Cutaneous Leishmaniasis in Karachi

Abstract

Background Cutaneous leishmaniasis (CL) is an infection caused by a protozoan parasite of the genus Leishmania, which is endemic in various parts of Sindh and Baloachistan and is widely spreading day by day.

Objective: To know the frequency of Cutaneous Leishmaniasis in the dermatology OPD and ward of JPMC, Hospital, Karachi. These patients were sent to microbiology Department, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre, Karachi, for observing Amastigotes (LD Bodies) by microscopy to diagnose the cases.

Study Design:  Experimental study.

Place and Duration: This study was carried out in the Department of Microbiology at BMSI, JPMC, Karachi, from November 2003 to April 2004.

Materials and Methods: The suspected cases of Cutaneous Leishmaniasis on clinical ground were sent by the dermatology OPD and ward of JPMC, Hospital, wounds were cleaned by the alcohol (spirit) swab. The  smear prepared  from  the skin  ulcer tissues  were  stained  with  Field  Stain  A  and  B for  microscopy to confirm the diagnosis by detecting Amastigotes (LD Bodies).

Results:  The total of 67 suspected patients with skin lesions were examined and 42 were found to be suffering from CL, on the basis of observing Amastigotes (LD Bodies) by microscopy. Their ages ranges from 2years to 58 years. Among these cases 29 (69.04%) were males and 13 (30.96%) were females.  Multiple lesions were seen in 16 (38.10%) cases only. Size of lesion varies from 1-10cms. Body distribution were 16 (38.10%) on upper limbs, 13 (30.95%) on lower limbs, followed by 2 (4.76%) head, 3 (7.15%) neck, 4 (9.53) face and 2 (4.76%) nose, 1(2.38%) trunk and abdomen 1 (2.38%). Morphological patterns seen were crusted plaques, non-healing ulcers, erythematous infiltrated nodules and papules. From above morphological forms 25 (59.14%) were wet type of lesions and 17 (42.86%) were dry type of lesions Majority of the cases were from the rural area 32 (76.19%) as compared to 10 (23.81%) urban area of the city.

Conclusion: Cutaneous leishmaniasis is endemic and increasing in Karachi and its surrounding area.