Leishmaniasis (Kala Azar)

您如何獲得Leishmaniasis (Kala Azar)？

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

易感性和抵抗力

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

有哪些症狀？

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. 

預防措施

沒有疫苗或藥物可以預防這種感染。最好的預防措施是通過限製沙蠅最活躍的黃昏和黎明之間的戶外活動來避免與沙蠅接觸。可以通過在空調或遮蔽良好的房間裡睡覺，穿上防護服並在裸露的皮膚上施加驅蟲劑來進一步降低暴露的風險。

治療

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. 

驗證

• 抗寄生蟲藥

通常在哪裡發生？

利什曼病的皮膚（皮膚）形式在中東、亞洲（特別是西南和中亞）、非洲（特別是熱帶地區和北非）和南歐被發現。它也在墨西哥、中美洲和南美洲的部分地區被發現。美國（德克薩斯州和奧克拉荷馬州）發生了病例。大多數病例發生在阿富汗、阿爾及利亞、伊朗、伊拉克、沙烏地阿拉伯、敘利亞、玻利維亞、巴西、哥倫比亞和秘魯。在智利、烏拉圭或加拿大沒有發現。

利什曼病的內臟（身體器官）形式在亞洲部分地區（印度次大陸、西南和中亞）、中東、東非和南歐被發現。它也在巴西和拉丁美洲其他地方的分散的地方發現。大多數病例發生在印度、孟加拉國、尼泊爾、蘇丹、埃塞俄比亞和巴西。