L. (L.) chagasi in aids and visceral leishmaniasis (kala-azar) co-infection

Concomitant skin lesions in visceral leishmaniasis (VL) or kala-azar are rare, being more common the description of post-kala-azar dermal leishmaniasis occurring post treatment of kala-azar. Skin lesions caused by Leishmania donovani are frequently seen in the aids-VL co-infection. In Brazil cutaneous or mucosal forms of tegumentary leishmaniasis concomitant with aids are more commonly registered. Here we present a case of aids-VL co-infection, with unusual cutaneous and digestive compromising attributed to L. (L.) chagasi, with special attention to ecthymatous aspect of the lesion, allied to the absence of parasite on the histological skin biopsy.

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Comparison of KAtex, Bone Marrow Aspiration and DAT for the Diagnosis of Visceral Leishmaniasis

Bangladesh Journal of Infectious Diseases ◽

10.3329/bjid.v6i1.42660 ◽

2019 ◽

Vol 6 (1) ◽

pp. 12-15

Author(s):

Ishrat Sharmin ◽

AKM Quamruzzaman ◽

Rezina Parveen ◽

M Abdulah Yusuf ◽

Rashida Akter Khanam

Keyword(s):

Bone Marrow ◽

Visceral Leishmaniasis ◽

Leishmania Donovani ◽

Bone Marrow Aspiration ◽

Cross Sectional Study ◽

Cross Sectional ◽

Medical College ◽

Kala Azar ◽

History Of ◽

One Year

Background: Newly developed KAtex test can be used as a non invasive tool for diagnosis of Kala-azar. Objectives: The aim of the present study was to compare KAtex, Bone marrow aspiration and DAT to diagnose VL. Methodology: This cross-sectional study was carried out in the Department of Microbiology at Dhaka Medical College, Dhaka, Bangladesh in collaboration with the Department of Parasitology, Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh for a period of one year. Clinically suspected Kala-azar (VL) cases of different age and sex attending IEDCR, Dhaka from different Kala-azar endemic areas of Bangladesh were selected for this study. Patients having fever for more than 2 weeks, with or without splenomegaly, having history of loss of body weight following onset of fever were clinically suspected as Kala-azar cases. Microscopy and culture was performed in bone marrow (BM). KAtex was performed with urine sample. Agglutination of sensitized latex indicated presence of Leishmania donovani antigen in urine and thereby visceral leishmaniasis. No agglutination indicates absence of antigen in urine. DAT was done with serums of all cases. Result: Among 130 clinically suspected VL cases, 70 (53.85%) cases were BM positive and 60(46.15%) cases were BM negative. All the 70 BM positive cases were positive by KAtex and DAT. Among 60 BM negative cases, 15 were positive by KAtex and 23 were positive by DAT. The sensitivity of KAtex was 100.0% and specificity was 75.0%. The sensitivity of DAT was 100.0% and specificity is 61.6%. Conclusion: In conclusion, KAtex test is a good diagnostic tool for the detection of VL in comparison with DAT. Bangladesh Journal of Infectious Diseases, June 2019;6(1):12-15

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Study of Visceral Leishmaniasis (Kala-azar) in Children of Nepal

Journal of Nepal Paediatric Society ◽

10.3126/jnps.v29i2.2041 ◽

2009 ◽

Vol 29 (2) ◽

pp. 67-73 ◽

Cited By ~ 1

Author(s):

Durga Datt Joshi

Keyword(s):

Visceral Leishmaniasis ◽

Leishmania Donovani ◽

Research Work ◽

Case Fatality ◽

Zoonotic Disease ◽

Morbidity And Mortality ◽

Sand Fly ◽

Epidemiological Surveillance ◽

Mortality Data ◽

Kala Azar

Introduction: Visceral leishmaniasis (VL) or Kala-azar is a potentially fatal vector-borne (sand fly phlebotomies spp) zoonotic disease caused by a protozoan parasite, Leishmania donovani. In Nepal, the disease is restricted to the Eastern Terai region which lies adjacent to the Bihar state of India. Although leishmaniasis is regarded as a significant health problem in Nepal by the Ministry of Health, there is no active case detection programme in the country. Objective: Objectives of this study were to determine the up-to-date morbidity and mortality trend for VL in children of Nepal. Method: The epidemiological surveillance team from the NZFHRC visited to eight zonal hospitals in Terai region during the month from September to December of each year 2003 to 2007. The morbidity and mortality data up to the year 2007 were collected every year. The team has also collected 66 blood serum samples of which 18 samples from children were collected for the diagnosis. Results: A total 25890 cases with 599 deaths were reported during the year 1980-2006. The case fatality rate (CFR) varied from 0.23% to 13.2%. Districtwise analysis showed that, during 2003, highest incidence was in Mahottari district (184/100,000), followed by Sarlahi (100/100,000) and Sunsari (96/100,000). The highest CFR was in Dhanusha (2.9%) followed by Bara (2.4%) and Saptari (2.0%). Majority (70.9%) of persons affected by VL were aged 15 years and above, followed by 10-14 years (13.9%), 5-9 years (11.9%) and 1-4 years (3.3%). VL cases recorded from different district of Nepal for the year 2004, 2005, 2006 and 2007 are recorded. CFR for the year 2004, 2005, 2006 and 2007 were 3.2%, 3.7%, 16.67% and 11.42% respectively. Conclusions: There should be regular surveillance research work to be carried out in endemic area. Mass public health education, to make the people aware about preventive aspects of the disease is important. The possibility of the existence of animal reservoirs as zoonotic disease should also be considered. This disease is very much serious in children below 15 years of age both in male and female, therefore it is essential to have paediatrician post at least in all VL six endemic districts. Key words: Epidemiology, Leishmaniasis, Kala-azar, Sandfly doi: 10.3126/jnps.v29i2.2041 J. Nepal Paediatr. Soc. Vol 29, No. 2, pp.67-73

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Visceral Leishmaniasis in Non-Endemic Districts of Bangladesh: Knowledge gap, Attitude and Practice of Inhabitants and Professionals for Treatment, Prevention and Control

Bangladesh Journal of Zoology ◽

10.3329/bjz.v43i2.27391 ◽

2016 ◽

Vol 43 (2) ◽

pp. 189-199 ◽

Cited By ~ 1

Author(s):

Hamida Khanum ◽

Sultan Uz Zaman ◽

Sabina Yesmin ◽

Sharmin Musa ◽

Hasina Banu ◽

...

Keyword(s):

Visceral Leishmaniasis ◽

Prevention And Control ◽

Leishmania Donovani ◽

Long Period ◽

Correct Knowledge ◽

Kala Azar ◽

Attitude And Practice ◽

And Control ◽

Knowledge Attitude And Practice ◽

Specific Agent

Investigation on knowledge, attitude and practice (KAP) of inhabitants and professionals for treatment, prevention and control of visceral leishmaniasis carried out on 519 inhabitants and 92 professionals of 6 districts (Panchagarh, Thakurgaon, Dinajpur, Bogra, Pabna and Shirajgonj) of Bangladesh. About 79.2% inhabitants agreed that they have heard about kala-azar disease. Regarding the transmission of kala-azar, 22.7% respondents answered by mosquito, about 38.3% said long period and irregular fever, 7.5% inhabitants knew enlargement of spleen and liver as sign and symptom of kala-azar. Among the professionals, about 80.4% of them have the correct knowledge regarding the specific agent (Leishmania donovani) of kala-azar. Investigation on knowledge, attitude and practice (KAP) of inhabitants and professional, 89.1% and 69.6% believe that spleen and liver are affected in kala-azar, 39.1% to 51.1% professionals understand that lymph nodes, blood and skin are involved as tissues due to kala-azar. Among the professionals, about 80.4% of them have the correct knowledge regarding the specific agent (L. donovani) of kala-azar.Bangladesh J. Zool. 43(2): 189-199, 2015

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INVESTIGATION OF LEISHMANIASIS VECTORS IN EL-KADOBA VILLAGE, WHITE NILE STATE, SUDAN

International Journal of Research -GRANTHAALAYAH ◽

10.29121/granthaalayah.v5.i1.2017.1938 ◽

2017 ◽

Vol 5 (1) ◽

pp. 430-441

Author(s):

Belal Abdallah A. Adam ◽

Moawia Mukhtar Hassan ◽

Osman Mohammed Abd Elnour ◽

Ahmed Hamid Awadallah

Keyword(s):

Visceral Leishmaniasis ◽

Leishmania Donovani ◽

Morphological Characters ◽

Sand Fly ◽

Leishmania Infection ◽

Sand Flies ◽

Kala Azar ◽

Ecological Aspects ◽

Binocular Microscope ◽

White Nile

Visceral leishmaniasis (VL; kala-azar) is one of the most important parasitic tropical diseases in Sudan and the Sudan is considered to be one of the most important foci in the world. The visceral leishmaniasis has been described in Sudan since the beginning of the twentieth century. In Sudan, VL is caused by Leishmania donovani complex: MON 18, MON 30 and MON 82 zymodemes and The proven vector is Phlebotomus (Larroussius) orientalis, in this study a survey was carried out to identify the principal vector of VL based on Leishmania infection, morphological characters and to determine some ecological aspects of the sand flies prevalent in the area . Ten species of sand flies were recorded, three Phlebotomus species and seven Sergentomyia species of these sandflies, P. rodhaini was collected only from Acacia seyal/Balanities aegyptiaca at the Island whereas S. hunti was collected from the Acacia nilotica forest only of the total collections, P. orientalis representing 3.80% (248 specimens) of the total collection and P. papatasi were 3.11% of the collection. Sand flies identification was done under a binocular microscope at 40x (magnification). The main features used for sand flies identification were the sperm theca of the female, the termination of the male and the pharyngeal and the ciboria toothed structures of both sexes. According to results of this study we recommended the following: more studies are needed in the future to determine the transmission season, and infection rates of Leishmania parasites in human and the animal host in this area. Annually Entomological surveys must be done to determine density of Sand fly Vectors and Encourage the use of personal protection tools (ITNs), repellents, and improving of houses to avoid bite of sand fly.

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Genome wide comparison of Leishmania donovani strains from Indian visceral leishmaniasis and para-Kala azar dermal leishmaniasis patients

Acta Tropica ◽

10.1016/j.actatropica.2021.106086 ◽

2021 ◽

pp. 106086

Author(s):

Nibedeeta Rani Sarraf ◽

Saikat Mukhopadhyay ◽

Anindyajit Banerjee ◽

Anjan Kumar Das ◽

Syamal Roy ◽

...

Keyword(s):

Visceral Leishmaniasis ◽

Leishmania Donovani ◽

Kala Azar ◽

Genome Wide

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An unusual case of post-kala-azar dermal leishmaniasis in a patient with HIV and visceral leishmaniasis co-infection

International Journal of STD & AIDS ◽

10.1177/0956462419868617 ◽

2019 ◽

Vol 30 (12) ◽

pp. 1221-1223

Author(s):

Tamara Elliott ◽

Jacqueline Simpson ◽

Kikkeri N Naresh ◽

Diana Lockwood ◽

Angela C Bailey

Keyword(s):

Human Immunodeficiency Virus ◽

Visceral Leishmaniasis ◽

Leishmania Infantum ◽

Leishmania Donovani ◽

Unusual Case ◽

Vector Borne Disease ◽

Kala Azar ◽

Immunodeficiency Virus ◽

Vector Borne

Visceral leishmaniasis (VL) is a vector-borne disease caused by Leishmania donovani complex. Post-kala-azar dermal leishmaniasis (PKDL) is a rash that can occur following treatment for VL due to L. donovani species. We describe an unusual case of PKDL occurring during treatment for Leishmania infantum VL in a patient with human immunodeficiency virus-co infection.

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MODELING POST-KALA-AZAR DERMAL LEISHMANIASIS AS AN INFECTION RESERVOIR FOR VISCERAL LEISHMANIASIS

Revista de Matemática Teoría y Aplicaciones ◽

10.15517/rmta.v27i1.39973 ◽

2019 ◽

Vol 27 (1) ◽

pp. 221-239

Author(s):

ANDREA CALDERÓN ◽

RYAN LANDRITH ◽

NHAN LE ◽

ILEANA MUÑOZ ◽

CHRISTOPHER M. KRIBS

Keyword(s):

Visceral Leishmaniasis ◽

Leishmania Donovani ◽

Combined Treatment ◽

Protozoan Parasite ◽

Bed Nets ◽

Kala Azar ◽

Complete Treatment ◽

The Relationship ◽

Incomplete Treatment ◽

Parasite Leishmania

Visceral Leishmaniasis (VL) is a potentially fatal disease caused by the protozoan parasite Leishmania donovani. This disease is a health problem for the very poor because it results in thousands of deaths and illnesses every year. Some countries, such as India and Bangladesh, have started programs to reduce the occurrences of VL by focusing on early diagnosis and complete treatment of VL. Post-Kala-azar Dermal Leishmaniasis (PKDL) is a cutaneous manifestation of Leishmaniasis that can occur following the incomplete treatment of VL. Diagnosis and treatment of PKDL are limited in affected regions, and PKDL has been identified as a possible reservoir for infection. This study develops a mathematical model of the relationship between the level of PKDL treatment and the incidences of VL during a given period. The results indicate a nearly linear relationship between PKDL treatment rates and the percent reduction of VL incidences. With the current treatments available and considering achievable levels of treatment, the model predicts that up to 20% of VL cases could be prevented by treating new PKDL cases. Hypothetical combined treatment initiatives including bed nets and insecticide spraying are also considered. Results suggest that the population of individuals with PKDL is certainly a significant factor in the transmission of L. donovani infection, with treatment of new cases particularly important.

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Accelerated Control of Visceral Leishmania donovani Infection in Interleukin-6-Deficient Mice

Infection and Immunity ◽

10.1128/iai.00490-08 ◽

2008 ◽

Vol 76 (9) ◽

pp. 4088-4091 ◽

Cited By ~ 27

Author(s):

Henry W. Murray

Keyword(s):

Visceral Leishmaniasis ◽

Interleukin 6 ◽

Leishmania Donovani ◽

Wild Type ◽

Therapeutic Blockade ◽

Th1 Cell ◽

Kala Azar ◽

Type Response ◽

Deficient Mice

ABSTRACT In patients with visceral leishmaniasis, increased levels of circulating interleukin-6 (IL-6) regularly accompany fully expressed, progressive infections (kala-azar). To experimentally test the role of IL-6, responses to an intracellular Leishmania donovani infection in the livers of IL-6−/− and wild-type mice were compared. IL-6−/− mice showed an enhanced control of the infection and earlier, rapid parasite killing along with additional evidence of a stimulated antileishmanial Th1-cell-type response: increased levels of circulating gamma interferon, accelerated granuloma assembly, and heightened responsiveness to chemotherapy. In this model of visceral leishmaniasis, IL-6 appears to act in a suppressive, macrophage-deactivating fashion, which identifies it as a potential target for therapeutic blockade.

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Evaluation of Enzyme-Linked Immunosorbent Assay for Diagnosis of Post-Kala-Azar Dermal Leishmaniasis with Crude or Recombinant k39 Antigen

Clinical and Vaccine Immunology ◽

10.1128/cdli.9.2.370-373.2002 ◽

2002 ◽

Vol 9 (2) ◽

pp. 370-373 ◽

Cited By ~ 1

Author(s):

P. Salotra ◽

G. Sreenivas ◽

A. A. Nasim ◽

B. V. Subba Raju ◽

V. Ramesh

Keyword(s):

Immunosorbent Assay ◽

Leishmania Donovani ◽

Skin Lesions ◽

Elisa Test ◽

Recombinant Antigen ◽

Enzyme Linked Immunosorbent Assay ◽

Invasive Test ◽

Kala Azar ◽

Axenic Amastigotes ◽

Higher Sensitivity

ABSTRACT The diagnosis of post-kala-azar dermal leishmaniasis (PKDL), a dermatosis that provides the only known reservoir for the parasite Leishmania donovani in India, remains a problem. Timely recognition and treatment of PKDL would contribute significantly to the control of kala-azar. We evaluated here the potential of the enzyme-linked immunosorbent assay (ELISA) as a diagnostic tool for PKDL. Antigen prepared from promastigotes and axenic amastigotes with parasite isolates that were derived from skin lesions of a PKDL patient gave sensitivities of 86.36 and 92%, respectively, in the 88 PKDL cases examined. The specificity of the ELISA test was examined by testing groups of patients with other skin disorders (leprosy and vitiligo) or coendemic infections (malaria and tuberculosis), as well as healthy controls from areas where this disease is endemic or is not endemic. A false-positive reaction was obtained in 14 of 144 (9.8%) of the controls with the promastigote antigen and in 14 of 145 (9.7%) of the controls with the amastigote antigen. Evaluation of the serodiagnostic potential of recombinant k39 by ELISA revealed a higher sensitivity (94.5%) and specificity (93.7%) compared to the other two antigens used. The data demonstrate that ELISA with crude or recombinant antigen k39 provides a relatively simple and less-invasive test for the reliable diagnosis of PKDL.

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Predicting Kala-Azar Disease Manifestations in Asymptomatic Patients with Latent Leishmania donovani Infection by Detection of Antibody against Recombinant K39 Antigen

Clinical and Vaccine Immunology ◽

10.1128/cdli.9.3.568-572.2002 ◽

2002 ◽

Vol 9 (3) ◽

pp. 568-572 ◽

Cited By ~ 6

Author(s):

Sarman Singh ◽

Veena Kumari ◽

Niti Singh

Keyword(s):

Visceral Leishmaniasis ◽

Leishmania Donovani ◽

Clinical Manifestations ◽

Latex Agglutination ◽

Enzyme Linked Immunosorbent Assay ◽

Kala Azar ◽

Asymptomatic Patients ◽

Iga Antibodies ◽

Latently Infected ◽

Scanty Information

ABSTRACT Clinically visceral leishmaniasis is suspected in only a fraction of infected persons, as the majority of these may not have clinical manifestations and remain asymptomatic. There is scanty information on diagnosing latent infections and predicting disease in asymptomatic persons. We therefore carried out a study on asymptomatic contacts of patients with visceral leishmaniasis and post-kala-azar dermal leishmaniasis by using methods for detection of antibody to recombinant K39 (rK39) antigen. A total of 240 patients with leishmaniasis and 150 asymptomatic contacts were tested for anti-rK39 immunoglobulin G (IgG) and IgA antibodies. Fifty-five asymptomatic persons were found to be seropositive. These individuals were monitored every 3 months for 1 year. On follow-up, 43.9% of the asymptomatic seropositive contacts developed kala-azar within the first 3 months, and a cumulative total of 69% developed kala-azar within 1 year. The rest remained asymptomatic and self-healed the infection. The sensitivity and specificity of rK39 enzyme-linked immunosorbent assay (ELISA) and dipstick tests were 100%, while an in-house-developed latex agglutination test had 80% sensitivity. The antibody profile showed that the IgG anti-rK39 antibodies reached a titer of up to 10−6 within 6 months of infection, started declining thereafter, and completely disappeared in 2 to 3 years in successfully treated cases. Significant titers of IgA antibodies were detectable a little earlier than those of IgG antibodies and were undetectable after 6 months. The study showed that mass screening of family members and contacts by using anti-rK39 ELISA could be a highly reliable tool for early diagnosis and to plan prophylactic treatment of latently infected asymptomatic carriers to eradicate kala-azar.

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