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Pakistan: Leishmaniasis Cases Almost Double

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    Posted: June 26 2018 at 12:10pm

Fears over disfiguring parasitic disease as cases double in northern Pakistan


Cases of a disfiguring parasitic disease have more than doubled in northern Pakistan with doctors saying they are left badly in need of drugs to treat victims.

Numbers of people detected with Leishmaniasis in Khyber Pakhtunwa province have jumped from 1,000 in the whole of 2017 to 1,700 cases in the first half of this year alone.

Better monitoring is starting to reveal the scale of the disease which is endemic in the province's remote districts and causes gruesome lifelong ulcers and scars on exposed parts of the body, officials said.

Bites from blood-sucking sandflies spread the disease as they move among people and animals carrying amoeba-like microbes in their gut.

The most dangerous form of Leishmaniasis, which occurs elsewhere in the world, kills without treatment. While gaining less attention than some other diseases, Leishmaniasis is the world's second most deadly parasitic infection.

Health officials in Peshawar said the preferred drug for treating victims was not available in Pakistan and the province was reliant on doses supplied by international organisations including Doctors Without Borders (MSF) and the World Health Organisation (WHO).

One feature of this is that it leaves a sore on exposed parts of the body. It affects all ages, but mostly the working classDr Pervez Khan

Dr Ayub Rose, director of health services in the province, told the Telegraph: “We are terribly in need of drugs to control the disease. The shortage of drugs is the main issue that we are facing. The increase in detection of cases is also due to improved monitoring and surveillance in all the endemic districts and tribal areas due to which we are reporting more cases.

“Injection of glucantime is the only drug of choice for its treatment which is not available in Pakistan.

“We have been urging the government to register the same drug in Pakistan so it could be provided to the patients. We also want the Drug Regulatory Authority of Pakistan (DRAP) to start its production locally because the disease is endemic in the country and we need its uninterrupted supply.”

The WHO has supplied 1,100 injections to hospitals in the worst affected districts in recent months and MSF has given 450.

The disease is closely linked to poverty and poor nutrition. Ulcers often develop on exposed limbs and the face and Dr Rose said girls and women were often most badly affected by any disfigurement.

He said: “The disease is a source of problems for females because it leaves lesions on the skin which cause them social problems.”

Dr Pervez Khan, of MSF in Peshawar, said: “One feature of this is that it leaves a sore on exposed parts of the body. It affects all ages, but mostly the working class.”

The local government last month set up a 10-bed provincial referral centre in Peshawar and Dr Rose said officials were trying to improve monitoring of the disease. He said there was also a need for an awareness campaign to persuade people to use bed nets and avoid sandfly bites.

Worldwide there are an estimated 700 000 to 1 million new cases of Leishmaniasis each year. Most people are struck by the cutaneous form found in Pakistan, but around 20 000 to 30 000 die elsewhere from the visceral form, also known as kala-azar, which attacks the liver and spleen.


At a glance | Leishmaniasis

  • There are 3 main forms of leishmaniases – visceral (also known as kala-azar and the most serious form of the disease), cutaneous (the most common), and mucocutaneous.
  • Leishmaniasis is caused by the protozoan Leishmania parasites which are transmitted by the bite of infected female phlebotomine sandflies.
  • The disease affects some of the poorest people on earth, and is associated with malnutrition, population displacement, poor housing, a weak immune system and lack of financial resources.
  • Leishmaniasis is linked to environmental changes such as deforestation, building of dams, irrigation schemes, and urbanisation.
  • An estimated 700 000 to 1 million new cases and 20 000 to 30 000 deaths occur annually.
  • Only a small fraction of those infected by Leishmania parasites will eventually develop the disease.

Source: World Health Organization

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