A review of kala-azar in Malta from 1947 to 1962

Since 1947, there has been a marked fall in the incidence of kala-azar in Malta. The factors responsible for this are the marked improvement in personal and environmental hygiene, reduction in animal reservoir, and DDT spraying. Kala-azar in Malta is a disease of young children. The diagnosis is not difficult and the association of pyrexia, splenomegaly, anaemia and leucopenia in a young child should suggest the diagnosis. This is confirmed by finding the Leishman Donovan bodies by marrow puncture which yields positive results in over 90 per cent. of cases. Splenic puncture is reserved for those cases where marrow puncture is negative. The anaemia is microcytic and hypochromic due to an associated iron deficiency. Neostibosan was the most satisfactory preparation used. It was safe and non-toxic. With Neostibosan, there were no relapses and a mortality of 0.75 per cent.