{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T09:00:29Z","timestamp":1781254829436,"version":"3.54.1"},"reference-count":11,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Visceral Leishmaniasis (VL), a severe systemic neglected tropical disease (NTD) caused by Leishmania donovani complex protozoa, poses a significant public health threat, particularly in East Africa, where it is fatal if untreated. Somalia is known to be endemic, but the true burden and programmatic challenges are poorly documented due to long\u2010standing conflict, population displacement, and a fragmented, resource\u2010constrained health system. We report the case of a 40\u2010year\u2010old male farmer from Borama, Awdal region (Somaliland), presenting with a 20\u2010day history of intermittent high\u2010grade fever, chills, progressive weakness, anorexia, and vomiting. Physical examination revealed marked hepatosplenomegaly and pallor. Laboratory investigations showed moderate anemia (Hemoglobin 9.4\u2009g\/dL), thrombocytopenia (114,000\/\u03bcL), and a highly elevated ESR (50\u2009mm\/h). Mild hyperbilirubinemia was noted, likely secondary to hemolysis. Tests for malaria, tuberculosis, and enteric fever were negative. Definitive parasitological confirmation was not feasible due to local resource limitations. A rapid diagnostic test (RDT) for VL based on rK39 antigen\u2014Kalazar Detect (Human) Rapid Test\u2014was positive. Ultrasound confirmed significant hepato\u2010splenomegaly. Based on the clinical presentation, positive rK39 RDT, and exclusion of other etiologies, a diagnosis of Visceral Leishmaniasis was established. The patient was treated according to WHO regional guidelines with Sodium Stibogluconate (SSG, 20\u2009mg\/kg\/day) and Paromomycin (PM, 15\u2009mg\/kg\/day) for 17\u2009days. The patient tolerated treatment well; the fever resolved within five days. At one\u2010week post\u2010therapy follow\u2010up, he showed significant clinical improvement. This case highlights the classic presentation of VL in a fragile setting and underscores the critical role of RDTs where parasitological confirmation is unavailable. It demonstrates the feasibility of the WHO\u2010recommended SSG+PM combination therapy despite systemic challenges.<\/jats:p>","DOI":"10.1002\/ccr3.72521","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T03:51:03Z","timestamp":1776225063000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Visceral Leishmaniasis in Somalia: Diagnosis and Management of a Classic Case in a Resource\u2010Limited Endemic Setting"],"prefix":"10.1002","volume":"14","author":[{"given":"Abdirahman Nuur","family":"Hussein","sequence":"first","affiliation":[{"name":"College of Health Sciences, School of Medicine and Surgery Amoud University  Borama Somalia"},{"name":"Medical Department Borama Regional Hospital  Borama Somalia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7206-8758","authenticated-orcid":false,"given":"Abdirahman Omer","family":"Ali","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Medicine and Surgery Amoud University  Borama Somalia"},{"name":"Medical Department Borama Regional Hospital  Borama Somalia"},{"name":"Director of Research and Publication Office, Somaliland Medical Association (SLM\u2010RPO)  Borama Somaliland Somalia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ridwan Zakariye","family":"Ahmed","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Medicine and Surgery Amoud University  Borama Somalia"},{"name":"Medical Department Borama Regional Hospital  Borama Somalia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sihaam Mohamed","family":"Abdirahman","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Medicine and Surgery Amoud University  Borama Somalia"},{"name":"Medical Department Borama Regional Hospital  Borama Somalia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Dek","family":"Abdiwahab","sequence":"additional","affiliation":[{"name":"College of Health Sciences, School of Medicine and Surgery Amoud University  Borama Somalia"},{"name":"Medical Department Borama Regional Hospital  Borama Somalia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.20\u20100666"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0005231"},{"key":"e_1_2_13_4_1","unstructured":"World Health Organization \u201cWHO Technical Report Series No. 949 \u201d(2010)."},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0000085"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cdt3.70027"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.2147\/PHMT.S501020"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms10040757"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.appr.2024.100198"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.35500\/jghs.2020.2.e3"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12936\u2010025\u201005673\u20103"},{"key":"e_1_2_13_12_1","volume-title":"WHO Guideline for the Treatment of Visceral Leishmaniasis","author":"World Health Organization","year":"2022"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72521","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72521","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T08:42:35Z","timestamp":1781253755000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":11,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/ccr3.72521"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72521","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-05-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-14","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72521"}}