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Diagnosis of Leishmaniasis (Kala-Azar)
Diagnosis of leishmaniasis follows elicitation of a detailed history, especially details about a recent travel, and physical examination. The symptoms are enquired into.
Samples of affected tissue are examined for the parasite under a microscope, in cultures, and through other means. A biopsy sample and aspirate is obtained from the margin of the skin lesion, spleen or bone marrow and the sample is spread on a slide and stained with Leishman's or Giemsa's stain (pH 7.2) for about 20 minutes. It is then visualized for Leishman-Donovan bodies or amastigotes. Amastigotes are small, round bodies 2-4ìm in diameter with indistinct cytoplasm, a nucleus and a small rod-shaped kinetoplast.
The leishmanin skin test, also known as the Montenegro test is widely used in some areas.
Blood tests are performed also to detect antibody (an immune response) to the parasite. This is helpful in diagnosing visceral leishmaniasis. Massively enlarged spleen and liver are hallmarks of a classic case of visceral leishmaniasis.
It should be noted that laboratory tests may even be negative in a person with leishmaniasis.
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Kala azar is highly suspected to be prevalent in NAGALAND, INDIA in both forms; Cutaneous and Visceral; Lack of Diagnostic Kits and knowledge of those Doctors at Kohima and Dimapur where most patients come for treatment is a problem.Most of them are ignorant of Kala azar. The State NVBDCP needs to gear up its resources for case detection. Few cases are suspected to be having Cutaneous Leishmaniasis,Few or one was recently confirmed of VL other forms cannot be ruled out. Kala azar is the 5th/6th most fatal parasitic disease.Experienced Doctors need be posted at State run major hospitals under HFW with a purpose to identify,diagnose and treat these fatal vector borne disease.They can be trained later in the process in ADVANCED Degree or DIPLOMA courses and also in TROPICAL medicine particularly Doctors with Public Health background like; DPH,DMCW these are time tested courses relevent in the present context, they are newly regulated as well- i.e. advantage, Nagaland.One thing is for sure there is KALA AZAR cases in Nagaland.