: (southern)  : 20091107.3851

2003

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Leishmaniasis - Sudan (03) 20031228.3152

2002

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Leishmaniasis - Sudan (02) 20021117.5835

Leishmaniasis - Sudan 20021110.5767

Early warning network (EWARN) - Sudan (south) 20020126.3399

2000

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Leishmaniasis, visceral - Kenya (Wajir) 20000625.1048

Leishmaniasis, visceral - Kenya (Wajir) (02) 20000626.1053

Leishmaniasis, visceral - Kenya (Wajir) (03) 20000705.1113

Leishmaniasis, visceral - Kenya (Wajir) (04) 20000714.1165

Leishmaniasis, visceral - Kenya (Wajir) (05) 20000825.1421

Leishmaniasis, visceral - Kenya (Wajir) (06) 20000828.1439

1997

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Leishmania/HIV co-infections 19970222.0427]

.................................................sb/ep/dk

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