Lameck Ododo/DNDi
                                Chepsera Limaru watches over her son Pturu Limaruk who suffers from kala-azar at the Amudat hospital in Uganda.
                                ? Credits

                                Leishmaniasis

                                  Overview

                                  The leishmaniases are a group of diseases caused by protozoan parasites from more than 20 Leishmania species. These parasites are transmitted to humans by the bite of an infected female phlebotomine sandfly, a tiny – 2–3 mm long – insect vector.

                                  There are three main forms of the disease: cutaneous leishmaniasis (CL), visceral leishmaniasis (VL), also known as kala-azar, and mucocutaneous leishmaniasis (MCL). CL is the most common form, VL is the most severe form and MCL is the most disabling form of the disease.

                                  Most people who become infected with the parasite do not develop any symptoms during their lifetime. Therefore, the term leishmaniasis refers to the condition of becoming sick due to a Leishmania infection, not to being infected with the parasite.

                                  In 2018, 92 and 83 countries or territories were considered endemic for, or had previously reported cases of, CL and VL, respectively.

                                  Today, more than 1 billion people live in areas endemic for leishmaniasis and are at risk of infection. An estimated 30 000 new cases of VL and more than 1 million new cases of CL occur annually.


                                  Symptoms

                                  CL usually produces ulcers on the exposed parts of the body, such as the face, arms and legs. There may be many lesions – sometimes up to 200 – which can cause serious disability. When the ulcers heal, they invariably leave permanent scars, which can lead to stigmatization, especially for women and girls.

                                  VL is characterized by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver and serious anaemia. If the disease is not treated, the fatality rate can be as high as 100% within 2 years.

                                  MCL produces lesions that can partially or totally destroy the mucous membranes of the nose, mouth and throat cavities and surrounding tissues. This disabling form can also lead to social exclusion.

                                  PKDL (post-kala-azar dermal leishmaniasis), a complication of VL, is mainly seen in East Africa and South-East Asia. It is characterized by a discoloured (hypopigmented) flat skin (macular) rash, combined with some slightly elevated (maculopapular) or elevated (nodular) rash, usually in patients who have recovered from VL. PKDL usually appears 6 months to 1 or more years after apparent cure of VL, but it may occur earlier or even concurrently with VL, especially in Sudan. PKDL heals spontaneously in most cases in Africa but rarely in patients in India.

                                  Treatment

                                  Antileishmanial treatment depends on the causative species and the condition of the patient (e.g. pregnancy, immunosuppression).

                                  Regardless of the causative Leishmania species, antileishmanial treatment cannot provide a sterile cure, and the parasite remains in the human body and can cause a relapse when there is immunosuppression.

                                  Treatment is complex and should be administered by highly experienced health personnel. Most antileishmanial medicines are injectable.

                                   

                                   

                                  Publications

                                  All →
                                  Global leishmaniasis surveillance: 2019–2020, a baseline for the 2030 roadmap

                                  Leishmaniasis continues to be a major health problem in 4 eco-epidemiological regions of the world: the Americas, East Africa, North Africa and West...

                                  Kala-azar in India – progress and challenges towards its elimination as a public health problem

                                  Visceral leishmaniasis is commonly known as kala-azar (KA), a word coined in the late nineteenth century in India, which literally means “black disease”,...

                                  Interactive timeline of facts

                                  This interactive timeline provides some insight into the disease history with inspiring moments. It consists of short stories grouped into six categories (epidemiology, disease control, partnership, vector control, case management and policy) identified by different colours.

                                  A display panel at the bottom right corner of the window (tool icon) can be used to select and display one or several specific categories.

                                  The timeline can be viewed either in 2D or in 3D by clicking the bottom left corner button.

                                  Navigating is easy by scrolling up or down using the mouse.

                                   

                                  Interactive timeline leishmaniasis

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