Idris Muhammad, Farid Jamila, Gul Nasreen
Department of Pathology, Ayub Medical College, Abbottabad, Pakistan.
J Ayub Med Coll Abbottabad. 2018 Jul-Sep;30(3):342-344.
Visceral Leishmaniasis (Kala Azar), a vector borne parasitic disease is endemic in many parts of the world including South East Asia. It is a chronic febrile ailment caused by Leishmania Donovani (LD). More than three hundred million people living in the endemic areas are at high risk and fourteen million are living with the disease.
This prospective study was conducted on seventy-five patients over a period of twelve years at the department of Pathology Ayub Medical College Abbottabad, focusing on the morphology of bone marrow aspirate obtained from patients. The aspirate was smeared on glass slides, fixed with alcohol and stained with Giemsa stain. The microscopic examination of stained slides was carried out by the single microscopist to avoid the difference of opinion. The initial diagnosis was further confirmed by tow experienced microscopists.
A minor difference was observed in the number of male and female participants, 38 versus 37, with male to female ratio of 1.02:1. The majority of the patients were 1- 15 years old. As much as 45.2% patients were 1-5 years old. In this age group, males were affected more than the females with male to female ratio of 1.4:1. Most of the patients belonged to district Battagram and Tor Ghar. Bone marrow aspiration was easy and the marrow aspirate was found having marrow fragments on naked eye examination in majority of the patients. Extrahistiocytic LD bodies alone were seen in 100%, extra and intrahistiocytic in 80% and intrahistiocytic alone in 33.3% patients. The parasite index was 1-5 to 1-10 in 53.4% and 26.6% patients respectively.
Visceral Leishmaniasis is endemic in the study area. Bone marrow examination, although an invasive procedure, gives direct microscopic diagnosis of visceral Leishmaniasis and may be considered where indicated.
内脏利什曼病（黑热病）是一种由媒介传播的寄生虫病，在包括东南亚在内的世界许多地区流行。它是由杜氏利什曼原虫（LD）引起的慢性发热性疾病。生活在流行地区的超过3亿人面临高风险，1400万人患有这种疾病。
这项前瞻性研究在阿伯塔巴德阿尤布医学院病理科对75名患者进行了为期12年的研究，重点关注从患者身上获取的骨髓穿刺物的形态。将穿刺物涂抹在载玻片上，用酒精固定，并用吉姆萨染色。由一名显微镜检查人员对染色玻片进行显微镜检查，以避免意见分歧。最初的诊断由两名经验丰富的显微镜检查人员进一步确认。
观察到男性和女性参与者数量存在微小差异，分别为38人和37人，男女比例为1.02:1。大多数患者年龄在1至15岁之间。多达45.2%的患者年龄在1至5岁之间。在这个年龄组中，男性受影响的人数多于女性，男女比例为1.4:1。大多数患者来自巴塔格拉姆区和托尔加尔区。骨髓穿刺很容易，在大多数患者的肉眼检查中发现骨髓穿刺物有骨髓碎片。仅在100%的患者中看到组织外LD小体，在80%的患者中看到组织外和组织内LD小体，在33.3%的患者中仅看到组织内LD小体。寄生虫指数分别在53.4%和26.6%的患者中为1-5至1-10。
内脏利什曼病在研究地区流行。骨髓检查虽然是一种侵入性检查，但能直接对内脏利什曼病进行显微镜诊断，在有指征的情况下可以考虑进行。
