ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

Health Importance Of The Treatment Of Visceral Leishmaniasis (Kala-azar)

Updated on March 31, 2014

Kala Azar Alleviation Initiative In India


Treatment of Visceral Leishmaniasis

Suspected cases should be hospitalized. Nutritional supplements, maintenance of oral hygiene and treatment of secondary infection from the general treatment.

Specific drugs: Two groups of drugs are available- pentavalent antimonials are used more often but they are contrainidicated in patients with coexistent tuberculosis. Aromatic diamidines are preferable in resistant cases and those with coexistent tuberculosis. Jaundice, renal disease, and hemorrhages are contraindications for aromatic diamidines.

Though several antimonial compounds have been introduced from time to time, sodium stibogluconate and methyl glucamine antimoniate (Glucantime) are the drugs most commonly available and used now. Among the aromatic diamidines pentamidine is available in most of the African countries and India and used more. Hydroxystilbamidine is more effective, but it is not freely available.

Sodium stibogluconate (Solustibosan, Stibatin, Pentostam) is available for instramuscular injection containing 100 mg of antimony/ml. The drug is started with an initial dose of 5 mg/Kg body weight and followed by subsequent larger doses 10 to 15 mg/Kg body weight daily for 6 to 10 days to reach a total dose of 3.6 to 4g for an adult. Children are given only up to 300 mg/day and infants 200mg. The ten day course is repeated thrice with an interval of ten days in between. The drug does not produce cumulative toxicity.

Effects Of Visceral Leishmaniasis Treatment


Adverse Effects Of Treatment Of Visceral Leishmaniasis

Adverse side effects include sudden death, cough, chest pain, abdominal colic, pain in the arms, vomiting, faintness and collapse. Hypersensitivity reactions may develop after the sixth or seventh injection. Adrenaline should be available at hand to control them.

Delayed hypersensitivity reaction leads to fever, arthralgia and vague illhealth. Serious toxic effects may be evident in the heart and liver. Cardiac involvement manifests as reversible ECG changes, hypotension and bradycardia. In those with pre-existing liver disease, hepatic failure may develop.

Methyl glucamine antimoniate (Glucantime): The intitial dose is 5 ml for adults and 3 ml for children and infants. Subsequent doses are 15 ml for adults and 5 to 10 ml for infants and children. The injections are given intramuscularly on alternate days for a total course of 15 injections. Longest courses are necessary in resistant cases.

Pentamidine is available for intramuscular or intravenous injection in a maximum daily dose of 3 to 4 mg/Kg body weight. This full dose is reached after one or two smaller initial doses. Intravenous injections are given slowly after diluting the drug in 25 ml of 25% glucose in a syringe. For intramuscular injections, 10% solution in distilled water is used. Injections are given for fresh cases. This full course may be repeated at intervals of two weeks depending on the response. Adverse side effects include sudden hypotension and hypoglycemia. Hypotension can be corrected by hypodermic injection of 0.5ml adrenaline solution. Temporary diabetic state may follow a course of pentamidine. Local reaction at the site of injection may lead to fibrosis.

Hydrpxystibamidine is best administered intravenously, slowly in a dose of 3 mg/Kg dissolved in 25 ml of 25% glucose. Initial doses have to be smaller. The total course is the same as for pentamidine.

Effects Of Treatment Of Visceral leishmaniasis

Fever comes down with one or two courses and the patient improves. The spleen returns to normal in 3 weeks of treatment. Anemia and leucopenia also improve. All patients who achieve cure should be observed for at least six months to detect relapse early. After this period, they may be considered cured. Drug resistant Kala-azar may respond to amphotericin B in the usual dosage.

© 2014 Funom Theophilus Makama


    0 of 8192 characters used
    Post Comment

    No comments yet.


    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at:

    Show Details
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the or domains, for performance and efficiency reasons. (Privacy Policy)
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)