Pediatric Visceral Leishmaniasis in Albania: A Retrospective Analysis of 1,210 Consecutive Hospitalized Patients (1995–2009)

Albania is a developing country that is rapidly improving in social, economic and sanitary conditions. The health care system in still in progress and the impact of some infectious diseases remains poorly understood. In particular, little information is available on incidence, clinical features and response to treatment of visceral leishmaniasis (VL) in childhood. We performed a retrospective analysis of data recorded from 1995 to 2009 at the national pediatric reference hospital of Tirana where any child suspected for VL is referred for specific diagnosis and treatment. Epidemiology, clinical features and management of the disease were considered. The main findings can be summarized as follows: i) The incidence of the disease in Albanian children (25/100,000 in the age group 0–6 years) is much higher than in developed Mediterranean countries endemic for VL; ii) The disease is associated with poor sanitary conditions as suggested by the high rate of severe clinical features and frequency of co-morbidities; iii) The cheapest drug available for Mediterranean VL treatment (meglumine antimoniate) is highly effective (99% full cure rate) and well tolerated. Limitations were identified in the low standard laboratory diagnostic capability and unsatisfactory medical surveillance in less urbanized areas. An improvement is warranted of a disease-specific surveillance system in Albania

Hematological and biochemical features recorded in patients at admittance.

<p>Hematological and biochemical features recorded in patients at admittance.</p

Symptoms and signs of patients and data from physical examination.

1<p>More than one symptom and sign or clinical findings at physical examination could be present in the same patient.</p>2<p>Ecchymosis, petechiae, epistaxis, or bleeding in the sites of injection.</p

Incidence of adverse events recorded in 1,210 pediatric patients treated with meglumine antimoniate.

<p>Incidence of adverse events recorded in 1,210 pediatric patients treated with meglumine antimoniate.</p

Schematic map of Albania showing the stratification by district of cumulative VL cases diagnosed in children from 1996 through 2009.

<p>Schematic map of Albania showing the stratification by district of cumulative VL cases diagnosed in children from 1996 through 2009.</p