Emerging visceral leishmaniasis patients in mid Southern Himalayan region – A public health concern

• DOI: 10.4103/jvbd.jvbd_231_24
• Publication Date: 2025-05-19T08:02:31Z
• Authors: Shivnarayan Sahu; Prasan Kumar Panda; YP Mathuria; Yogesh Arvind Bah...

Background & objectives: Visceral Leishmaniasis (VL, Or Kala-azar) is a potentially lethal vector-borne disease caused by intracellular protozoa of the genus Leishmania, serve as primary reservoir; traditionally endemic to Bihar, Jharkhand, West Bengal, and Eastern Uttar Pradesh Indian states along river belts, has recently been observed in past few years tertiary care teaching hospital located Himalayan region (non-endemic, Uttarakhand). This study was done identify clinical features, demographics, complications risk factors involved patients non-endemic hospital. Methods: retrospective with present-day follow-up all on VL who were admitted from Jan 2018 2024. Diagnosis established rK 39 antigen test and/or Leishman-Donovan (LD) bodies bone marrow examination. The laboratory data, duration stay outcomes, associated collected proforma analysed. Factors (Uttarakhand) above Rishikesh (>1120 feet sea level) analysed using Chi-square. Results: Male constituted 92% population which 67% this middle Southern Himalaya (Uttarakhand). Risk such residence rural area (p = 0.47), near vegetation 0.12), poor household characteristics 0.073), low educational status nearby water body sewage or garbage disposal 0.241), insect bites 0.040) emergence. Fever (100%) malaise most common symptoms presented followed pain abdomen (29%). Pallor Splenomegaly abnormality identified examination hepatomegaly (83%). Anemia (100%), leukopenia (100 %) biochemical detected thrombocytopenia (79%), acute liver injury (63%), hemophagocytic lymphohistiocytosis (HLH) (58%). diagnosed rK39 (67%), LD (67%) both positive 29% patients. Mortality seen 17 % secondary sepsis (75%) one case post-discharge due unknown reasons. Interpretation conclusion: emerging found have higher mortality organ involvement (hepatomegaly) compared non-Himalayan region. Govt should initiate surveillance program before declaring elimination/eradication.