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Challenges for management of post kala-azar dermal leishmaniasis and future directions

Authors Mondal D, Hamano S, Hasnain MG, Satoskar A

Received 30 April 2014

Accepted for publication 13 August 2014

Published 14 November 2014 Volume 2014:5 Pages 105—111


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Dr Thomas Unnasch

Dinesh Mondal,1 Shinjiro Hamano,2 Md Golam Hasnain,1 Abhay R Satoskar3

1Centre for Nutrition and Food Security, Parasitology Laboratory, (icddr, b) Mohakhali, Dhaka, Bangladesh; 2Department of Parasitology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan; 3Departments of Pathology and Microbiology, Wexner Medical Center, The Ohio State University, Columbus, OH, USA

Abstract: Post kala-azar dermal leishmaniasis (PKDL) is a skin complication resulting from infection with Leishmania donovani (LD) parasite. It mostly affects individuals who have previously suffered from visceral leishmaniasis (VL) caused by LD. In some cases, PKDL develops among people infected with LD, but do not show any symptoms of VL. Clinical presentation includes hypopigmented macules/papules/nodules or polymorphic lesions (combination of two or more lesions). Except for skin lesions, PKDL patients are generally healthy and usually do not seek medical care. These patients play an important role in interepidemic transmission of the infection and subsequent VL outbreak. Therefore, proper diagnosis and treatment of PKDL patients is important for the control of VL in endemic countries, especially in the Indian subcontinent where VL is anthroponotic. Here, we report the challenges in the estimation of PKDL burden, its diagnosis, and treatment, and suggest possible solutions based on recent literature, reports, published manuals, and web-based information.

Keywords: post kala-azar dermal leishmaniasis, Bangladesh, challenge, treatment, diagnosis, prevention

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