Iranian Journal of Parasitology 2014. 9(1):1-5.

Clinical Features and Laboratory Findings of Visceral Leishmaniasis in Children Referred To Children Medical Center Hospital, Tehran, Iran during 2004-2011.
Azam Tofighi Naeem, Shima Mahmoudi, Farah Saboui, Homa Hajjaran, Babak Pourakbari, Mehdi Mohebali, Mohammad Reza Zarkesh, Setareh Mamishi



Background: Visceral leishmaniasis (VL) is one of the most important parasitic diseases endemic in northwestern and southern areas of Iran. The aim of the pre-sent study was to review the records of children hospitalized with VL in order to characterize the clinical features of children as well as laboratory finding in Chil-dren Medical Center Hospital, Tehran, Iran.

Methods: The medical records of all children with a final diagnosis of VL were reviewed from 2004 to 2011. Demographic, clinical information, laboratory find-ing and treatment were considered.

Results: A total number of 34 children with confirmed VL through 2004-2011 were included in the study. The most prevalent sign and symptoms were fever (97.1%), pallor and weakness (97.1%), appetite loss (61.8%), splenomegaly (97.1%) and hepatomegaly (88.2%). The most frequent laboratory abnormalities were hematological including anemia (97.1%), thrombocytopenia (91.2%) and leukopenia (67.6%). Direct agglutination test (DAT) was performed in 23 cases and all of them showed anti-Leishmania antibodies with titers of ≥ 1: 3200. In addition, 90% of patients had positive rK39 results. Identification of Leishmania in the aspirates of the bone marrow was found in 83.3% of patients.

Conclusion: Regional surveillance system in order to monitoring of leishmania-sis trends as well as detection of new emerging foci is recommended.


Children; Iran; Visceral leishmaniasis

Full Text:



Maltezou HC. Drug resistance in visceral leish-maniasis. J Biomed Biotechnol. 2010;20-10:6175212.

Tiuman TS, Santos AO, Ueda-Nakamura T, Nakamura CV. Recent advances in leishmania-sis treatment. Int J Infect Dis. 2011;15: 525-532.

Braga ASdC, Toledo Junior ACdC, Rabello A. Factors of poor prognosis of visceral leishman-iasis among children under 12 years of age: A retrospective monocentric study in Belo Hori-zonte, state of Minas Gerais, Brazil, 2001-2005. Rev Soc Bras Med Trop. 2013;46:55-59.

Desjeux P. Leishmaniasis: Current situation and new perspectives. Comp Immunol Micro-biol Infect Dis. 2004;27:305-318.

Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, den Boer M. Leishmaniasis worldwide and global estimates of its incidence. PLoS One. 2012;7: 35671.

Postigo JAR. Leishmaniasis in the world health organization eastern Mediterranean region. Int J Antimicrob Agents. 2010;36 Suppl1: S62-5 7.

Fu Q, Li S-Z, Wu W-P, Hou Y-Y, Zhang S, Feng Y, Zhang L-P, Tang L-H. Endemic char-acteristics of infantile visceral leishmaniasis in the people's republic of china. Parasit Vectors. 2013;6:143.

Mondal D, Singh SP, Kumar N, Joshi A, Sundar S, Das P, Siddhivinayak H, Kroeger A, Boelaert M. Visceral leishmaniasis elimination programme in India, Bangladesh, and Nepal: Reshaping the case finding/case management strategy. PLoS Negl Trop Dis. 2009;3(1):e355.

Picado A, Dash AP, Bhattacharya S, Boelaert M. Vector control interventions for visceral leishmaniasis elimination initiative in south Asia, 2005-2010. Indian J Med Res. 2012;136(1):22-31.

Srividya G, Kulshrestha A, Singh R, Salotra P. Diagnosis of visceral leishmaniasis: Develop-ments over the last decade. Parasitol Res. 2012;110:1065-1078.

Mohebali M, Edrissian G, Nadim A, Hajjaran H, Akhoundi B, Hooshmand B, Zarei Z, Arshi S, Mirsamadi N, Naeini KM. Application of di-rect agglutination test (DAT) for the diagnosis and seroepidemiological studies of visceralleishmaniasis in iran. Iran J Parasitol. 2006;1(1): 15-25 12.

Ashkan MM, Rahim KM. Visceral leishmania-sis in pediatrics: A study of 367 cases in south-west Iran. Trop Doct. 2008;38:186-188.

Mohebali M. Visceral leishmaniasis in Iran: Review of the epidemiological and clinical fea-tures. Iran J Parasitol. 2013;8(3):348-358.

Babakhan L, Mohebali M, Akhoundi B, Edris-sian GH, Keshavarz H. Rapid detection of Leishmania infantum infection in dogs: A com-parative study using fast agglutination screening test (fast) and direct agglutination test (DAT) in Iran. Parasitol Res. 2009;105:717-720.

Hamzavi Y, Hamzeh B, Mohebali M, Ak-houndi B, Ajhang K, Khademi N, Ghadiri K, Bashiri H, Pajhouhan M. Human visceral leish-maniasis in Kermanshah Province, western Iran, during 2011-2012. Iran J Parasitol. 2012;7(4):49-56.

Mohebali M, Mamishi S, Desjeux P. Evalua-tion of rapid “dipstick rk39” test in diagnosis and serological survey of visceral leishmaniasis in humans and dogs in Iran. Arch Iran Med. 2003; 6 (1): 29 – 31

Mohebali M, Edrissian GH, Shirzadi MR, Ak-houndi B, Hajjaran H, Zarei Z, Molaei S, Shar-ifi I, Mamishi S, Mahmoudvand H. An obser-vational study on the current distribution of visceral leishmaniasis in different geographicalzones of Iran and implication to health policy. Travel Med Infect Dis. 2011;9:67-74.

Salahi-Moghaddam A, Mohebali M, Moshfae A, Habibi M. Ecological study and risk map-ping of visceral leishmaniasis in an endemic ar-ea of Iran based on a geographical information systems approach. Geospat Health. 2010;5:71-77.

Nadim A, Javadian E, Tahvildar-Bidruni Gh MM, Abaei M. Epidemiological aspects of ka-la-azar in Meshkin-Shahr, Iran: Investigation on vectors. Iranian J Publ Health. 1992;21:61-72.

Sundar S, Rai M. Laboratory diagnosis of vis-ceral leishmaniasis. Clin Diagn Lab Immunol. 2002;9:951-958.

Thakur C. Socio-economics of visceral leish-maniasis in Bihar (India). Trans R Soc Trop Med Hyg. 2000;94:156-157.

Chappuis F, Rijal S, Soto A, Menten J, Boelaert M. A meta-analysis of the diagnostic perfor-mance of the direct agglutination test and rk39 dipstick for visceral leishmaniasis. BMJ. 2006;333(7571):723.

Sundar S, Singh R, Maurya R, Kumar B, Chha-bra A, Singh V, Rai M. Serological diagnosis of indian visceral leishmaniasis: Direct agglutina-tion test versus rk39 strip test. Trans R Soc Trop Med Hyg. 2006;100:533-537.


  • There are currently no refbacks.

Creative Commons Attribution-NonCommercial 3.0

This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 Unported License which allows users to read, copy, distribute and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited properly.