Meghan R. Perry

TL;DR: It is concluded that arsenic contamination may have played a significant role in the development of Leishmania antimonial resistance in Bihar because inadequate treatment with antimonials drugs is not exclusive to India, whereas widespread antimonIAL resistance is.

TL;DR: It is reported here that both enantiomers of PA-824 show potent parasiticidal activity against Leishmania donovani, the causative agent of visceral leishmaniasis (VL), and may have potential for future use in combination therapy with fexinidazole, currently in phase II clinical trials against VL.

TL;DR: An additional hypothesis is proposed to explain the substantially lower efficacy of antimony in Bihar compared to other regions in the world and the possible contribution of arsenic to decreased antimonial efficacy in Bihar.

TL;DR: This study indicates a trend towards increased treatment failure in arsenic exposed patients, and the limitations of the retrospective study design may have masked a strong association between arsenic exposure and selection for antimonial resistance in the field.

TL;DR: Testing the hypothesis that exposure to arsenic in drinking water in this region has resulted in antimony-resistant Leishmania parasites in Bihar suggests that arsenic contamination might have contributed to the development of antimonial resistance in Leishmaniases in Bihar.