One-year prospective study of pediatric cutaneous leishmaniasis: a neglected tropical disease in sub Himalayan region, India.

Background: Satluj Valley of Himachal Pradesh is a newly identified focus of Cutaneous Leishmaniasis (CL) and here disease is still in emerging phase. Although children are most commonly affected victims by CL but till date no such study has been done on childhood CL in this region.

Methods: All newly diagnosed cases of CL were registered and detailed clinico-epidemiological parameters of children between 0-18 years were recorded. Imprint smears for LD bodies and biopsies for histopathology were done in atypical cases to confirm clinical diagnosis.

Results: Over a period of one year 337 cases of CL were registered, out of them 115 children (0-18 years) were enrolled for this study. School going (6-18 years) population was predominantly affected age group. Males outnumbered the females with a ratio of 1.88. Face was most commonly affected site and most (65.21%) cases presented with single lesion. Nodules (40.87%), plaques (24.35%) and papules (7.39%) were commonly observed morphologies although mixed patterns and atypical forms were also found. Most (62.60%) cases presented within 1-3 months of lesion onset. All cases responded well to treatment with antimonials. Lesional pain, swelling, bleeding, pigmentation and scarring were minor post treatment side effects.

Conclusions: Pediatric CL is an emerging infection along the Satluj valley of Himachal Pradesh (HP). Although clinical diagnosis is simple, and all cases respond well to antimonials. But, availability of diagnostic tests is essential to diagnose atypical cases. Further annual record keeping, and reporting is recommended to know the exact disease burden so as to promote the effective treatment and preventive measures.