A Review of Leishmaniasis: Current Knowledge and Future Directions

Abstract

Purpose of Review The goal of this review is to summarize the current knowledge of the epidemiology, clinical manifestations, diagnosis, and treatment of cutaneous, mucosal, and visceral leishmaniasis. We will describe the most recent findings and suggest areas of further research in the leishmaniasis field. Recent Findings This article reviews newer leishmaniasis tests (including rapid diagnostic tests using rK39 antibodies), vaccine candidates, and updated treatment recommendations. Summary While leishmaniasis is a complex disease, learning the prominent clinical manifestations and major parasite species can guide the recommendations for diagnosis and treatment.

Recent Progress in the Development of Indole-Based Compounds Active against Malaria, Trypanosomiasis and Leishmaniasis

“…Other kinetoplastid diseases that have been long neglected in terms of chemotherapy development are the leishmaniases. They consist of a complex group of parasitic diseases that are caused by intracellular flagellate protozoa of the genus Leishmania and have multiple clinical manifestations [ 31 ]. To date, over 20 species of Leishmania parasites, from the subgenera Leishmania and Viannia , have been identified as infective for humans [ 32 ].…”

“…The main mode of transmission is the bite of hematophagous phlebotomine sand flies (mainly of the genera Phlebotomus and Lutzomyia ) [ 34 ]. Leishmaniases have virtually global distribution, being present in almost 100 countries and endemic in Africa, the Americas, Asia and the Mediterranean region [ 31 ]. An estimated 700,000 to 1 million new cases occur worldwide annually [ 35 ].…”

“…In addition, coinfection with HIV even further complicates the management of visceral leishmaniasis [ 40 ]. Although the chemotherapy for leishmaniasis is more diverse than that for other kinetoplastid diseases, it suffers from the same limitations such as prolonged and high-cost treatment, low therapeutic index, leading to side effects, treatment discontinuation and reported emergence of drug resistance [ 20 , 31 , 33 ]. The first-line treatments for leishmaniasis ( Figure 3 ) are pentavalent antimonials (e.g., sodium stibogluconate ( 8 ) and meglumine antimoniate ( 9 )), but other alternatives such as pentamidine ( 3 ), miltefosine ( 10 ), ketoconazole ( 11 ), amphotericin B ( 12 ) and paromomycin ( 13 ) can be used [ 41 ].…”

Diversity and Epidemiology of Bat Trypanosomes: A One Health Perspective

“…A One Health approach to study the epidemiology, transmission and evolutionary dynamics of vector-borne diseases is crucial for the success of human and animal disease control programmes, particularly neglected diseases in low to middle income countries. These include, for example, dengue fever, leishmaniasis and Chagas disease (or American trypanosomiasis) which collectively represent a significant global health challenge [ 2 , 3 , 4 ].…”

Leishmania 360°: Guidelines for Exosomal Research

“…(2) visceral leishmaniasis (green areas). Both forms present expanding geographic ranges and rapid adaptation influenced by risk factors, with new epidemiological scenarios emerging in previously disease-free areas [9,28,29]. Diagram showing the development of the nanovesicle, which begins with endocytosis, forming the early endosomes, which develop into late endosomes by inward budding, and finally multivesicular bodies that may either undergo degradation (generating lysosomes) or merge with the cell membrane and, by exocytosis, release intraluminal endosomal vesicles that become exosomes in the extracellular environment [30].…”