Leishmaniasis

The leishmaniases are a group of diseases caused by protozoan parasites from more than 20 Leishmania species. These parasites are transmitted to humans by the bite of an infected female phlebotomine sandfly, a tiny – 2–3 mm long – insect vector.

There are three main forms of the disease: cutaneous leishmaniasis (CL), visceral leishmaniasis (VL), also known as kala-azar, and mucocutaneous leishmaniasis (MCL). CL is the most common form, VL is the most severe form and MCL is the most disabling form of the disease.

Antileishmanial treatment depends on the causative species and the condition of the patient (e.g. pregnancy, immunosuppression).

Regardless of the causative Leishmania species, antileishmanial treatment cannot provide a sterile cure, and the parasite remains in the human body and can cause a relapse when there is immunosuppression.

Treatment is complex and should be administered by highly experienced health personnel. Most antileishmanial medicines are injectable

CL usually produces ulcers on the exposed parts of the body, such as the face, arms and legs. There may be many lesions – sometimes up to 200 – which can cause serious disability. When the ulcers heal, they invariably leave permanent scars, which can lead to stigmatization, especially for women and girls.

VL is characterized by irregular bouts of fever, substantial weight loss, swelling of the spleen and liver and serious anaemia. If the disease is not treated, the fatality rate can be as high as 100% within 2 years.