Abstract
Leishmaniasis is a neglected vector-borne tropical infection considered to be a disease of the poor. Concentrated in poverty-stricken countries within Southeast Asia, East Africa, and Latin America, it is also endemic in several Mediterranean countries. The management of the heterogeneous syndromes determined by parasites belonging to the genus Leishmania is particularly difficult in developed, non-endemic countries owing to the unfamiliarity of physicians with clinical symptoms, diagnostic possibilities, and available treatment options. Therefore, travelers and other people who may be exposed to sand flies in endemic areas should receive counseling regarding leishmaniasis and appropriate protective measures. Serological diagnosis is rarely used for cutaneous and mucocutaneous diseases, but it is the most commonly used technique for visceral leishmaniasis. The drugs used to treat this last disease are expensive and sometimes have toxic side effects. This review highlights the diagnostic, chemotherapeutic, and immunizing strategies to control leishmaniasis, though no human vaccine is commercially available currently owing to the complexity of the cellular immune response to this parasite.
Highlights
Leishmaniasis is a neglected vector-borne tropical infection that is considered to be a disease of the poor [1].Concentrated in poverty-stricken countries within Southeast Asia, East Africa, and Latin America, it is endemic in several Mediterranean countries [2]
Integrated diagnosis based on clinical symptoms together with an rK39 immunochromatographic rapid test is commonly used, whereas a combination of molecular and serological tests are especially useful for asymptomatic infections in endemic areas [25]
The spectrum of infection is subclinical, localized, and disseminated; it depends on the immune status of the host, on the parasite, and on immune-inflammatory responses
Summary
Leishmaniasis is a neglected vector-borne tropical infection that is considered to be a disease of the poor [1].Concentrated in poverty-stricken countries within Southeast Asia, East Africa, and Latin America, it is endemic in several Mediterranean countries [2]. International traveling has caused an increase of leishmaniasis cases in non-endemic countries, making the recognition of this parasitic infection important [4]. In European countries, only two Leishmania species are endemic: L. infantum, responsible for zoonotic cutaneous and systemic disease within the Mediterranean region, with a reservoir in the domestic dog; and L. tropica, causing sporadic cases of anthroponotic cutaneous disease mainly in Greece.
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