Topic
Visceral leishmaniasis
About: Visceral leishmaniasis is a research topic. Over the lifetime, 7486 publications have been published within this topic receiving 184865 citations. The topic is also known as: Kala-Azar & viscus leishmaniasis.
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TL;DR: The importance of the dog as the reservoir of visceral leishmaniasis was confirmed, with the breeds most affected were doberman and German shepherd, independent of sex and use.
Abstract: Canine leishmaniasis was studied in 1,823 dogs from the Lisbon metropolitan region. The breeds most affected were doberman and German shepherd, independent of sex and use. Young adult (12.2%) and older dogs (14.7%) had higher prevalences of infection. Parasitological confirmation of serological diagnosis was higher in dogs with indirect fluorescent antibody test titer greater than or equal to 1:512, indicating that parasitological patency is a late event. Exposure of Leishmania in lymph nodes is more efficient for parasitological confirmation (75.4% of cases). Frequent signs of disease were enlarged lymph nodes and onychogriphosis. However, 53.8% of the dogs with significant antibody titers (greater than or equal to 1:128) showed no symptom, suggesting that canine leishmaniasis has a prolonged asymptomatic period. This study confirmed the importance of the dog as the reservoir of visceral leishmaniasis.
246 citations
TL;DR: Intralesional or systemic antimonials are the gold standard for the treatment of visceral leishmaniasis, however, other therapeutic options appear promising, and Liposomal amphotericin B could be an alternative to antimony in south American cutaneous leish maniasis with mucosal involvement.
245 citations
TL;DR: Major differences in the drug susceptibilities of parasites at both stages were compared, which show the specific chemosusceptibility of the parasite at the mammalian stage, demonstrate the potential of using cultured amastigotes instead of promastigote in a drug-screening procedure for early detection.
Abstract: Using a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide microassay, previously described as a means of quantifying Leishmania amazonensis in vitro at the amastigote stage (D. Sereno and J. L. Lemesre, Parisitol. Res., in press), we have compared the activities of seven drugs, including those currently used to treat leishmaniasis, against axenically grown amastigote and promastigote forms of three Leishmania species (L. amazonensis, L. mexicana, and L. infantum, responsible for diffuse cutaneous, cutaneous, and visceral leishmaniasis, respectively). The ability of axenically cultured amastigote organisms to be used in an investigation of antileishmanial agents was first evaluated. We have confirmed the toxicities of sodium stibogluconate (Pentostam), pentamidine, and amphotericin B to active and dividing populations of axenically cultured amastigotes. The toxicity of potassium antimonyl tartrate trihydrate, which is generally higher than that of Pentostam, seemed to indicate that pentavalent antimony can be metabolized in vivo to compounds, possibly trivalent in nature, which are more active against the amastigote organisms. When the drug susceptibilities of parasites at both stages were compared, great variations were found for all the drugs studied. These major differences, which show the specific chemosusceptibility of the parasite at the mammalian stage, demonstrate the potential of using cultured amastigotes instead of promastigotes in a drug-screening procedure for early detection. This in vitro model may help in the isolation of active compounds, particularly those with low-grade activities, against the mammalian stage of the parasite.
241 citations
TL;DR: A simple, rapid, non invasive, accurate and cost effective marker of active VL, which can be used in field conditions, is necessary to improve diagnosis of VL.
Abstract: Leishmaniasis is a vector-borne disease with up to 350 million people at risk of infection worldwide. Among its different clinical manifestations, visceral is the most severe form. Since clinical features of visceral leishmaniasis (VL) mimic several other common diseases, accurate diagnosis is crucial as the treatment is associated with significant toxicity. Invasive and risky techniques involving demonstration of the parasites in stained preparations from splenic and bone marrow aspirate is still the gold standard for VL diagnosis. Serological tests using rK39 in ELISA or rapid immunochromatographic format, Direct Agglutination Test (DAT), immunoblotting have issues related to a significant proportion of asymptomatic individuals being positive with these tests and their inability to diagnose relapses as these remain positive for several months to years after cure. PCR is the most common molecular technique successfully used for diagnosis and differentiation of species. Through this review we focus extensively on the comparative utilities of the various diagnostic tools currently available for VL, describing in depth their advantages and disadvantages, addressing the recent advances attained in the field. A simple, rapid, non invasive, accurate and cost effective marker of active VL, which can be used in field conditions, is necessary to improve diagnosis of VL.
239 citations
TL;DR: Although leishmaniasis could contribute to death in a significant number of HIV-infected patients, it was the main cause of death in only a few of them and should be considered as an AIDS-defining disease.
237 citations