Title: Cyto-Pathological Diagnosis of Post Kala-Azar Dermal Leishmaniasis (PKDL) in Tertiary Care Hospital, At Patna, Bihar
Authors: Dr Sunil Kumar, Dr C P Jaiswal, Dr Satyendu Sagar
Objective: Post–kala-azar dermal leishmaniasis (PKDL) has potential for transmission of visceral leishmaniasis (VL) in endemic population which is dermatosis after cure of VL. It has importance for public health problem for elimination of visceral leishmaniasis (VL). The aim of present study was to evaluate the cyto-pathological diagnosis of post kala-azar dermal leishmaniasis.
Material and Methods: A total of 122 patients attending in Medical and Skin & VD OPD for different PKDL lesions were included in study.
Result: Out of 122 patients, 102 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 (c2 = 5.72, P < 0.01). 33% of the VL patient’s development PKDL within one year of treatment. The appearance of lesions and diagnosis is an important factor in VL transmission. There was a significant association between type of lesions and duration of appearance after VL treatment (c2 = 6.59, P = 0.001). Diagnosis of PKDL is still difficult in the field condition; however in tertiary care centres NMCH Patna demonstrated presence of LD bodies in macular lesion 39% and papulo-nodular 100%.
Conclusion: Majority of macular lesions were still undiagnosed even by advanced techniques which can hamper the national elimination programme for VL. India is a developing country and has high endemicity of VL particularly north Bihar, which contributes more than 80% of total VL and PKDL of India. Most sophisticated tests available today for the diagnosis of PKDL have their own challenges like lack of limited resources, lack of skills, lack of interpretations, lack of infra-structures; poorly contribute to diagnosis and delay the treatment among poor populations.