Trends in Post-Kala-Azar Dermal Leishmaniasis in Sudan: Cases, Ethnic Distribution, and Recovery.

Abstract

Post-kala-azar dermal leishmaniasis (PKDL) is a neglected tropical disease that can develop after treatment of leishmaniasis. It causes significant health risks and serves as a reservoir, perpetuating transmission. Current information on PKDL characteristics is crucial for effective disease management and control. This study aimed to describe clinical and epidemiological characteristics of PKDL patients in eastern Sudan. A retrospective cross-sectional study was conducted on suspected PKDL patients (N = 37) at a tertiary hospital in eastern Sudan. Blood samples were tested for anti-rK39 antibodies to confirm the diagnosis of the disease. Demographic, clinical, and epidemiological data of the PKDL patients were gathered and analyzed. Most PKDL cases (69.4%) came from specific locations involving one ethnic group (94.6%), mainly affecting young males (54.1%). A family history of PKDL was noted in only 27.0% of cases; 51.4% developed PKDL within 1 month after visceral leishmaniasis (VL) treatment. Most cases (56.8%) were grade 1 (a low level of parasitic load), predominantly featuring macular (51.4%), papular (18.9%), and nodular (13.5%) lesions. All patients had skin rashes; 91.9% exhibited no fever, and 29.7% reported itching. Lesions appeared within a month after VL treatment, with most patients recovering spontaneously within 3-18 months. PKDL was particularly prevalent in specific regions and ethnic groups, namely the Masaleet and Dago tribes. These findings can enhance PKDL understanding and management in the region.