Leishmaniasis is a parasitic disease whose area of ​​distribution is the tropics, subtropics and southern Europe. In our country, the foci of the disease are the southern border regions.

The disease is caused by Leishmania parasites, which are spread by sandflies. In Bulgaria, however, the main vector and source of deworming are people and some mammals such as dogs, foxes and jackals who have fallen ill.

There are several forms of the disease in humans, and the most common of them are cutaneous, which causes the formation of skin wounds, and the visceral form, which affects some internal organs, usually the spleen, liver liver and bone marrow.

What are the symptoms?

Cutaneous leishmaniasis

In some people, parasitosis occurs without any symptoms or signs. People who develop clinical symptoms develop one or more skin sores. Sores can change in size and shape over time.

At first, the sores look like papules or nodules and then turn into volcano-like ulcers with raised edges and a crater in the middle. Crusts may form on the wounds.

The sores are usually painless, but they may be painful if the lymph nodes are located near the sores, for example under the arm if the sores are on the shoulder or arm.

Visceral leishmaniasis

This form of the disease is also asymptomatic in some people. And in people who develop symptoms, they are most often fever, weight loss, enlargement or swelling of the spleen and liver fraction.

It is possible that infected people have a reduced number of blood cells, for example red blood cells /anemia/, white blood cells /leukopenia/ and platelets /thrombocytopenia/.

What are the potential complications?

With the skin form, the possible complications are:

• Bleeding;
• Other infections due to a weakened immune system, which may be fatal.
• Disfigurement;

The visceral form is often fatal. However, death often occurs as a result of complications rather than the disease itself. People with AIDS are at a very high risk of developing complications and also often do not respond positively to the treatment administered.

Treatment of leishmaniasis

Treatment is with antiparasitic drugs such as amphotericin B. In the cutaneous form, ulcers often heal on their own, but this can take months and leave unsightly scars.

And that is why the treatment can speed up healing and contribute to the reduction of scars, it will also prevent the development of complications. When facial wounds have caused disfigurement, plastic surgery is resorted to.

The visceral form of the parasitosis in all cases requires treatment, and several drugs are used for this purpose. Preparations containing antimony compounds, such as meglumine antimonate and sodium stibogluconate, are most often applied.

Is it possible to protect ourselves?

There are no approved vaccines and drugs that can be administered prophylactically. The only way to prevent the disease is to protect yourself from being bitten by a sand fly or from contact with an infected person or animal.

To be bitten by a sand fly you must:

• Wear clothing that covers as much skin as possible. It is recommended to wear long-sleeved blouses or shirts that are tucked into the trousers, and longer socks if possible.
• Use insect repellents on exposed skin and at the edges of pants and sleeves. The most effective repellants contain diethyl-meta-toluamide, better known as DEET.

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