Basher A, Rashid M M, Habibullah A M, Nath R, Akter D, Chowdhury I H, Azim A, Nath P, Faiz M A
Dr Ariful Basher, Registrar, Infectious and Tropical Medicine, Mymensingh Medical College & Hospital (MMCH), Mymensingh, Bangladesh; E-mail:
Mymensingh Med J. 2019 Apr;28(2):328-332.
Post Kala-azar Dermal Leishmaniasis (PKDL) is the sequel of visceral leishmaniasis in Indian subcontinent and may appear among patients with or without previous history of visceral leishmaniasis (VL). The aim of the study is to understand the male reproductive safety profile of miltefosine used for the treatment of Post Kala-azar Dermal Leishmaniasis (PKDL) in Bangladesh. From January 2017 to March 2017, an exploratory study was carried out on male fertility capacity in Bangladesh among male patients above 14 years old with PKDL treated with miltefosine. Twenty nine male patients were included to observe the effect of miltefosine on reproductive health. All PKDL patients had history of visceral leishmaniasis (VL) in different time periods. Among them three (10.3%) patients were unable to ejaculate semen. In semen analysis, 3 patients (10.3%) were found azoospermia (sperm count & motility- 0, viscosity- good, pH- 7 to 8), microscopically there was presence of RBC (5-15/HPF), WBC (8-15/HPF). Another 3 patients (10.3%) were found oligospermia (sperm count- 4.2 to 15.3 million/ml, motility- 20 to 50%, viscosity- good, pH- 6 to 9, RBC- 4 to 15/HPF, WBC- 4 to 15/HPF). The study documented some important findings in evaluating male infertility and selection of drug regimens in treating PKDL patients with miltefosine for 12 weeks.
黑热病后皮肤利什曼病（PKDL）是印度次大陆内脏利什曼病的后遗症，可能出现在有或没有内脏利什曼病（VL）既往史的患者中。本研究的目的是了解在孟加拉国用于治疗黑热病后皮肤利什曼病（PKDL）的米替福新对男性生殖安全性的影响。2017年1月至2017年3月，在孟加拉国对14岁以上接受米替福新治疗的PKDL男性患者的生育能力进行了一项探索性研究。纳入了29名男性患者以观察米替福新对生殖健康的影响。所有PKDL患者在不同时间段都有内脏利什曼病（VL）病史。其中三名（10.3%）患者无法射出精液。在精液分析中，3名患者（10.3%）被发现无精子症（精子计数和活力为0，粘度良好，pH值为7至8），显微镜下可见红细胞（5 - 15/HPF），白细胞（8 - 15/HPF）。另外3名患者（10.3%）被发现少精子症（精子计数为420万至1530万/ml，活力为20%至50%，粘度良好，pH值为6至9，红细胞为4至15/HPF，白细胞为4至15/HPF）。该研究记录了在评估男性不育以及选择用米替福新治疗PKDL患者12周的药物方案方面的一些重要发现。
