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Clinical Epidemiologic Profile of a Cohort of Post–Kala-Azar Dermal Leishmaniasis Patients in Bihar, India
Post–kala-azar dermal leishmaniasis (PKDL) has important public health implications for transmission of visceral leishmaniasis (VL). Clinical and epidemiologic profiles of 102 PKDL patients showed that median age of males and females at the time of diagnosis was significantly different (P = 0.013). A significant association was observed between family history of VL and sex of PKDL patients (χ2 = 5.72, P < 0.01). Nearly 33% of the patients showed development of PKDL within one year of VL treatment. The observed time (median = 12 months) between appearance of lesions and diagnosis is an important factor in VL transmission. A significant association was observed between type of lesions and duration of appearance after VL treatment (χ2 = 6.59, P = 0.001). Because PKDL was observed during treatment with all currently used anti-leishmanial drugs, new drug regimens having high cure rates and potential to lower the PKDL incidence need to be investigated.
Author Notes
Authors' addresses: Vidya Nand Rabi Das, Krishna Pandey, and Naresh K. Sinha, Division of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, Bihar, India, E-mails: drvnrdas@yahoo.com, drkrishnapandey@yahoo.com, and naresh_kumarsinha@yahoo.com. Alok Ranjan, Department of Epidemiology and Biostatistics, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, Bihar, India, E-mail: aranjan30@yahoo.com. Dharmendra Singh, Sushmita Das, and Pradeep Das, Division of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, Bihar, India, E-mails: singhd72@yahoo.co.in, sushmita.de2008@gmail.com, and drpradeep.das@gmail.com. Neena Verma, Division of Pathology, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, Bihar, India, E-mail: verma_neena@yahoo.com. Chandra S. Lal, Division of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, Bihar, India, E-mail: drcslal@sify.com. Rakesh B. Verma and Niyamat A. Siddiqui, Department of Biostatistics, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, Bihar, India, E-mails: rbihariverma@yahoo.com and niyamatalisiddiqui@yahoo.com.