Leishmaniasis is a parasitic disease spread from rodents by the bite of infected sand flies. Sand flies become infected by biting an infected animal (for example, a rodent or dog) or person. Since sand flies do not make noise when they fly, people may not realise they are present. Sand flies are very small and may be hard to see; they are only about one-third the size of typical mosquitoes. Sand flies usually are most active in twilight, evening, and nighttime hours (from dusk to dawn).
Manifestations: There is three different expression of the disease. These are characterised by their geographic occurrence and symptoms:
Leishmania cutanea is a benign disease. This which causes skin sores. The sores need up to several years to heal. This disease occurs in:
India
Western Asia
Africa
Leishmaniasis braziliensis is more serious. This form spreads to bones. This form occurs in:
South America
Central America
Leishmaniasis viscerale (kala azar) is a serious disease, which untreated, will cause death in about 70% of infected people. The symptoms are
Fever
weight loss
enlarged spleen
enlarged liver (usually the spleen is bigger than the liver)
swollen glands
Diarrhoea
Diagnose and treatment: The parasite is demonstrated in the sore or in blood. Treatment is available.
Prevent Leismaniasis by:
Stay in well-screened or air-conditioned areas as much as possible.
Avoid outdoor activities, especially from dusk to dawn, when sand flies are the most active.
When outside, wear long-sleeved shirts, long pants, and socks. Tuck your shirt into your pants.
Apply insect repellent on uncovered skin and under the ends of sleeves and pant legs. Follow the instructions on the label of the repellent. The most effective repellents are those that contain the chemical DEET (N,N-diethylmetatoluamide). The concentration of DEET varies among repellents. Repellents with DEET concentrations of 30-35% are quite effective, and the effect should last about 4 hours. Lower concentrations should be used for children (no more than 10% DEET). Repellents with DEET should be used sparingly on children from 2 to 6 years old and not at all on children less than 2 years old.
Spray clothing with permethrin-containing insecticides. The insecticide should be reapplied after every five washings.
Spray living and sleeping areas with an insecticide to kill insects.
If you are not sleeping in an area that is well screened or air-conditioned, use a bed net and tuck it under your mattress. If possible, use a bed net that has been soaked in or sprayed with permethrin. The permethrin will be effective for several months if the bed net is not washed. Keep in mind that sand flies are much smaller than mosquitoes and therefore can get through smaller holes. Fine-mesh netting (at least 18 holes to the inch, some sources say even finer) is needed for an effective barrier against sand flies. This is particularly important if the bed net has not been treated with permethrin. However, it may be uncomfortable to sleep under such a closely woven bed net when it is hot.
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