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Post kala-azar dermal leishmaniasis: A threat to elimination program
Mallikarjuna Rao Gedda1,2, Bhawana Singh1, Dhiraj Kumar1,3
1Infectious Disease Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Plos Neglected Tropical Diseases
|July 3, 2020
Summary
Post kala-azar dermal leishmaniasis (PKDL) is a neglected skin manifestation of visceral leishmaniasis (VL) that perpetuates transmission. Eradicating PKDL is crucial for global leishmaniasis elimination programs.
Area of Science:
- Tropical medicine
- Infectious diseases
- Public health
Background:
- Leishmaniasis is a global health issue affecting developing nations, causing significant mortality.
- Post kala-azar dermal leishmaniasis (PKDL) is a secondary skin manifestation following visceral leishmaniasis (VL).
- PKDL cases, especially in the Indian subcontinent, act as a reservoir for Leishmania donovani, hindering VL elimination efforts.
Purpose of the Study:
- To review the multifaceted aspects of PKDL essential for sustained visceral leishmaniasis elimination.
- To highlight the importance of addressing PKDL as a critical component of VL control strategies.
Main Methods:
- This review synthesizes current knowledge on PKDL.
- It focuses on epidemiological, clinical, and transmission dynamics of PKDL.
- It discusses challenges and proposes strategies for PKDL management and control.
Main Results:
- PKDL emerges in 2.5%–20% of VL survivors, presenting as macular or nodular lesions.
- In the Indian subcontinent, PKDL can occur post-VL or even without prior VL history.
- PKDL patients are a significant reservoir, perpetuating anthroponotic Leishmania donovani transmission.
Conclusions:
- PKDL is a critical barrier to visceral leishmaniasis elimination due to its role as an infection reservoir.
- Limited treatment options and knowledge gaps necessitate focused research and intervention for PKDL.
- Integrating PKDL eradication into VL elimination programs is imperative for disease control.
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