Quantitation of Amastigotes of Leishmania Donovani in Smears of Splenic Aspirates from Patients with Visceral Leishmaniasis

Jeffrey D. Chulay Clinical Research Centre, Kenya Medical Research Institute, U.S. Army Medical Research Unit-Kenya, Nairobi

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Anthony D. M. Bryceson Clinical Research Centre, Kenya Medical Research Institute, U.S. Army Medical Research Unit-Kenya, Nairobi

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DOI:
https://doi.org/10.4269/ajtmh.1983.32.475
Volume/Issue:
Volume 32: Issue 3
Page(s):
475–479
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During a 20-month period, more than 500 splenic aspirations were performed in 89 patients with suspected or proven visceral leishmaniasis. The two complications which occurred (intra-abdominal bleeding and penetration of the intestine in one patient each) both resolved with conservative management. Parasite density in splenic aspirate smears was graded on a logarithmic scale from 0 (no parasites in 1,000 microscopic fields) to 6+ (> 100 parasites per microscropic field). Among 46 newly diagnosed and 17 relapsed or drug-resistant patients with visceral leishmaniasis, the average initial parasite grade was 4.35 ± 0.92 (mean ± SD) and 4.15 ± 1.37, respectively. The grading system was useful in measuring the speed of response to treatment, and in distinguishing slow responders from nonresponders. This was especially valuable for managing patients with drug-resistant visceral leishmaniasis. The system also provided a means of comparing the efficacy of different treatment regimens, and for calculating the optimum duration of treatment.
Copyright:
Copyright © 1983 by The American Society of Tropical Medicine and Hygiene 1983
Accepted:
08 Oct 1982
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Published Online:
May 1983
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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