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Review
. 2003 Feb 15;326(7385):377-82.
doi: 10.1136/bmj.326.7385.377.

Leishmaniasis: new approaches to disease control

Clive R Davies  1 , Paul Kaye, Simon L Croft, Shyam Sundar
Affiliations
Review

Leishmaniasis: new approaches to disease control

Clive R Davies et al. BMJ. .
No abstract available

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Figures

Figure 1
Figure 1
Global distribution of leishmaniasis
Figure 2
Figure 2
Diagnostic results from three serum samples using the rapid rK39 immuno-chromatographic dipstick test for diagnosing visceral leishmaniasis. The single band represents a negative control, while the two results with a double band reflect positive diagnoses for patients with visceral leishmaniasis. This user friendly test is now widely used in Nepal and India
Figure 3
Figure 3
Children taking miltefosine, the first oral drug for visceral leishmaniasis, which was registered in India in March 2002. Trials indicate that this drug is highly effective, even against antimony resistant cases
Figure 4
Figure 4
This deltamethrin treated collar (Scalibor, InterVet, Boxmeer, Netherlands) provides dogs (the reservoir host of L infantum) with long term protection against sandfly bites and canine visceral leishmaniasis. Field trials in Iran show that providing all dogs in a community with collars also protects children against L infantum infection
Figure 5
Figure 5
The life cycle of Leishmania parasites and targets for vaccination. Leishmania cycle between sandfly vectors, where they exist as multiplicative “procyclic” promastigotes and infective “metacyclic” promastigotes, and their mammalian host, where they exist as intracellular amastigotes living predominantly in the phagolysosome of macrophages. After initial infection, amastigotes may replicate for some time before triggering an inflammatory and adaptive immune response. The latter requires migration of dermal dendritic cells to draining lymph nodes and their presentation of antigens derived from Leishmania to both CD4 and CD8 T cells. These then accumulate in the developing inflammatory lesion and promote parasite destruction by producing cytokines able to activate macrophage defences. Vaccination may promote these responses if vaccine antigens are delivered in an appropriate way to trigger both T cell subsets. Alternatively, immune responses against sandfly saliva may cause rapid local inflammation not conducive to parasite survival or block the function of salivary immunomodulators. Finally, host immune responses may target essential steps in parasite development within the sandfly (such as attachment to the fly midgut)
See this image and copyright information in PMC

Comment in

References

    1. World Health Organization. The world health report. Geneva: WHO; 2002. Annex 3: Burden of disease in DALYs by cause, sex and mortality stratum in WHO regions, estimates for 2001; pp. 192–197.www.who.int/whr/2002/whr2002_annex3.pdf . ( www.who.int/whr/2002/whr2002_annex3.pdf) )
    1. Sundar S, Reed SG, Singh VP, Kumar PCK, Murray HW. Rapid accurate field diagnosis of visceral leishmaniasis. Lancet. 1998;351:563–565. - PubMed
    1. Zijlstra EE, Nur Y, Desjeux P, Khalil EA, el Hassan AM, Groen J. Diagnosis of visceral leishmaniasis with the recombinant k39 strip test: experience from Sudan. Trop Med Int Health. 2001;6:108–113. - PubMed
    1. Attar ZJ, Chance ML, el Safi S, Carney J, Azazy A, El Hadi M, et al. Latex agglutination test for detection of urinary antigens in visceral leishmaniasis. Acta Trop. 2001;78:11–16. - PubMed
    1. Martin Sanchez J, Lopez-Lopez MC, Acedo-Sanchez C, Castro-Fajardo JJ, Pineda JA, Morillas-Marquez F. Diagnosis of infection with Leishmania infantum using PCR-ELISA. Parasitology. 2001;122:607–615. - PubMed

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