IS ONE-YEAR FOLLOW-UP JUSTIFIED IN KALA-AZAR POSTTREATMENT

Sixty-five patients, 51 males and 14 females, with clinical and parasi tological evidence of visceral leishmaniasis were initially treated as follows: 44.6% were on intravenous sodium stibogluconate (pentostam) 20mg/kg/d for 30 days, 35.4% was on a combination of pentostam as abov e and allopurinol 21 mg/kg/d in three divided doses: for 30 days while 20% was on pentostam 10 mg/kg thrice/d intravenously for 10 days, All patients were parasitologically negative by the end of their respecti ve treatment regimen, All patients were reviewed at 2 months, 6 months , and 12 months periods in order to evaluate the relapse rates and opt imal Follow-up period, Thirteen patients (20%) relapsed st 2 months an d one patient (1.5%) relapsed at 6 months follow-up periods respective ly, There was no relapse between 6 months and 12 months follow-up peri od, The mean liver and spleen sizes in responders showed a dramatic re duction at 2 months followup and thereafter a gradual reduction occurr ed in the next 10 months, Weight gain continued throughout the year, A part from platelet count which showed a sustained high level from disc harge to 12 months Follow-up, the peripheral blood indices stabilized from 2 months follow-up, Relapses were retreated until parasitological ly negative twice and then followed up, for a period of 12 months, At follow-cap the liver and spleen sizes reduced gradually in the next 12 months, In this sub-population, the mean platelet count dropped at th e initial 2 months follow-up, the count, however, rose at 2 months rev iew after re-treatment, was sustained upto 6 months Follow-up and ther eafter steadily rose in the remainder of the 12 months follow-up perio d, The other blood indices stabilized at 6 months follow-up and did no t change in the next 6 months, The mean weight gain between re-treatme nt and 12 months follow-up was slight. It was concluded that relapses occur between two and six months post-treatment, no relapses occur bet ween 6 months and 12 months post-treatment, platelet count is a good p rognostic index and in kala-azar post-treatment patient Follow-up shou ld be for six months only.