Impact of sequelae of visceral leishmaniasis and their contribution to ongoing transmission of Leishmania donovani.

Malcolm S Duthie,Prakash Ghosh,Dinesh Mondal,Yasuyuki Goto

doi:10.1093/femspd/ftz057

Abstract

ABSTRACTVisceral leishmaniasis (VL) in the Old World is caused by infection with Leishmania donovani. Although the numbers of new reported cases of VL in Africa have been relatively stable for several years, the low numbers currently reported on the Indian subcontinent suggest a positive impact of new treatments and intervention strategies. In both regions, however, VL relapse and post-kala-azar dermal leishmaniasis (PKDL) maintain infectious reservoirs and therefore present a threat to control programs. In this review, we outline the evolving appreciation of PKDL as an impactful disease in its own right and discuss the various diagnostic methods that can be applied for the detection and characterization of PKDL cases. We also highlight the data that indicate the potential, and likely contribution, of PKDL cases to ongoing transmission of L. donovani.

Highlights

Visceral leishmaniasis (VL; known as kala-azar) results from infection with either Leishmania donovani or Leishmania infantum
The numbers of new reported cases of VL in Africa have been relatively stable for several years, the low numbers currently reported on the Indian subcontinent suggest a positive impact of new treatments and intervention strategies
The prediction of those patients most likely to succumb to post-kala-azar dermal leishmaniasis (PKDL) may be possible based upon particular antigen-specific antibody levels, the use of these responses to detect/diagnose PKDL would likely be constrained to patients for whom earlier information was available

Summary

Introduction

Visceral leishmaniasis (VL; known as kala-azar) results from infection with either Leishmania donovani or Leishmania infantum. PKDL is much more common among treated VL patients than relapse, with case numbers and incidence rates varying between Leishmania-endemic regions.

Results

Conclusion