Leishmaniasis: Epidemiological Trends and Diagnosis
Anupam Jhingaran, Mitali Chatterjee and Rentala Madhubala
from: Leishmania: After The Genome (Edited by: Peter J. Myler and Nicolas Fasel). Caister Academic Press, U.K. (2008)
Human Leishmaniasis consists of a spectrum of diseases ranging from simple self-limiting or asymptomatic cutaneous forms to a horribly disfiguring, debilitating mucocutaneous form and a fatal if untreated visceral form. Some of the clinical diversity may be the result of the genetic diversity of the parasite. Infection may be classified into three clinical syndromes namely cutaneous leishmaniasis (Oriental sore), mucocutaneous leishmaniasis (Espundia) and visceral leishmaniasis (Kala-azar). Clinical manifestation of the disease depends on the species involved. The symptoms range from cutaneous ulcers to fatal visceral lesions. Because of the diversity of its epidemiological situations, no single diagnosis, treatment and control will be suitable for all. Field diagnosis is difficult in the absence of simpler and less invasive tests with good sensitivity and specificity. The existing parasitological tests from marrow aspirates and splenic aspirates require are invasive and unsuitable for all patients. Recently developed nucleic acid based methods offer an advantage but require sophisticated equipment. Sero-diagnosis has long been in but is associated with a cross-reactivity problem. Nonetheless, many recombinant antigens have helped make these tests more specific. Thus the field of diagnosis is improving and newer approaches offer great promise in making the diagnosis specific and sensitive read more ...