SPLENOMEGALY IN BARINGO DISTRICT, KENYA, AN AREA ENDEMIC FOR VISCERALLEISHMANIASIS AND MALARIA

The relationship between splenomegaly and visceral leishmaniasis (VL) was investigated during a cross-sectional study in 2,941 individuals i n Baringo District, Kenya, where both malaria and VL are endemic. Sple en size was correlated with presence of malaria parasites in thick blo od films and with evidence of present or past Leishmania donovani infe ction as determined by serology and history. Marked splenomegaly (Hack ett grade 3 or greater) significantly correlated with present or previ ous leishmanial infection (chi(2) = 53.5; p<0.001) whereas moderate sp lenomegaly (Hackett grade 1 or 2) significantly correlated with malari a parasitaemia (chi(2) = 73.03; p<0.001), The presence of antimalarial antibodies did not contribute to the differentiation of the cause of splenomegaly. The diagnostic significance of splenomegaly in this popu lation is discussed.