Desjeux P. Leishmaniasis: current situation and new perspectives

Department of Control, Prevention and Elimination (CDS/CPE), Cluster of Communicable Diseases, World Health Organization (WHO), Avenue Appia, 1211 Geneva 27, Switzerland.
Comparative Immunology Microbiology and Infectious Diseases (Impact Factor: 2.02). 10/2004; 27(5):305-18. DOI: 10.1016/j.cimid.2004.03.004
Source: PubMed


Leishmaniasis represents a complex of diseases with an important clinical and epidemiological diversity. Visceral leishmaniasis (VL) is of higher priority than cutaneous leishmaniasis (CL) as it is a fatal disease in the absence of treatment. Anthroponotic VL foci are of special concern as they are at the origin of frequent and deathly epidemics (e.g. Sudan). Leishmaniasis burden remains important: 88 countries, 350 million people at risk, 500,000 new cases of VL per year, 1-1.5 million for CL and DALYs: 2.4 millions. Most of the burden is concentrated on few countries which allows clear geographic priorities. Leishmaniasis is still an important public health problem due to not only environmental risk factors such as massive migrations, urbanisation, deforestation, new irrigation schemes, but also to individual risk factors: HIV, malnutrition, genetic, etc em leader Leishmaniasis is part of those diseases which still requires improved control tools. Consequently WHO/TDR research for leishmaniasis has been more and more focusing on the development of new tools such as diagnostic tests, drugs and vaccines. The ongoing effort has already produced significant results. The newly available control tools should allow a scaling up of control activities in priority areas. In anthroponotic foci, the feasibility of getting a strong impact on mortality, morbidity and transmission, is high.

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    • "tries including Iran, Afghanistan, Saudi Arabia , Syria, Brazil, Nepal and Peru (Desjeux 2004). The clinical signs and symptoms of CL in humans are in two forms: dry or anthroponotic (Anthroponotic Cutaneous Leishmaniasis or ACL) and wet or zoonotic (Zoonotic Cutaneous Leishmaniasis or ZCL) forms. "

    Full-text · Article · May 2016 · Journal of Arthropod-Borne Diseases
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    • "Clinical disease becomes apparent within weeks to months after infection, depending on the (sub-)species of Leishmania and the host's immune status (Vannier-Santos et al., 2002). The clinical manifestations following Leishmania infection may range from localized, single lesions to multiple cutaneous ulcers, satellite lesions, or nodular lymphangitis, to disease forms with mucosal and even potentially fatal systemic visceral involvement (Desjeux, 2004;Reithinger et al., 2007). Currently, an estimated 12 million individuals in ninety-eight countries throughout the world suffer from one of these forms of leishmaniasis, approximately 350 million people are at risk of contracting the infection, and more than 2 million disability-adjusted life years are lost annually due to this disease (World Health Organization, 2014). "
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    ABSTRACT: Ethnopharmacological relevance: Plant-based preparations are extensively used in Surinamese folk medicine for treating leishmaniasis, but often without a scientific rationale. Aim of the study: To evaluate twenty-five Surinamese medicinal plants for their potential efficacy against leishmaniasis. Materials and methods: Concentrated plant extracts were evaluated for their effect on the viability of L. (V.) guyanensis AMC, L. (L.) major NADIM5, and L. (L.) donovani GEDII promastigotes, as well as intracellular amastigotes of L. (L.) donovani BHU814 in infected THP-1 cells. Selectivity was assessed by cytotoxicity against THP-1 cells. Results: The only plant extract that showed potentially meaningful anti-leishmanial activity was that from Solanum lycocarpum that displayed mean IC50 values of about 51, 61, and<16µg/mL against L. (V) guyanensis, L. (L) major, and L. (L) donovani promastigotes, respectively; about 374µg/mL against L. (L) donovani amastigotes; and>500µg/mL against THP-1 cells. The Bryophyllum pinnatum, Inga alba, and Quassia amara extracts displayed moderate to high IC50 values against promastigotes (about 51 to>500µg/mL) and/or amastigotes (about 224 to>500µg/mL) but were relatively toxic to THP-1 cells (IC50 values<16 to about 42µg/mL). The remaining plant extracts exhibited in many cases IC50 values close to, around, or above 500µg/mL against promastigotes, amastigotes, and THP-1 cells. Conclusions: The S. lycocarpum preparation may be useful against leishmaniasis and may have a good safety index, warranting further investigations into its active constituents and mechanism(s) of action.
    Full-text · Article · Jan 2016 · Journal of Ethnopharmacology
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    • "Leishmaniasis, a vector-borne disease, is endemic in 88 countries (including 72 developing and 13 least developed countries) (Desjeux 1996). Around 30 sandfly species (belonging to genera Phlebotomus) are proven vectors of many important diseases (Desjeux 2004). In addition to Leishmaniasis, Phlebotomus spp. "
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    ABSTRACT: Insecticide resistance is one of the most important evolutionary phenomena for researchers. Overuse of chemicals has induced resistance in insect pests that ultimately has led to the collapse of disease control programs in many countries. The erroneous and inappropriate management of insect vectors has resulted in dissemination of many vector-borne diseases like dengue, malaria, diarrhea, leishmaniasis, and many others. In most cases, the emergence of new diseases and the revival of old ones can be related with ecological changes that have favored rapid growth of vector densities. Understanding molecular mechanisms in resistant strains can assist in the development of management programs to control the development and spread of resistant insect populations. The dominant, recessive, and co-dominant forms of genes encoding resistance can be investigated, and furthermore, resistance development can be addressed either by the release of susceptible strains or timely insecticide rotation. The present review discusses the resistance level in all important insect vectors of human diseases; the molecular basis of evolvement of resistance has also been discussed.
    Full-text · Article · Jan 2016 · Parasitology Research
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