LEISHMANIASIS - SUDAN
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A ProMED-mail post

Date: Thu, 22 Jan 1998 13:05:35 -0500
From: Dorothy Preslar
Source: Al-Sharee al-Siasi, 24 Dec 1997; Deutsche Presse-Agentur, 21 Jan 1998


A Khartoum newspaper reported in late Dec there had been 4000 cases of
leishmaniasis in the Eastern Sudan. On 21 Jan 1998, DPA reported on the
situation, quoting the health minister of the Gadarif state who provided
the same statistic, saying that cases had dramatically increased during
December and was "spreading at an alarming rate" in areas around the Atbara
and Rahad rivers.

Leishmaniasis, in the Sudan known in its worst [visceral] form as
Kala-azar, is a parasitic protozoan "wasting" disease, spread by the
sandfly, that can affect internal organs.

According to the health minister, the medicine for treating the disease is
scarce (some say unavailable) within the country. Further, Britain is
Sudan's only source for the medicine and does not manufacture it in large
quantities. [The current APHA communicable disease manual says that
Pentostam is available from the US CDC; the other effective drug is
Glucantime (antimony). Cases unresponsive to antimony may be treated with
amphotericin B or pentamidine.]

The minister said treatment for one patient costs 250,000 Sudanese pounds,
which is eight times the average monthly wages of a government employee.
There are reports of expired medicine being used.

The one treatment center that has been established, at Galabat province, is
attracting patients from other Sudanese states and from neighboring
Ethiopian districts. This has created an extra burden. The federal minister
of health, Ihsan al-Ghabshawi, has told the national parliament that her
ministry is not capable of launching a campaign against the disease.

However, Tariq Abdel- Karim of the Sudanese Green Medicine Society says
that he and his colleagues will be able to provide medication for the
kala-azar patients in eastern Sudan and indeed in any part of Sudan that
may be struck by the epidemic. This medication, a mixture of herbs, costs
50,000 pounds for one dose.

There are indications that the disease is also present in the Nuba mountain
region of central Sudan.