Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh.
Acta Parasitol. 2024 Sep;69(3):1704-1716. doi: 10.1007/s11686-024-00880-5. Epub 2024 Aug 20.
Visceral leishmaniasis (VL) is caused by an intracellular parasite that is transmitted to humans by sandfly bites. It is prevalent throughout Asia, Africa, the Americas, and the Mediterranean area, where 147 million people are at risk of contracting the illness. The manifestation of heterotrophic illness relies on both Leishmania implicated and the host's immunological response, ranging from asymptomatic to severe leishmaniasis with potentially lethal effects.
We reviewed the literature (published till 31st December 2023) on the worldwide situation of leishmaniasis, standard and novel detection techniques, and traditional and modern treatment strategies and endeavors to eliminate VL. Moreover, epidemiological data was collected from the World Health Organization's publicly available databases. GraphPad Prism Version 8 was used to analyze and produce figures based on the epidemiological data.
Diagnosis of parasites in tissues or serology is commonly employed. Diagnosis by identifying parasite DNA using molecular techniques is becoming more popular. Despite recent findings of L. donovani resistance to pentavalent antimoniate medications, it continues to be the cornerstone in the medical management of VL. Amphotericin B and its lipid formulations, injectable paromomycin, and oral miltefosine are among the new therapy options being researched. The number of reported VL cases has reduced remarkably over the last decade due to human interventions made to eliminate VL. Particularly countries from the South East Asian region have experienced momentous progress in reducing VL cases and eliminating this disease from this region. Owing to the robust elimination programs, countries such as Bangladesh has eliminated VL as a public health concern. India and Nepal are on the verge of its elimination.
Rapid diagnosis, effective and inexpensive treatment, simple access to newly discovered medications, appropriate vector control, and a well-designed vaccine are all required for the elimination of this disease burden in impoverished areas of the globe.
内脏利什曼病（VL）是由一种通过沙蝇叮咬传播给人类的细胞内寄生虫引起的。它在亚洲、非洲、美洲和地中海地区流行，全球有 1.47 亿人面临感染该病的风险。异养疾病的表现既依赖于涉及的利什曼原虫，也依赖于宿主的免疫反应，从无症状到可能致命的严重利什曼病不等。
我们对有关利什曼病的全球状况、标准和新型检测技术以及传统和现代治疗策略和努力消除 VL 的文献进行了综述，并从世界卫生组织公开数据库中收集了流行病学数据。GraphPad Prism 版本 8 用于分析和根据流行病学数据生成图表。
通常采用在组织或血清中检测寄生虫或鉴定寄生虫 DNA 的分子技术来进行诊断。尽管最近发现利什曼原虫对五价锑药物产生耐药性，但它仍然是 VL 医学管理的基石。两性霉素 B 及其脂质制剂、注射用巴龙霉素和口服米替福新是正在研究的新治疗选择之一。由于人类干预消除 VL，过去十年中报告的 VL 病例数量显著减少。特别是东南亚国家在减少 VL 病例和消除该地区该病方面取得了重大进展。由于强有力的消除计划，孟加拉国等国家已经消除了 VL 这一公共卫生问题。印度和尼泊尔也即将实现消除 VL 的目标。
在全球贫困地区消除这种疾病负担，需要快速诊断、有效且廉价的治疗、简单获得新发现的药物、适当的病媒控制以及精心设计的疫苗。
