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Definition

Leishmaniasis is a disease caused by parasites of the Leishmania type.[1] It is spread by the bite of certain types of sandflies.[1]The treatment is determined by where the disease is acquired, the species of Leishmania, and the type of infection.[1]Out of 200 countries and territories reporting to WHO, 97 countries and territories are endemic for leishmaniasis.[2]

Signs and symptoms 1

Clinical presentation is divided into three syndromes which are cutaneous leishmaniasis, mucocutaneous leishmaniasis, and visceral leishmaniasis.[3]

Signs and symptoms 2

The symptoms of leishmaniasis are skin sores which erupt weeks to months after the person is bitten by infected sand flies.[3]

Cause

Infections in humans are caused by more than 20 species of Leishmania.[1]

Transmission

Although most of the literature mentions only one genus transmitting Leishmania to humans (Lutzomyia), a 2003 study suggested a new classification for New World sand flies, elevating several subgenera to the genus level. In some regions of the world, the genus Phlebotomus is considered the vector of leishmaniasis.[4]

Risk factors

Risk factors include poverty, malnutrition, deforestation, lack of sanitation, suppressed immune system and urbanization.[1]

Diagnosis

Leishmaniasis is diagnosed in the hematology laboratory by direct visualization of the amastigotes. Buffy-coat preparations of peripheral blood or aspirates from marrow, spleen, lymph nodes, or skin lesions should be spread on a slide to make a thin smear that is stained with Leishman or Giemsa stain. [5]

Prevention

There is no vaccine available, however using insecticide can reduce phlebotomine sandfly numbers which in turn reduces the risk of cutaneous leishmaniasis infection.[6][7]To provide good protection against sandflies, fine mesh sizes of 0.6 mm or less are required, however a mosquito net with 1.2 mm mesh will provide a limited reduction in the number of sandfly bites.[8]

Treatment

For visceral leishmaniasis in India, South America, and the Mediterranean, liposomal amphotericin B is the recommended treatment and is often used as a single dose.[9][10] Rates of cure with a single dose of amphotericin have been reported as 95 percent.[9] In Africa, a combination of pentavalent antimonials and paromomycin is recommended.[10]

Epidemiology

The settings in which leishmaniasis is found range from rainforests in Central and South America to deserts in western Asia and the Middle East. It affects as many as 12 million people worldwide, with 1 and a half to 2 million new cases each year.[11] In 2014, more than 90% of new cases reported to WHO occurred in six countries: Brazil, Ethiopia, India, Somalia, South Sudan and Sudan.[12]

History 1

Descriptions of conspicuous lesions similar to cutaneous leishmaniasis appear on tablets from King Ashurbanipal from the seventh century BCE, some of which may have derived from even earlier texts from 1500 to 2500 BCE. Persian physicians, including Avicenna in the tenth century CE, gave detailed descriptions of what was called balkh sore.[13] In 1756, Alexander Russell, after examining a Turkish patient, gave one of the most detailed clinical descriptions of the disease.[14]

History 2

David Douglas Cunningham, Surgeon Major of the British Indian army, may have seen it in 1885 without being able to relate it to the disease.[15][16] Peter Borovsky, a Russian military surgeon working in Tashkent, conducted research into the etiology of "oriental sore", locally known as sart sore, and in 1898 published the first accurate description of the causative agent, correctly described the parasites relation to host tissues and correctly referred it to the protozoa. [17]

References

  1. 1.0 1.1 1.2 1.3 1.4 "Leishmaniasis Fact sheet N°375". World Health Organization. January 2014. Archived from the original on 21 February 2014. Retrieved 17 February 2014.
  2. "Leishmaniasis: Situation and trends". WHO Global Health Observatory. Archived from the original on 30 May 2018. Retrieved 30 May 2018.
  3. 3.0 3.1 Maxfield, Luke; Crane, Jonathan S. (2022). "Leishmaniasis". StatPearls. StatPearls Publishing. Retrieved 3 June 2022.
  4. Myler, Peter J; Fasel, Nicolas (2008). Leishmania: After The Genome. Caister Academic Press. ISBN 978-1-904455-28-8. Archived from the original on 23 April 2008.
  5. Dacie, John V.; Bain, Barbara J.; Bates, Imelda (2006). Dacie and Lewis practical hematology. Philadelphia: Churchill Livingstone/Elsevier. ISBN 978-0-443-06660-3.
  6. González, Urbà; Pinart, Mariona; Sinclair, David; Firooz, Alireza; Enk, Claes; Vélez, Ivan D; Esterhuizen, Tonya M; Tristan, Mario; Alvar, Jorge (2015-08-06). Cochrane Infectious Diseases Group (ed.). "Vector and reservoir control for preventing leishmaniasis". Cochrane Database of Systematic Reviews (8): CD008736. doi:10.1002/14651858.CD008736.pub2. PMC 4561525. PMID 26246011.
  7. Prevention, CDC-Centers for Disease Control and (19 February 2020). "CDC - Leishmaniasis - Prevention & Control". www.cdc.gov. Retrieved 9 June 2022.
  8. Alexander, B.; Maroli, M. (March 2003). "Control of phlebotomine sandflies". Medical and Veterinary Entomology. 17 (1): 1–18. doi:10.1046/j.1365-2915.2003.00420.x. ISSN 0269-283X. Retrieved 9 June 2022.
  9. 9.0 9.1 Barrett, Michael P.; Croft, Simon L. (1 December 2012). "Management of trypanosomiasis and leishmaniasis". British Medical Bulletin. 104 (1): 175–196. doi:10.1093/bmb/lds031. ISSN 0007-1420. Retrieved 10 June 2022.
  10. 10.0 10.1 Sundar, Shyam; Chakravarty, Jaya (1 January 2013). "Leishmaniasis: an update of current pharmacotherapy". Expert Opinion on Pharmacotherapy. 14 (1): 53–63. doi:10.1517/14656566.2013.755515. ISSN 1465-6566. Retrieved 10 June 2022.
  11. Leishmaniasis: Magnitude of the problem Archived 26 October 2013 at the Wayback Machine. World Health Organization.
  12. "Epidemiological situation: Epidemiology". World Health Organization. Archived from the original on 16 March 2014. Retrieved 30 May 2018.
  13. Cox FE (October 2002). "History of human parasitology". Clinical Microbiology Reviews. The Wellcome Trust. 15 (4): 595–612. doi:10.1128/CMR.15.4.595-612.2002. ISBN 978-1-869835-86-6. OCLC 35161690. PMC 126866. PMID 12364371.
  14. "WHO: Leishmaniasis background information – a brief history of the disease". Archived from the original on 15 March 2014.
  15. Cunningham DD (1885). On the presence of peculiar parasitic organisms in the tissue of a specimen of Delhi boil. Scientific memoirs officers Medical Sanitary Departments Government India. Calcutta: Printed by the superintendent of government printing, India. pp. 21–31. OCLC 11826455.
  16. Cox FE (October 2002). "History of human parasitology". Clinical Microbiology Reviews. 15 (4): 595–612. doi:10.1128/CMR.15.4.595-612.2002. PMC 126866. PMID 12364371.
  17. Hoare CA (1938). "Early discoveries regarding the parasite of oriental sore". Transactions of the Royal Society of Tropical Medicine and Hygiene. 32 (1): 67–92. doi:10.1016/S0035-9203(38)90097-5.