Public health aspects of visceral leishmaniasis in Montenegro

Abstract

Leishmaniasis belongs to the parasitic communicable zoo noses, caused by members of Leishmania species.The infected phlebotomies sand fly carries the parasites, which cause the different forms of disease. Retrospective/prospective review of records for documented cases of visceral leishmaniasis (VL) in period from 1992 to 2012 in Montenegro shows 83 diagnostic cases, and 1 (1.20%) case with dermal leichmaniasis. with 3 (3.61%) deaths cases. Analyses of age show: 36 (43.37%) children and 47 (56.63%) adults. Examinations are based on epidemiological, clinical, hematological, patohystological and serological investigations. Infection can be sub-clinically or clinically manifested with acute, sub-acute, and chronic type. Incubation in clinically manifested infections ranges from several weeks to several months. In our study, the prevalence of general infective syndrome is registered in all of 83 manifested cases (100%). Enlarged spleen in 79 (95.18%) cases, enlarged liver in 37 (44.57%) cases, anemia in 49 (59.04%) cases, pancytopenia in 32 (38.55%) cases, and increased activity of serum aminotransferases in 37 (44.57%) cases. The diagnosis was confirmed by an analysis of bone marrow biopsy material by direct microscopy of serial sections colored by Romanowski and Giemsa s staining, and by immune-biochemical methods. Serological diagnostic is confirmed by using agglutination test. In Montenegro (in humans and dogs) two types of leishmania (L) (L. donovani, L. infantum were presented). As to therapy treatment, the common treating is with antimony drugs: glucantime is relatively satisfactory for a long time. During 2008 there were registered cases not responding to the therapy and those were manifested with relapses after therapy. In the first line of therapy, we used meglumine antimony (Glucantime) in 78 (93.97%) patients. Resistence developed in 7 (8.97%) during treatment, and relapse occurred in 5 (6.41%) patients. It was 1 (1.20%) patient treated with Miltefosine the one who had a relapse, and with Amphotericin B (Ambisome) 4 (4.82%) patients.

Human Vector-Borne Transmissible Parasitic Diseases in Montenegro

“…Based on epidemiological studies, the extension of endemic focus of leishmaniasis in our environment is evident, based on the number of registered cases in nonendemic areas of Montenegro. Veterinary studies of domestic and stray dogs from different parts of Montenegro confirmed their high level of infection with Leishmania parasites up to 83% [16].…”

“…Veterinary service does not have data on the prevalence of infections in dogs in Montenegro. Numerous human cases have been reported for the European Union [16,17,18,19]. In 1999, most reported cases originated from the Mediterranean area, where Dirofilaria spp.…”

Systematic Review: Re‐emergence of human leishmaniasis in the Balkans

“…76 cases originated from central parts of the country – Podgorica (most affected), Cetinje, Danilovgrad and Nikšić municipalities, and 6 cases occurred in mountain regions of Bijelo Polje, Berane, Plav and Rožaje municipalities [24]. In the 1992–2012 period 83 cases of VL were recorded [25]: 36 cases (43.37%) in children and 47 (56.63%) in adults.…”

Untitled

“…It is also thought to be endemic in Romania, Bosnia, Macedonia, Montenegro and Bulgaria (Diza, 2008;Tsatchev et al, 2010;Alvar et al, 2012;Andric et al, 2013;Mircean et al, 2014).…”