Abstract
Visceral Leishmaniasis (VL) is one of the most neglected tropical diseases worldwide. The diagnosis and treatment of this disease is quite complex. Sodium Antimony Gluconate (SAG) which used to be a very effective treatment has now developed resistance and is potentially a cardio-toxic drug. Pentamidine has now been discarded because of adverse effect of diabetes mellitus. Amphotericin-B is an effective drug but can cause nephrotoxicity. Miltefosine is a new oral effective drug which has recently been introduced in the kala-azar elimination program in the Indian subcontinent. Paromomycin is an injectable aminoglycoside which is quite cheap but can cause ototoxicity and nephrotoxicity. Sitamaquine, an oral antimalarial drug is still in phase-II trial stage. Combination Therapy is been tried with good results. Single dose Ambisome (liposomal Amphotericin-B) though costly is a very good alternative.
Highlights
The poor and about 90% of the people affected with Visceral Leishmaniasis (VL) earn less than 2$ a day (Sinha et al, 2005)
After the launching of Miltefosine, a new aminoglycoside drug namely Paromomycin was tried in VL under sponsorship of Institute of One World Health, USA
The phaseIII trials sponsored by DNDi were conducted with a combination of Miltefosine and Paromomycin showing 98.7% cure rate, Ambisome + Miltefosine and Ambisome + Paromomycin having a cure rate of 97.5% whereas single dose Ambisome (10 mg kg−1) had a cure rate of 96%
Summary
The poor and about 90% of the people affected with VL earn less than 2$ a day (Sinha et al, 2005). The like Sodium Antimony Gluconate (SAG) (c) mostly worldwide prevalence and incidence of VL are 2.5 injectable and toxic drugs (d) costly drugs (e) increasing million and 0.5 million respectively per year and about proportion of Leishmania-HIV co-infection and About 90% of the cases occur in five countries namely to as low as 40% in Bihar) various clinical drug trials on
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