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Leishmaniasis

This article is about human leishmaniasis. For the disease in canids, see canine leishmaniasis.

Leishmaniasis
Other namesLeishmaniosis
Cutaneous leishmaniasis in the hand of a Central American adult
Pronunciation
SpecialtyInfectious disease
SymptomsSkin ulcers, fever, low red blood cells, enlarged liver[2][3]
CausesLeishmania parasites spread by sandflies[2]
PreventionBug nets, insecticide[2]
Frequency4–12 million[4][5]
Deaths24,200 (2015)[6]

Leishmaniasis is a wide array of clinical manifestations caused by protozoal parasites of the Trypanosomatida genus Leishmania.[7] It is generally spread through the bite of phlebotomine sandflies, Phlebotomus and Lutzomyia, and occurs most frequently in the tropics and sub-tropics of Africa, Asia, the Americas, and southern Europe.[2][8] The disease can present in three main ways: cutaneous, mucocutaneous, or visceral.[2] The cutaneous form presents with skin ulcers, while the mucocutaneous form presents with ulcers of the skin, mouth, and nose. The visceral form starts with skin ulcers and later presents with fever, low red blood cell count, and enlarged spleen and liver.[2][3]

Infections in humans are caused by more than 20 species of Leishmania.[8][2] Risk factors include poverty, malnutrition, deforestation, and urbanization.[2] All three types can be diagnosed by seeing the parasites under microscopy.[2] Additionally, visceral disease can be diagnosed by blood tests.[3]

Leishmaniasis can be partly prevented by sleeping under nets treated with insecticide.[2] Other measures include spraying insecticides to kill sandflies and treating people with the disease early to prevent further spread.[2] The treatment needed is determined by where the disease is acquired, the species of Leishmania, and the type of infection.[2] Some possible medications used for visceral disease include liposomal amphotericin B,[9] a combination of pentavalent antimonials and paromomycin,[9] and miltefosine.[10] For cutaneous disease, paromomycin, fluconazole, or pentamidine may be effective.[11]

About 4 to 12 million people are currently infected[4][5] in some 98 countries.[3] About 2 million new cases[3] and between 20 and 50 thousand deaths occur each year.[2][12] About 200 million people in Asia, Africa, South and Central America, and southern Europe live in areas where the disease is common.[3][13] The World Health Organization has obtained discounts on some medications to treat the disease.[3] It is classified as a neglected tropical disease.[14] The disease may occur in a number of other animals, including dogs and rodents.[2]

  1. ^ "Leishmaniasis definition and meaning | Collins English Dictionary". Archived from the original on 24 December 2013. Retrieved 23 December 2013.
  2. ^ a b c d e f g h i j k l m n "Leishmaniasis Fact sheet N°375". World Health Organization. January 2014. Archived from the original on 21 February 2014. Retrieved 17 February 2014.
  3. ^ a b c d e f g Barrett MP, Croft SL (2012). "Management of trypanosomiasis and leishmaniasis". British Medical Bulletin. 104 (1): 175–96. doi:10.1093/bmb/lds031. PMC 3530408. PMID 23137768.
  4. ^ a b "Leishmaniasis Magnitude of the problem". World Health Organization. Archived from the original on 26 October 2013. Retrieved 17 February 2014.
  5. ^ a b Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (GBD 2015 Disease Injury Incidence Prevalence Collaborators) (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
  6. ^ Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (GBD 2015 Mortality Causes of Death Collaborators) (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  7. ^ Roy M, Rawat A, Kaushik S, Jyoti A, Srivastava VK (1 August 2022). "Endogenous cysteine protease inhibitors in upmost pathogenic parasitic protozoa". Microbiological Research. 261: 127061. doi:10.1016/j.micres.2022.127061. ISSN 0944-5013. PMID 35605309. S2CID 248741177.
  8. ^ a b Rawat A, Roy M, Jyoti A, Kaushik S, Verma K, Srivastava VK (August 2021). "Cysteine proteases: Battling pathogenic parasitic protozoans with omnipresent enzymes". Microbiological Research. 249: 126784. doi:10.1016/j.micres.2021.126784. PMID 33989978. S2CID 234597200.
  9. ^ a b Sundar S, Chakravarty J (January 2013). "Leishmaniasis: an update of current pharmacotherapy". Expert Opinion on Pharmacotherapy. 14 (1): 53–63. doi:10.1517/14656566.2013.755515. PMID 23256501. S2CID 207479873.
  10. ^ Dorlo TP, Balasegaram M, Beijnen JH, de Vries PJ (November 2012). "Miltefosine: a review of its pharmacology and therapeutic efficacy in the treatment of leishmaniasis". The Journal of Antimicrobial Chemotherapy. 67 (11): 2576–97. doi:10.1093/jac/dks275. PMID 22833634.
  11. ^ Minodier P, Parola P (May 2007). "Cutaneous leishmaniasis treatment". Travel Medicine and Infectious Disease. 5 (3): 150–8. doi:10.1016/j.tmaid.2006.09.004. PMID 17448941.
  12. ^ Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. (December 2012). "Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010". Lancet. 380 (9859): 2095–128. doi:10.1016/S0140-6736(12)61728-0. hdl:10536/DRO/DU:30050819. PMC 10790329. PMID 23245604. S2CID 1541253.
  13. ^ Ejazi SA, Ali N (January 2013). "Developments in diagnosis and treatment of visceral leishmaniasis during the last decade and future prospects". Expert Review of Anti-Infective Therapy. 11 (1): 79–98. doi:10.1586/eri.12.148. PMID 23428104. S2CID 20508342.
  14. ^ "Neglected Tropical Diseases". cdc.gov. 6 June 2011. Archived from the original on 4 December 2014. Retrieved 28 November 2014.
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