A veterinarian's fight against leishmaniasis. (Two Million New Cases Each Year).

Even though the world's diverse nations had united more than half a century ago, the pace of dissemination of technology is crawling. Today, a word can echo all around the universe through satellites, yet a simple parasitic disease goes untreated in most areas of the world. Global population is on the rise, as are poverty and a deadly disfiguring disease--leishmaniasis--which affects humans and dogs and is transmitted by the bite of hematophagous sandflies (phlebotomies, owl midges).

According to the Journal of Clinical Microbiology (May 2002), two million new human cases occur each year and at least 350 million people are exposed to the risk of leishmania parasite infection. Now veterinarians not only treat animal diseases but have also become effective sensors to alarm health authorities in order to save the lives of animals as well as humans. Rabies, tuberculosis, Escherichia coli (E. coil) and leishmaniasis are common diseases that veterinarians diagnose and then alert health officials.

In existence for a very long time, leishmaniasis is still affecting many children worldwide, particularly in Pakistan. I have alerted medical professionals that there still is a great reservoir for leishmaniasis of protozoa parasites among dogs, cats, rodents and ground squirrels. Little or no attention however has been given to this disease, especially in remote areas of Sindh, Pakistan, where people are the victims of chronic poverty.

The World Health Organization (WHO) appointed a handful of people to handle an enormous and rapidly growing number of leishmaniasis victims. The disease in some cases is said to be self-limiting, yet a sequela to the devastating disfiguration of faces and limbs. A large number of victims still live in places with dirt roads and in dwellings without running water or electricity. Many world bodies and international and non-governmental organizations are working to cope with this disease.

Dogs are kept in villages not as pets but for guarding livestock, policing property and signalling intrusion by a stranger. The majority of dogs in Pakistan are scavengers, living on garbage, bones and discarded food.

Dogs and cats have a large body volume compared to rodents and squirrels, and hence are easy targets for sandflies to take a meal and then transmit the disease to children. No effective drug is being manufactured in Pakistan or any developing country, so these drugs have to be imported from Europe, possibly through WHO. With the help of an already financially unstable but supportive Government, many veterinarians in Pakistan can minimize the disease by reducing the population of dogs and cats through spay/neuter programmes. I have opened three charity hospitals in the country which offer free spaying and neutering for these animals.

However, no data or record of incidence is available regarding the prevalence of leishmaniasis among these stray dogs. I recently recorded ten dogs grossly affected with the cutaneous form of leishmaniasis, and in some cases they also suffered from secondary complications of lymphoadenopahy, skin ulceration and infection. It was also discovered that households with dogs infected with leishmaniasis also had children suffering from the disease. A Board-certified American human pathologist confirmed impression smears from the lesions of these children to be positive for leishmaniasis.

Very few people are able to avail themselves of European-imported medications, and even fewer are on weak and less effective medications, such as metronidazole (antiparasitic drug), resulting in a large number of children continuing to be victims of this devastating disease. As veterinarians, we can only minimize zoonotic diseases by decreasing the population of animals through a sterilization programme. Developing countries should get support from WHO, the United Nations and other international organizations to manufacture the drugs, which can be subsidized by the Government and be made available to the ordinary poor population.

Dr. Inayat ullah H. Kathio, D.V.M., of the Pittston Animal Hospital and Wilkes-Barre Animal Hospital, Inc. (Pennsylvania, United States), is a Fellow and Research Officer/Consultant at the Food and Agriculture Organization of the United Nations. He owns three animal hospitals in Pakistan, which provide free services.