Leishmaniasis (Kala Azar)

如何获得Leishmaniasis (Kala Azar)？

Leishmaniasis is transmitted through the bite of infected female sand flies.  It is rarely transmitted through blood transfusions and needle sharing. 

易感性和抗性

Anyone can be infected with leishmaniasis. Lifelong immunity can occur against a particular species of leishmaniasis but may not protect against other forms.

症状是什么？

Leishmaniasis is characterized by the development of single or multiple sores. The symptoms of leishmaniasis vary based on the form of the disease. In the cutaneous (skin) form, skin ulcers develop on exposed areas, such as the face, arms and legs. These usually heal within months, but leave visible scars. This is the most common form of the disease. The diffuse cutaneous form produces many wide-spread skin ulcers and sores in the skin resembling those of leprosy. This form is probably due to an immune deficiency and is difficult to treat.

In the mucocutaneous form, the ulcers and sores destroy the mucous membranes of the nose, mouth and throat cavities and surrounding tissues. This form of leishmaniasis can deform, disable and completely destroy the nose and nasal cavities, leaving victims with severe emotional difficulties and rejection from society.

The visceral form (also called kala azar) affects multiple organs and is characterized by high fever, substantial weight loss, swelling of the spleen and liver, and anaemia. If left untreated, the disease can have a fatality rate as high as 100 percent within two years. 

预防措施

没有疫苗或药物可以预防这种感染。最好的预防措施是通过限制沙蝇最活跃的黄昏和黎明之间的户外活动来避免与沙蝇接触。可以通过在空调或遮蔽良好的房间里睡觉，穿上防护服并在裸露的皮肤上施加驱虫剂来进一步降低暴露的风险。

处理

Treatment for leishmaniasis varies depending on the form, but generally consists of drug therapies containing antimony (known as pentavalent antimonials), such as Pentostam, available in the USA or Glucantime, used in South America and other areas. Spontaneous healing of cutaneous leishmaniasis can occur, however, any leishmaniasis infection should be detected and treated promptly. 

Another drug, miltefosine (trade names Impavido and Miltex) is a broad-spectrum phospholipid antimicrobial drug that effectively kills the parasite. This drug became the first (and still the only prescribed) oral drug in the treatment of leishmaniasis. It can be administered orally and topically. Increasing resistance to this drug has been reported recently in India

In many parts of the world, some species of the parasite have become partially or fully resistant to antimony. Leishmaniasis in Kenya and India can be less responsive to this treatment than in Mediterranean countries. These cases may be treated with other drugs (amphotericin B or pentamidine) that are not used routinely due to their toxicity. 

药物

• 抗寄生虫药

它常见于哪里？

利什曼病的皮肤（皮肤）形式在中东、亚洲（特别是西南和中亚）、非洲（特别是热带地区和北非）和南欧被发现。它也在墨西哥、中美洲和南美洲的部分地区被发现。美国（得克萨斯州和俄克拉荷马州）发生了病例。大多数病例发生在阿富汗、阿尔及利亚、伊朗、伊拉克、沙特阿拉伯、叙利亚、玻利维亚、巴西、哥伦比亚和秘鲁。在智利、乌拉圭或加拿大没有发现。

利什曼病的内脏（身体器官）形式在亚洲部分地区（印度次大陆、西南和中亚）、中东、东非和南欧被发现。它也在巴西和拉丁美洲其他地方的分散的地方发现。大多数病例发生在印度、孟加拉国、尼泊尔、苏丹、埃塞俄比亚和巴西。