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Leishmaniasis

Category: Illness or disabilities

Type

Involuntary

Introduction and description

Leishmania  is a genus of trypanosomatic  protozoa and is the parasite responsible for the disease leishmaniasis. 

 It is spread through sandflies of the genus Phlebotomus in the Old World, and of the genus Lutzomyia in the New World. At least 93 sandfly species are proven or probable Leishmania vectors worldwide.

Leishmania currently affects 12 million people in 98 countries. There are about 2 million new cases each year and between 20 and 50 thousand deaths occur each year.   About 200 million people in Asia, Africa, South and Central America, and southern Europe live in areas where the disease is common.

Disability-adjusted life year for leishmaniasis per 100,000 inhabitants, the more red the greater the risk - source WHO

Symptoms

The symptoms of leishmaniasis are skin sores which erupt weeks to months after the person affected is bitten by sand flies. Other consequences, which can manifest anywhere from a few months to years after infection, include fever, damage to the spleen and liver and anemia

Leishmaniasis is considered one of the classic causes of a markedly enlarged spleen; the organ, which is not normally felt during examination of the abdomen, may even become larger than the liver in severe cases.

The cutaneous form presents with skin ulcers, while the mucocutaneous form presents with ulcers of the skin, mouth, and nose, and the visceral form starts with skin ulcers and then later presents with fever, low red blood cells, and enlarged spleen and liver. All three types can be diagnosed by seeing the parasites under the microscope. Additionally, visceral disease can be diagnosed by blood tests.

 

 

Treatment and prevention

Prevention  is obviously better and this can be achieved in part by sleeping under nets.

As the other causes [or risk factors] according to the Leishmaniasis Fact sheet N°375,  from the World Health Organization. January 2014  are poverty, malnutrition, deforestation, and urbanization; it also makes sense to address these and improve nutrition, stop deforestation, improve living conditions in urban areas and alleviate poverty.

Wikipedia has details of pharmaceutical treatments, we will post any plant based observations as and when we discover them. 

Miltefosine (MIL) is an oral antileishmanial drug used for treatment of visceral leishmaniasis (VL) in the Indian subcontinent. Recent reports indicate a significant decline in its efficacy with a high rate of relapse in VL as well as post kala-azar dermal leishmaniasis (PKDL). We investigated the parasitic factors apparently involved in miltefosine unresponsiveness in clinical isolates of Leishmania donovani.  PMID: 28575060

This tred is true of a number of pharmaceuticals.

References and further reading

PLoS Negl Trop Dis. 2017 Jun 2;11(6):e0005641. doi: 10.1371/journal.pntd.0005641. eCollection 2017 Jun. Increased miltefosine tolerance in clinical isolates of Leishmania donovani is associated with reduced drug accumulation, increased infectivity and resistance to oxidative stress.  Deep DK1,2, Singh R1, Bhandari V1, Verma A1, Sharma V1, Wajid S2, Sundar S3, Ramesh V4, Dujardin JC5, Salotra P1.

  • 1 National Institute of Pathology (ICMR), Safdarjung Hospital Campus, New Delhi, India.
  • 2 Department of Biotechnology, Faculty of Science, Jamia Hamdard, New Delhi, India.
  • 3 Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
  • 4 Dermatology Department, Safdarjung Hospital and Vardhman Mahavir Medical College (VMMC), New Delhi, India.
  • 5 Unit of Molecular Parasitology, Department of Parasitology, Institute of Tropical Medicine, Antwerp, Belgium.

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