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Visceral leishmaniasis in the Indian subcontinent: advances in diagnostics, therapies, and public health initiatives

Abstract

Kala-Azar, also known as visceral leishmaniasis, is a neglected tropical illness that mostly affects populations with inadequate resources and has a significant global morbidity and mortality rate. This systematic review summarises developments in public health initiatives, treatment, and diagnosis for the management of VL. Disease identification has been improved by diagnostic advancements such as rK39 dipstick tests, ELISA, and PCR; nonetheless, regional variations in sensitivity and specificity, as well as the ongoing dependence on invasive techniques, underscore the necessity for widely available, non-invasive substitutes. New developments in medicine, including liposomal amphotericin B and combination treatments with paromomycin or miltefosine, have greatly increased therapy effectiveness while lowering toxicity and length of treatment. Cost, opposition, and restricted accessibility issues still exist, nevertheless. As a reservoir for disease transmission, post-kala-azar dermal leishmaniasis (PKDL) continues to be a major obstacle to eradication. Although they have proven successful, vector control methods like indoor residual spraying (IRS) and durable insecticidal nets are hampered by DDT resistance and environmental issues. The illness load in the Indian subcontinent has been decreased as a result of public health measures like the Kala-Azar Elimination Initiative. Socioeconomic factors including poverty, malnutrition, and a lack of proper healthcare facilities still obstruct advancement in spite of these achievements. The urgent need for economical combination treatments, cost-effective diagnostics, and long-term vector control methods is highlighted by this review. To eradicate visceral leishmaniasis worldwide, a multisectoral strategy that addresses underlying vulnerabilities is necessary.

More information

Type
Journal Article
Author
Rishav
Ahmed N
Raj Y
Yanamadala PK