Epidemiology

• South Asia, S. America

• L. donovani (endemic Africa/South Asia, anthroponotic)and L.infantum (Mediterranian, reservoir: dogs) are the major species. L. chagasi (South America)

Clinical

• Irregular fever

• Weight loss

• Hepatosplenomegaly

• Kala-azar: 'black fever'

Post kala-azar dermal leishmaniasis (PKDL)

Diagnosis

• Visualise parasite: amastigote Donovan bodies [see donovanosis]) in macrophage on bone marrow or spleen

• Antigen detection: RK39 (a recombinant antigen comprising of 39 amino acid repeats (rK39) from Leishmania Chagasi syn infantum) ELISA and immunochromatographic rapid strip test formats)

• Antibody detection: Direct Agglutination Test (DAT)

Treatment

• Liposomal Amphoteracin B

• Oral miltefocin

• Paramonycin (previously)

Prevention