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ISDS 2016 Conference Abstracts

Epidemiology of visceral leishmaniasis in Georgia
Nora Kokaia*1, Nino Iashvili1, Manana Murusidze1 and Giorgi Babuadze2
1S. Virsaladze Research Institute of Medical Parasitology and Tropical Medicine in Georgia, Tbilisi, Georgia; 2National Center for 
Disease Control and Public Health, Tbilisi, Georgia

Objective
The purpose of this study was to describe the epidemiology of 

visceral leishmaniasis in Georgia and to define new control measures.

Introduction
Visceral leishmaniasis (VL) is a zoonotic, protozoal infection that 

is endemic in Georgia, which commonly affects young children. 
In recent years, the incidence of VL has increased sharply and the 
geographic distribution has increased. Recently, VL moved to highly 
populated areas as new foci appeared from 2010-2015, during which, 
610 laboratory confirmed cases of VL were registered in Georgia. 
The majority of cases were found in East Georgia (94.2%) and 5.8% 
of cases in West Georgia (representing new foci of VL in Georgia).

Methods
Blood samples from 2,100 individuals suspected to have VL were 

tested using the rk39 based VL rapid diagnostic test, an enzyme-linked 
immunosorbent assay (ELISA). Also, 1,575 randomly selected dogs 
(stray and pet) and 77 wild canids were tested for VL using the same 
ELISA. Confirmed human cases were followed up for 9-12 months.

Results
The most affected age group was 0-5 years (72.2%). Of the 

patients, 13.9% were HIV positive and lethal outcomes were observed 
in 2.1%of patients. Mortality was associated with delayed diagnosis 
and HIV co-infection. Relapse developed in 6.4% of cases. Among 
HIV positive patients, secondary prophylaxis was conducted with 
liposomal amphotericin B, which decreased the number of relapses by 
76% in 12-24 month follow-ups. A high incidence of VL in humans 
was associated with a high prevalence of leishmaniasis in stray and 
domestic dogs. Leishmania antibodies were found in 23.7% of stray 
and domestic dogs and 2.6% of wild animals screened in Tbilisi.

Conclusions
Overall, the VL situation in Georgia is concerning and new control 

measures are needed. Our study revealed a high prevalence of VL 
in humans and dogs in East Georgia. Early and accurate diagnosis/
treatment and effective control measures should be conducted 
regularly to prevent the spread of VL in Georgia. In addition, 
secondary prophylaxis in HIV infected patients is also recommended.

Keywords
Epidemiology; Zoonotic; Visceral Leishmaniasis; One Health

Acknowledgments
Participation in this conference was made possible by financial support 
provided by the US Defense Threat Reduction Agency. The findings, 
opinions and views expressed herein belong to the authors and do not 
reflect an official position of the Department of the Army, Department of 
Defense, or the US Government, or any other organization listed.

*Nora Kokaia
E-mail: irma.kokaia@mail.ru

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e152, 2017