Leishmaniasis in Sindh, Pakistan: outbreak and review of the literature

Background Cutaneous leishmaniasis (CL) is endemic in Pakistan and is widely spreading day by day. Earlier, we proposed that leishmaniasis is endemic in Jacobabad, Dadu and Larkana districts of Sindh Province. It was pointed out that the disease is dramatically spreading in the country and warned that if the preventive measures were not taken at right time there would be a serious public health problem in the country. Since then, we have regular watch on the disease.Objective Fresh clinical observations of CL patients who visited our department from 2004 to 2005.Patients and methods This study was conducted in the Department of Dermatology, Chandka Medical College Larkana. A total of 1640 cases of CL were seen during this period.Results Among the 1640 patients, 470 were residents of different cities of Balochistan Province; and 1170 were the residents of different cities of Sindh Province like Jacobabad, Ratodero, Shahdadkot, Qambar, Warah, Mehar, Dadu, Dokri and Larkana. All the patients were aged between 3 months and 60 years. Seven hundred eighty were males and 860 were females. Duration of the disease ranged from 1 to 12 months. Most of the patients had single lesions but multiple lesions were also seen on the exposed (mainly) and unexposed parts of the body. Clinically, the lesions were classified as dry ulcerative, wet ulcerative, dry papular, nodular, and crusted lesions. Diagnosis was made on the basis of smear test and clinical presentation of the skin lesions. All the cases were treated with the meglumine antimoniate 600 mg/day (adults) and 15 mg/kg/day (children) either intramuscularly for 20 consecutive days or intralesionally for 10 alternate days.Conclusion Cutaneous leishmaniasis is endemic in the Sindh Province. The molecular characterization and other studies are needed for further evaluation of this disease