Affiliation:
1. Department of Medicine and Research Laboratory of Internal Medicine, Medical School, University of Thessaly, Larissa, Greece
Abstract
Abstract
Leishmaniasis is a vector-borne disease caused by protozoan parasites of the genus
Leishmania. It is transmitted by phlebotomine female sand flies of the genera Phlebotomus
and Lutzomyia in the old and new world, respectively. More than 20 well-recognized
Leishmania species are known to infect humans and cause visceral (VL), cutaneous (CL)
and mucocutaneous (ML) forms of the disease. Approximately 350 million people are at
risk of contracting the disease and an estimated 1.6 million new cases occur annually. The
disease mainly affects poor people in Africa, Asia and Latin America, and is associated with
malnutrition, population migration, poor residency conditions, frail immune system and lack
of resources. Previously, diagnosis of leishmaniasis relied mainly on invasive techniques of
detecting parasites in splenic and bone marrow aspirates. Nevertheless, serological tests
using the recombinant kinesin antigen (rK39) and molecular methods (polymerase chain
reaction) are considered the best options for diagnosis today, despite problems related to
varying sensitivities and specificities and field adaptability. Therapy of leishmaniasis ranges
from local treatment of cutaneous lesions to systemic often toxic, therapy for disseminated CL,
ML and VL. Agents with efficacy against leishmaniasis include amphotericin B, pentavalent
antimonial drugs, paromomycin and miltefosine. No single therapy of VL currently offers
satisfactory efficacy along with safety. This article provides a brief and updated systematic
review on the epidemiology, diagnosis and treatment of this neglected disease.
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