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| Author | Dr. A Amato Gauci MD, MSc |
| Abstract | Visceral Leishmaniasis (Kala-Azar) caused by Leishmania infantum, has been recognized as a significant cause of morbidity and mortality in children since the turn of the century. A post-war declining trend in notified cases has not been sustained. A steady increase in new cases has been observed over the last decade. Cutaneous Leishmaniasis has only recently been described in Malta. Notifications from this variant now equal those of Visceral Leishmaniasis in number. Infection in the primary reservoir, domestic dogs, is highly prevalent. The sandfly has been the subject of three expeditions and Phlebotomus perniciosus is established as the vector for both forms of Leishmaniasis. This report was commissioned by the national Leishmaniasis Control Committee. The aim is to collate all relevant information related to this public health problem, analyse it and prepare draft recommendations for effective prevention and control measures. Notification data was analysed in some detail. Small scale studies on the prevalence of disease in dogs were carried out. Three different Leishmanin skin tests (Montenegro tests) were piloted on known cases and healthy controls and were found to be equally effective in detecting past infection. A cross-sectional study of villagers from Gozo using a skin test derived from a L.infantum zymodeme obtained from a local case showed wide variations in orevalence. This information was used to formulate conclusions and detailed recommendations for discussion by the committee. |
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| Key words | cutaneous leishmaniasis, dogs, Kala-Azar, leishmania infantum, sandfly, visceral leishmaniasis |