scholarly journals Pharmacotherapeutic Options for Visceral Leishmaniasis—Current Scenario

2009 ◽  
Vol 2 ◽  
pp. CPath.S821 ◽  
Author(s):  
Krishna Pandey ◽  
Prabhat Kumar Sinha ◽  
Vidyanand Ravi Das ◽  
Sanjiva Bimal ◽  
Shubhankar K. Singh ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Standard Treatment ◽  
Neglected Tropical Diseases ◽  
Oral Drug ◽  
Oral Drugs ◽  
Kala Azar ◽  
The Poor ◽  
Pipe Line ◽  
Current Scenario ◽  
Lipid Formulations

Visceral leishmaniasis (VL) or Kala-azar is a protozoal disease, which was previously regarded as one of the most neglected tropical diseases. Management of this disease is quite difficult, because it is said to affect the poorest of the poor. Previously Sodium Stibogluconate (SSG) was regarded as the gold standard treatment for VL. But due to the increasing unresponsiveness, to this drug various other drugs were tried and are still being tried. Pentamidine is very toxic and has been discarded of late. Amphotericin B and its lipid formulations are very effective but require hospital admission and monitoring. Oral drugs like Miltefosine have already been launched. An amino glycoside Paromomycin and another oral drug Sitamaquine are in the pipe line. Interferon gamma has been used with discouraging results.

scholarly journals Efficacy and Safety of Paromomycin for Visceral Leishmaniasis: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Pashupati Pokharel ◽  
Rakesh Ghimire ◽  
Pratik Lamichhane
Keyword(s):  
Systematic Review ◽  
Drug Resistance ◽  
Visceral Leishmaniasis ◽  
South America ◽  
South Asia ◽  
Neglected Tropical Diseases ◽  
Tropical Diseases ◽  
Efficacy And Safety ◽  
Kala Azar ◽  
Resource Limited

Visceral leishmaniasis, also known as kala-azar is one of the most commonly neglected tropical diseases affecting a large number of rural and resource-limited people in South Asia, Africa, and South America. Paromomycin, an aminoglycoside drug, is frequently used for the treatment of visceral leishmaniasis. Despite limited therapies for visceral leishmaniasis and emerging drug resistance, a proper review on the action of paromomycin for kala-azar is lacking. This systematic review aims to look for the efficacy and safety aspects of paromomycin for the treatment of visceral leishmaniasis.

scholarly journals Recent Development of Visceral Leishmaniasis Treatments: Successes, Pitfalls, and Perspectives

2018 ◽  
Vol 31 (4) ◽  
Author(s):  
Fabiana Alves ◽  
Graeme Bilbe ◽  
Séverine Blesson ◽  
Vishal Goyal ◽  
Séverine Monnerat ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Eastern Africa ◽  
Systematic Research ◽  
Pharmacokinetic Studies ◽  
Oral Drugs ◽  
Kala Azar ◽  
Geographical Regions ◽  
Substantial Progress ◽  
Underlying Mechanisms ◽  
Near Future

SUMMARYResearch in visceral leishmaniasis in the last decade has been focused on how better to use the existing medicines as monotherapy or in combination. Systematic research by geographical regions has shown that a universal treatment is far from today's reality. Substantial progress has been made in the elimination of kala-azar in South Asia, with a clear strategy on first- and second-line therapy options of single-dose liposomal amphotericin B and a combination of paromomycin and miltefosine, respectively, among other interventions. In Eastern Africa, sodium stibogluconate (SSG) and paromomycin in combination offer an advantage compared to the previous SSG monotherapy, although not exempted of limitations, as this therapy requires 17 days of painful double injections and bears the risk of SSG-related cardiotoxicity. In this region, attempts to improve the combination therapy have been unsuccessful. However, pharmacokinetic studies have led to a better understanding of underlying mechanisms, like the underexposure of children to miltefosine treatment, and an improved regimen using an allometric dosage. Given this global scenario of progress and pitfalls, we here review what steps need to be taken with existing medicines and highlight the urgent need for oral drugs. Furthermore, it should be noted that six candidates belonging to five new chemical classes are reaching phase I, ensuring an optimistic near future.

scholarly journals Post-Kala-Azar Dermal Leishmaniasis Without Previous History of Visceral Leishmaniasis

2016 ◽  
Vol 95 (6) ◽  
pp. 1383-1385 ◽  
Author(s):  
Golam Hasnain ◽  
Dinesh Mondal ◽  
Shakhawat Hossain ◽  
Shinjiro Hamano ◽  
Prakash Ghosh ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Previous History ◽  
Kala Azar ◽  
History Of

scholarly journals How effective is dog culling in controlling zoonotic visceral leishmaniasis? a critical evaluation of the science, politics and ethics behind this public health policy

2011 ◽  
Vol 44 (2) ◽  
pp. 232-242 ◽  
Author(s):  
Carlos Henrique Nery Costa
Keyword(s):  
Visceral Leishmaniasis ◽  
Control Measure ◽  
Scientific Evidence ◽  
Critical Evaluation ◽  
Scientific Data ◽  
Ethical Considerations ◽  
Brazilian Government ◽  
Kala Azar ◽  
Scientific Results

INTRODUCTION: Zoonotic kala-azar, a lethal disease caused by protozoa of the genus Leishmania is considered out of control in parts of the world, particularly in Brazil, where transmission has spread to cities throughout most of the territory and mortality presents an increasing trend. Although a highly debatable measure, the Brazilian government regularly culls seropositive dogs to control the disease. Since control is failing, critical analysis concerning the actions focused on the canine reservoir was conducted. METHODS: In a review of the literature, a historical perspective focusing mainly on comparisons between the successful Chinese and Soviet strategies and the Brazilian approach is presented. In addition, analyses of the principal studies regarding the role of dogs as risk factors to humans and of the main intervention studies regarding the efficacy of the dog killing strategy were undertaken. Brazilian political reaction to a recently published systematic review that concluded that the dog culling program lacked efficiency and its effect on public policy were also reviewed. RESULTS: No firm evidence of the risk conferred by the presence of dogs to humans was verified; on the contrary, a lack of scientific support for the policy of killing dogs was confirmed. A bias for distorting scientific data towards maintaining the policy of culling animals was observed. CONCLUSIONS: Since there is no evidence that dog culling diminishes visceral leishmaniasis transmission, it should be abandoned as a control measure. Ethical considerations have been raised regarding distorting scientific results and the killing of animals despite minimal or absent scientific evidence

scholarly journals EXPANSION OF VISCERAL LEISHMANIASIS IN THE STATE OF RIO DE JANEIRO, BRAZIL: REPORT OF THE FIRST AUTOCHTHONOUS CASE IN THE MUNICIPALITY OF VOLTA REDONDA AND THE DIFFICULTY OF DIAGNOSIS

2014 ◽  
Vol 56 (3) ◽  
pp. 271-274 ◽  
Author(s):  
Luiz Henrique Conde Sangenis ◽  
Sebastião Roberto de Almeida Lima ◽  
Cíntia Xavier de Mello ◽  
Daniela Trindade Cardoso ◽  
Jurema Nunes Mello ◽  
...  
Keyword(s):  
Visceral Leishmaniasis ◽  
Symptom Onset ◽  
Urban Areas ◽  
Correct Diagnosis ◽  
Great Difficulty ◽  
The State ◽  
Differential Diagnoses ◽  
The North ◽  
Kala Azar ◽  
Epidemiological Changes

Visceral Leishmaniasis has been showing remarkable epidemiological changes in recent decades, with marked expansion and an emergence of cases in urban areas of the North, Southeast and Midwest regions of Brazil. The Kala-azar cases reported here, despite being very characteristic, presented a great difficulty of diagnosis, because the disease is not endemic in Volta Redonda. The child underwent two hospitalizations in different hospitals, but got the correct diagnosis only after 11 months of symptom onset. In this report we discuss the main differential diagnoses and call attention to the suspected symptoms of visceral leishmaniasis in patients with prolonged fever, hepatosplenomegaly and pancytopenia, even in areas not traditionally endemic for the disease.

scholarly journals Hyponatremia in visceral leishmaniasis

2010 ◽  
Vol 52 (5) ◽  
pp. 253-258 ◽  
Author(s):  
Frederico A. Lima Verde ◽  
Francisco A.A. Lima Verde ◽  
Francisco José V. Veronese ◽  
Augusto S. Neto ◽  
Galdino Fuc ◽  
...  
Keyword(s):  
Uric Acid ◽  
Visceral Leishmaniasis ◽  
Antidiuretic Hormone ◽  
Hormone Secretion ◽  
Extracellular Volume ◽  
Urine Osmolality ◽  
Control Group ◽  
Volume Depletion ◽  
Antidiuretic Hormone Secretion ◽  
Kala Azar

There are few reports linking hyponatremia and visceral leishmaniasis (kala-azar). This is a study of 55 consecutive kala-azar patients and 20 normal individuals as a control group. Hyponatremia and serum hypo-osmolality were detected in 100% of kala-azar patients. High first morning urine osmolality (750.0 ± 52.0 vs. 894.5 ± 30.0mOsm/kg H2O, p < 0.05), and high 24-hour urine osmolality (426.0 ± 167.0 vs. 514.6 ± 132.0 mOsm/kg H2O, p < 0.05) demonstrated persistent antidiuretic hormone secretion. Urinary sodium was high (82.3 ± 44.2 vs.110.3 ± 34.7 mEq/L, p < 0.05). Low seric uric acid occurred in 61.8% of patients and increased fractional urinary uric acid excretion was detected in 74.5% of them. Increased glomerular filtration rate was present in 25.4% of patients. There was no evidence of extracellular volume depletion. Normal plasma ADH levels were observed in kala-azar patients. No endocrine or renal dysfunction was detected. It is possible that most hyponatremic kala-azar patients present the syndrome of inappropriate antidiuretic hormone secretion.

scholarly journals Detection of urinary leishmanial antigen by latex agglutination test (KAtex) in kala-azar patients

1970 ◽  
Vol 9 (4) ◽  
pp. 216-222 ◽  
Author(s):  
Md Abdus Salam ◽  
Dinesh Mondal ◽  
Mamun Kabir ◽  
Rashidul Haque
Keyword(s):  
Visceral Leishmaniasis ◽  
Confidence Interval ◽  
Medical Science ◽  
Latex Agglutination ◽  
Agglutination Test ◽  
Latex Agglutination Test ◽  
Healthy Controls ◽  
Predictive Values ◽  
Non Invasive ◽  
Kala Azar

Background: A new unique latex agglutination test (KAtex) that detects a stable, nonprotein, disease specific parasite antigen in the freshly voided urine of patients suffering from active kala-azar has been introduced by Kalon Biological Ltd. UK. This is absolutely non-invasive method of diagnosis for visceral leishmaniasis and suitable for implementation as a rapid diagnostic tool at the point of care. Objective: Diagnostic potential of KAtex was evaluated among clinically suspected kala-azar patients in an endemic zone of Bangladesh. Methodology: KAtex was done using freshly voided urine according to the manufacturer’s instructions for sixty (60) clinically suspected patients of kala-azar admitted in Rajshahi Medical College Hospital (RMCH), Bangladesh and forty (40) healthy controls during December 2005 to June 2006. Leishmania nested Polymerase Chain Reaction (Ln-PCR) using peripheral blood buffy coat was performed for all study population (100) and Ln-PCR positive cases were considered as confirmed cases of kalaazar. Results: Out of 60 clinically suspected kala-azar patients, 56 were Ln-PCR positive and 53 of 56 Ln-PCR positive cases were KAtex positive (sensitivity, 94.64%; Mantel-Haenszel Chi sq. 79.66, p= 0.0000, confidence interval [CI], >95 to 100%). None of the healthy controls was found positive by Ln-PCR but 2 of 40 were KAtex positive (specificity, 95%; confidence interval [CI], >95 to 100%). The positive and negative predictive values of KAtex were noted as 98.10% and 92.85% respectively. Conclusion: This limited prospective study suggests that KAtex is an absolutely non-invasive urinebased antigen detection test with high sensitivity and specificity and may be useful for screening active kala-azar patients, particularly suitable for field use. Key words: Visceral leishmaniasis; Kala-azar; KAtex; Ln-PCR; sensitivity; specificity. DOI: 10.3329/bjms.v9i4.6688Bangladesh Journal of Medical Science Vol.09 No.4 July 2010 pp.216-222

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