This study demonstrates the potential value of using Leishmania strains isolated from VL patients for monitoring drug sensitivty and resistance emergence, as well as for systematic use in high-throughput screening (HTS) during novel anti-leishmanial drug discovery.
Insecticide susceptibility status of Phlebotomus argentipes and polymorphisms in voltage-gated sodium channel (vgsc) gene in Kala-azar endemic areas of West Bengal, India
This study evaluated insecticide susceptibility of Phlebotomus argentipes sand flies in West Bengal, India and looked at associated polymorphisms in insecticide target genes. Key findings:
- Sand fly populations were found resistant to DDT but susceptible to deltamethrin and malathion.
- Mutations L1014S and L1014F were also detected. The latter was found associated with deltamethrin/DDT resistance.
The authors conclude that Type II pyrethroid tolerability can be an indication of emergence of resistance against it. Malathion may be used as an alternative in the study areas if needed in future.
Policy Recommendations From Transmission Modeling for the Elimination of Visceral Leishmaniasis in the Indian Subcontinent
The initial effectiveness of liposomal amphotericin B (AmBisome) and miltefosine combination for treatment of visceral leishmaniasis in HIV co-infected patients in Ethiopia: A retrospective cohort study
This study examined the initial effectiveness of a combination treatment of AmBisome and miltefosine in HIV / VL co-infected patients in Ethiopia.
Review describing the challenges of VL treatment and control for immunocompromised individuals.
A fine scale eco-epidemiological study on endemic visceral leishmaniasis in north ethiopian villages
In an effort to better understand tranmission of VL in Northern Ethiopia, this study evaluated entomological, epidemiological and ecological factors associated with VL in three endemic villages.
Key findings include:
- Vertisols (also known as black-cotton soil) were found positively related with Phlebotomus orientalis sand fly populations. Vertisols around houses could conribute to anthroponotic transmission.
- From those found infected with Leishmania donovani the majority was under 15 years old. Also significantly more males succumbed to VL than females.
- The study reported high abudance of infected individuals with high parasitemias who remain asymptomatic. These individuals may serve as a reservoir for anthroponotic transmission.
Socioeconomic benefit to individuals of achieving 2020 targets for four neglected tropical diseases controlled/eliminated by innovative and intensified disease management: Human African trypanosomiasis, leprosy, visceral leishmaniasis, Chagas disease
Positive Influence of Behavior Change Communication on Knowledge, Attitudes, and Practices for Visceral Leishmaniasis/Kala-azar in India
Study from India illustrating the importance of community engagement and health promotion activities within VL elimination programs. "Households that were exposed to community-based BCC activities largely using group and interpersonal communication had better knowledge, attitudes, and practices related to VL, including acceptance of IRS as a preventive measure, than households not exposed".
“Kala-Azar is a Dishonest Disease”: Community Perspectives on Access Barriers to Visceral Leishmaniasis (Kala-Azar) Diagnosis and Care in Southern Gadarif, Sudan
Early diagnosis and treatment is the principal strategy to control visceral leishmaniasis (VL), or kala-azar in East Africa. As VL strikes remote rural, sparsely populated areas, kala-azar care might not be accessed optimally or timely. We conducted a qualitative study to explore access barriers in a longstanding kala-azar endemic area in southern Gadarif, Sudan. Former kala-azar patients or caretakers, community leaders, and health-care providers were purposively sampled and thematic data analysis was used. Our study participants revealed the multitude of difficulties faced when seeking care. The disease is well known in the area, yet misconceptions about causes and transmission persist. The care-seeking itineraries were not always straightforward: “shopping around” for treatments are common, partly linked to difficulties in diagnosing kala-azar. Kala-azar is perceived to be “hiding,” requiring multiple tests and other diseases must be treated first. Negative perceptions on quality of care in the public hospitals prevail, with the unavailability of drugs or staff as the main concern. Delay to seek care remains predominantly linked to economic constraint: albeit treatment is for free, patients have to pay out of pocket for everything else, pushing families further into poverty. Despite increased efforts to tackle the disease over the years, access to quality kala-azar care in this rural Sudanese context remains problematic. The barriers explored in this study are a compelling reminder of the need to boost efforts to address these barriers.