Academic Journal
Visceral leishmaniasis: current status of control, diagnosis, and treatment, and a proposed research and development agenda
| العنوان: | Visceral leishmaniasis: current status of control, diagnosis, and treatment, and a proposed research and development agenda |
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| المؤلفون: | Guerin, P. J., Oliaro, P., Sundar, S., Boelaert, M., Croft, S. L., Desjeux, P., Wasunna, M. K., Bryceson, A. D. M. |
| سنة النشر: | 2002 |
| المجموعة: | Institute of Tropical Medicine (ITM): TropMed Central Antwerp |
| مصطلحات موضوعية: | Protozoal diseases, Leishmaniasis, Visceral, Kala azar, Control strategies, Reservoirs, Early detection, Case management, Vector control, Insecticides, Spraying, DDT, Impregnated bednets, Serology, ELISA, PCR, Treatment, Antimonials, Drug resistance, Second-line drugs, Pentamidine, Adverse effects, Amphotericin B, Drug development, Miltefosine, Sitamaquine, Research, Genomics, Molecular biology |
| الوصف: | Visceral leishmaniasis is common in less developed countries, with an estimated 500000 new cases each year. Because of the diversity of epidemiological situations, no single diagnosis, treatment, or control will be suitable for all. Control measures through case finding, treatment, and vector control are seldom used, even where they could be useful. There is a place for a vaccine, and new imaginative approaches are needed. HIV co-infection is changing the epidemiology and presents problems for diagnosis and case management. Field diagnosis is difficult; simpler, less invasive tests are needed. Current treatments require long courses and parenteral administration, and most are expensive. Resistance is making the mainstay of treatment, agents based on pentavalent antimony, useless in northeastern India, where disease incidence is highest. Second-line drugs (pentamidine and amphotericin B) are limited by toxicity and availability, and newer formulations of amphotericin B are not affordable. The first effective oral drug, miltefosine, has been licensed in India, but the development of other drugs in clinical phases (paromomycin and sitamaquine) is slow. No novel compound is in the pipeline. Drug combinations must be developed to prevent drug resistance. Despite these urgent needs, research and development has been neglected, because a disease that mainly affects the poor ranks as a low priority in the private sector, and the public sector currently struggles to undertake the development of drugs and diagnostics in the absence of adequate funds and infrastructure. This article reviews the current situation and perspectives for diagnosis, treatment, and control of visceral leishmaniasis, and lists some priorities for research and development. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 1473-3099 |
| Relation: | http://dx.doi.org/10.1016/S1473-3099(03)00518-8; ITG-H4A; HEALTH; U-EPID; JIF; DOI; ABSTRACT; http://hdl.handle.net/10390/1278; http://www.ncbi.nlm.nih.gov/pubmed/12150849 |
| DOI: | 10.1016/S1473-3099(03)00518-8 |
| الاتاحة: | http://hdl.handle.net/10390/1278 https://doi.org/10.1016/S1473-3099(03)00518-8 http://www.ncbi.nlm.nih.gov/pubmed/12150849 |
| رقم الانضمام: | edsbas.1D5201A6 |
| قاعدة البيانات: | BASE |
| تدمد: | 14733099 |
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| DOI: | 10.1016/S1473-3099(03)00518-8 |