[Visceral leishmaniasis: clinical and epidemiological features among children and adolescents in Georgia].

The aim of the study was to describe the clinical and epidemiological features of children and adolescents with visceral leishmaniasis in Georgia. We performed a retrospective analysis of demographic, clinical and laboratory data from children and adolescents under age of 18 (n=200) with visceral leishmaniasis admitted to the referral center -- Tbilisi S. Virsaladze Institute of Parasitology between 2000 and 2005. Diagnosis was based on detection of amastigotes in the bone marrow punctate. Age ranged from 4 months to 15.9 years, the average age was 2.79+/-0.17 years. There were 84 girls and 116 boys. 190 cases came from Eastern Georgia (123 from the capital), 10 cases -- from Western Georgia. The period between manifestation of first clinical signs of the disease and admission to the referral center varied from 1 week to 1 year (6.8+/-0,6 weeks in average). Main clinical and laboratory presentations were splenomegaly and hepatomagaly, anemia, pancytopenia (84.5%). Among associated diseases, the most frequent were bronchitis and pneumonia (7.0%) and jaundice (3.5%). In all patients glucantime was used for treatment. One patient died. Visceral leishmaniasis can be considered as an important etiological agent of the fever of unknown origin in Georgia, particularly in Eastern Georgia and in children under six. Health care workers should be trained for the early recognition and appropriate management of visceral leishmaniasis and its complications.