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Visceral leishmaniasis

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1053: 154: 1139: 70: 1195:(DNDi). Combination therapies allow for the use of existing drugs in combination, each in lower doses, which helps to decrease the incidence of severe side effects and drug toxicity, as well as the risk for development of resistance against the drugs; they have been shown to be cost-effective strategies. Comparative homology modelling of the enzyme Hypoxanthine-guanine phosphoribosyl transferase (HGPRT; EC 2.4.2.8) in 790:. T cells isolated from both cured and asymptomatic PBMC activate autologous macrophages to kill intracellular amastigotes. IFN-γ activates macrophages to kill intracellular parasites so its role in VL has been studied extensively and IFN-γ production is often used as a marker of protective immunity. Cured PBMC generally secrete less IFN-γ and more 703:
responded to this new treatment. Miltefosine has received approval by the Indian regulatory authorities in 2002, in Germany in 2004 and in U.S.A. in 2014. It is now registered in other countries such as Nepal, Argentina, Bangladesh, Bolivia, Colombia, Ecuador, Guatemala, Honduras, Mexico, Pakistan, Paraguay, Peru, and Israel.
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tests look for an immune response and not for the organism itself, the test does not become negative after the patient is cured, it cannot be used as a check for cure, or to check for re-infection or relapse. Likewise, patients with abnormal immune systems (e.g., HIV infection) will have false-negative tests.
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DNDi has a number of compounds in preclinical and phase 1 development, but no novel drugs are expected in the next 5 years. In the meantime, new combination therapies, and well as improvements to existing drugs targets, are under development. Single-dosage administrations of liposomal amphotericin B
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is the first oral treatment for this disease. The cure rate of miltefosine in Phase III clinical trials is 95%; Studies in Ethiopia show that is also effective in Africa. In HIV immunosuppressed people which are coinfected with leishmaniasis it has shown that even in resistant cases 2/3 of the people
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Regulatory B cells are known to favor development of regulatory T cells and suppress development of Type 1 T helper cells by producing IL-10 and other down-regulatory cytokines. IL-10 levels are elevated in B cells from VL PBMC. A study of dogs with naturally acquired VL showed that the percentage of
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and could explain the anergy of VL, poor response to drug treatment, development of PKDL, and relapses. A role for regulatory cells in VL has long been suspected. A variety of regulatory T and B cells have been implicated in VL, including Type 1 T helper cells that secrete IL-10 in addition to IFN-γ,
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immunity and prevent IFN-γ from activating macrophages, its role in VL has been studied extensively and elevated IL-10 production is often used as a marker of non-protective immunity in VL. Elevated levels of IL-10 in the plasma, infected tissues, and PBMC of VL patients accompany the anergy of VL.
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The drug is generally better tolerated than other drugs. Main side effects are gastrointestinal disturbance in the first or second day of treatment (a course of treatment is 28 days) which does not affect the efficacy. Because it is available as an oral formulation, the expense and inconvenience of
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There are a number of problems with serological testing: in highly endemic areas, not everyone who becomes infected will actually develop clinical disease or require treatment. Indeed, up to 32% of the healthy population may test positive, but not require treatment. Conversely, because serological
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4. If you are not sleeping in a well-screened or air-conditioned area, use a bed net and tuck it under your mattress. If possible, use a bed net that has been soaked in or sprayed with a pyrethroid-containing insecticide. The same treatment can be applied to screens, curtains, sheets, and clothing
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antigen specific T cell clones from cured patient PBMC confirm that cured patients have a mixed T cell response that involves both CD4+ helper T cells and CD4+ and CD8+ regulatory T cells. Two studies of asymptomatic T cell clones show that most have Type 1 profiles and secrete more IFN-γ than T
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antigen specific IL-10 secretion, suggesting that CD8+ regulatory T cells are responsible for endogenous IL-10 secretion. CD4+ clones could only be isolated from VL PBMC after CD8+ T cell depletion. The CD4+ clones had little effect on IL-10 secretion but decreased IFN-γ secretion when mixed with
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Even with recovery, kala-azar does not always leave its hosts unmarked. Some time after successful treatment—generally a few months with African kala-azar, or as much as several years with the Indian strain—a secondary form of the disease may set in, called post kala-azar dermal leishmaniasis, or
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that allows mobility. The promastigotes live extracellularly in the alimentary canal, reproducing asexually, then migrate to the proximal end of the gut where they become poised for a regurgitational transmission. As the fly bites, the promastigotes are released from the proboscis and introduced
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antigen specific IL-10 and IFN-γ secretion are not correlated, suggesting that endogenous secretion is more important in pathology. Addition of anti-IL-10 increases proliferation and IFN-γ secretion by PBMC from some patients. Both CD4+ and CD8+ T cells have been shown to contribute to IL-10
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antigen specific IFN-γ secretion The highest levels of IL-10 mRNA in spleen cells is in CD8+ and other non-FoxP3+ T cells. White blood cell CD8+ T cells from VL patients have elevated IL-10 levels. There is a 9.6 fold increase in IL-10 expressing CD8+ T cells among PBMC lymphocytes from PKDL
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is sorely lacking and parasites or insect vectors are becoming increasingly resistant to existing anti-parasite drugs. Possibly due to the lack of financial return, new drugs are slow to emerge and much of the basic research into potential drug targets takes place in universities, funded by
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hospitalization is avoided, and outpatient distribution of the drug becomes an option, making miltefosine a drug of choice. However, there are some important disadvantages: 1) there is evidence of reduced efficacy after a decade of use 2) it is potentially embryotoxic, fetotoxic and
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As of 2018, there are no vaccines or preventive drugs for visceral leishmaniasis, but vaccines are in development. The most effective method to prevent infection is to protect from sand fly bites. To decrease the risk of being bitten, these precautionary measures are suggested:
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for use in treating VL; its antileishmanial properties were first identified in the 1980s. A treatment with paromomycin costs about US$ 15. The drug had originally been identified in the 1960s. The Indian government approved paromomycin for sale and use in August 2006.
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and Dr. William McClure, are credited with finding the cure for the disease in China. Largely uncredited for her contribution, Dow was one of the first to isolate the microorganism in China and conduct clinical studies on its origin. This work continued under
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More than 90% of the global burden of visceral leishmaniasis (VL) was contributed by seven countries in 2015: Brazil, Ethiopia, India, Kenya, Somalia, South Sudan and Sudan. In India, more than 70% of VL cases are reported from the state of Bihar. North
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3. Apply insect repellent to exposed skin and under the ends of sleeves and pant legs. Follow the instructions on the label of the repellent. The most effective repellents generally are those that contain the chemical DEET (N,N-diethylmetatoluamide).
755:, and genetic and environmental factors. Protective immunity develops either after successful treatment of VL (cured) or after asymptomatic infections that resolve without development of VL (asymptomatic). Both types of immunity are characterized by 6974: 6959: 575:) gave correct, positive results in 64% of the people with the disease and it gave correct, negative results in 93% of the people without the disease. Other types of tests have not been studied thoroughly enough to ascertain their efficacy. 3551:
Pasquau F, Ena J, Sanchez R, et al. (June 2005). "Leishmaniasis as an opportunistic infection in HIV-infected patients: determinants of relapse and mortality in a collaborative study of 228 episodes in a Mediterranean region".
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PKDL. This condition manifests first as small, measle-like skin lesions on the face, which gradually increase in size and spread over the body. Eventually the lesions may coalesce to form disfiguring, swollen structures resembling
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2. When outdoors (or in unprotected quarters), minimize the amount of exposed (uncovered) skin to the extent that is tolerable in the climate. Wear long-sleeved shirts, long pants, and socks; and tuck your shirt into your pants.
2874:"Mixed Inflammatory/Regulatory Cytokine Profile Marked by Simultaneous Raise of Interferon-g and Interleukin-10 and Low Frequency of Tumor Necrosis Factor-a Monocytes Are Hallmarks of Active Human Visceral Leishmaniasis Due to 914:
However, while the disease's geographical range is broad, it is not continuous. The disease clusters around areas of drought, famine, and high population density. In Africa, this has meant a knot of infection centers mostly in
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or regulatory T cells. Some clones secreted soluble factors that caused the death of CD8+ regulatory T cells but not CD4+ T cells from VL patients, which might explain the strong protective immunity of asymptomatic patients.
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Thakur CP, Pandey AK, Sinha GP, Roy S, Behbehani K, Olliaro P (1996). "Comparison of three treatment regimens with liposomal amphotericin B (AmBisome) for visceral leishmaniasis in India: a randomized dose-finding study".
1025:; as such the disease is named for the darkening of the skin on the extremities and abdomen that is a symptom of the Indian form of the disease. The agent of the disease was also first isolated in India by Scottish doctor 931:
region, are almost totally cut off from the rest of the country, and most people tend to remain at their place of birth although there have been huge population movements due to the civil war, leading to severe epidemics.
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for the treatment of kala-azar) and a new disease, post kala-azar dermal leishmaniasis. Brahmachari's cure for visceral leishmaniasis was the urea salt of para-amino-phenyl stibnic acid which he called Urea Stibamine.
1549:"Time to death and its determinant factors of visceral leishmaniasis with HIV co-infected patients during treatment period admitted at Metema hospital, Metema, Ethiopia: a hospital-based cross-sectional study design" 1103:
out of the region, and these traveled either across the southern border or into the remoter western part of the country called the Upper Nile, where both war and the disease that went with it had not yet penetrated.
422:). So, it appears that a great majority of kala-azar patients in the Indian subcontinent are exposed to a RNA virus in LS, the co-infecting parasite with LD i.e. the "LD-LS-Lepsey NLV1 triple pathogen" phenomenon. 1804:
Alexander, Bruce; Lopes de Carvalho, Renata; McCallum, Hamish; Pereira, Marcos Horácio (December 2002). "Role of the Domestic Chicken (Gallus gallus)in the Epidemiology of Urban Visceral Leishmaniasis in Brazil".
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A 2018 study published details of a new potential preclinical drug candidate for the treatment for visceral leishmaniasis with an anti-leishmanial drug-like chemical series based on a pyrazolopyrimidine scaffold.
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sometimes being seen as well. The blackening of the skin that gave the disease its common name in India does not appear in most strains of the disease, and the other symptoms are very easy to mistake for those of
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patients. In the one study of T cell clones from VL patients, the clones isolated from VL PBMC were 100% CD8+. When mixed with self PBMC one or three years after successful treatment the CD8+ T cells decreased
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infection. Progress of the disease is extremely variable, taking anywhere from one to twenty weeks, but a typical duration for the Sudanese strain of the disease is narrower, between twelve and sixteen weeks.
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dipstick test is easy to perform, and village health workers can be easily trained to use it. The kit may be stored at ambient temperature and no additional equipment needs to be carried to remote areas. The
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Thakur CP, Singh RK, Hassan SM, Kumar R, Narain S, Kumar A (1999). "Amphotericin B deoxycholate treatment of visceral leishmaniasis with newer modes of administration and precautions: a study of 938 cases".
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PKDL patients also have elevated IL-10 levels. VL patients with the highest IL-10 levels are more likely to be unresponsive to treatment and progress to PKDL. PBMC secretion of IL-10 without the addition of
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test) gave correct, positive results in 92% of the people with visceral leishmaniasis and it gave correct, negative results in 92% of the people who did not have the disease. A second rapid test (called
4117:"Effectiveness of miltefosine in cutaneous leishmaniasis caused by Leishmania tropica in Pakistan after antimonial treatment failure or contraindications to first line therapy-A retrospective analysis" 1099:, where civil war has been continuous since 1983, the violence has been concentrated in the more populated south, and kala-azar was concentrated there too. But the wars have driven a steady stream of 7622: 474:
response of the macrophage. The daughter cells protozoans then migrate to fresh cells or through the bloodstream to find new hosts. In this way the infection is progressive, spreading to the host's
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El-Amin LM, Khalid KE, El-Badry AA (2020). "Risk-free point-of-care visceral leishmaniasis diagnostics: combining buffy coat microscopy and immunoassay in tertiary rural hospitals in Sudan".
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in the New World. Sandflies are tiny flies, measuring 3–6 mm long by 1.5–3 mm in diameter, and are found in tropical or temperate regions throughout the world. The sandfly species
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is the primary vector of this disease. The larvae grow in warm, moist organic matter around human habitations (such as old trees, house walls, or waste) making them hard to eradicate.
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is completed in two hosts, humans and sandflies. The adult female sandfly is a bloodsucker, usually feeding at night on sleeping prey. When the fly bites an individual infected with
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in its various liposomal preparations. In East Africa, the WHO recommended treatment is SSG&PM (sodium stibogluconate and paromomycin) developed by Drugs for Neglected Diseases
446:, which is round, non-motile, and only 3–7 micrometers in diameter. Inside the stomach of the sandfly, the amastigotes quickly transform into elongated and motile forms called the 267:
synthesised urea stibamine (carbostibamide) in 1922 and determined that it was an effective substitute for the other antimony-containing compounds in the treatment of VL caused by
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antigen specific T cell proliferation and IFN-γ secretion. Co-culture of T cells with B cells decreased the percentage of CD4+ T cell proliferation and IFN-γ secretion four-fold.
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regulatory B cells increased three-fold during VL. Depletion of B cells increased CD4+ T cell proliferation and IFN-γ secretion but decreased IL-10 secretion. Blocking IL-10 or
7509:"Synthesis, characterization, and mechanistic studies of a gold nanoparticle-amphotericin B covalent conjugate with enhanced antileishmanial efficacy and reduced cytotoxicity" 5356:
Hailu A, van Baarle D, Knol G, et al. (2005). "T Cell and Cytokine Profiles in Human Visceral Leishmaniasis during Active and Asymptomatic or Sub-clinical Infection with
1939:"Breeding sites of phlebotomine sand flies (Diptera: Psychodidae) and efficiency of extraction techniques for immature stages in terra-firme forest in Amazonas State, Brazil" 1217:
have been shown to be effective, and oral formulations are currently under development to increase access and facilitate distribution of the efficacious drug in the field.
5607:"High Levels of Plasma IL-10 and Expression of IL-10 by Keratinocytes during Visceral Leishmaniasis Predict Subsequent Development of Post-kala-azar Dermal Leishmanniasis" 1463: 510:
mRNA were also up-regulated in lesional tissue from PKDL patients. However, T regs are not elevated in spleen cells from VL patients nor does depletion of T regs increase
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antigen specific proliferation and IFN-γ secretion and increased IL-10 secretion. Depletion of CD8+ T cells from VL PBMC stopped endogenous IL-10 secretion but increased
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responses and protective immunity so its role in VL has also been studied. Addition of IL-12 to some VL PBMC increases proliferation and IFN-γ secretion in response to
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Cillari E, Vitale G, Arcoleo F, et al. (1995). "In Vivo and In Vitro Cytokine and Mononuclear Cell Subsets in Sicilian Patients with Visceral Leishmaniasis".
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Sundar S, Singh RK, Maurya R, et al. (June 2006). "Serological diagnosis of Indian visceral leishmaniasis: direct agglutination test versus rK39 strip test".
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were defenseless against this new pathogen, foreign to them though it came only from another part of their own country. One village at the center of the epidemic,
7358: 462:. Inside the cells they transform back into the smaller amastigote form. The amastigotes replicate in the most hostile part of the macrophage cell, inside the 6571:
Ansari MY, Dikhit MR, Sahoo GC, Das P (April 2012). "Comparative modeling of HGPRT enzyme of L. donovani and binding affinities of different analogs of GMP".
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and other antigens as the disease progresses. In addition to skin test negativity, VL patient PBMC do not proliferate or secrete IL-2 or IFN-γ in response to
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Mookerjee Basu J, Mookerjee A, Banerjee R, Saha M, Singh S, Naskar K, Tripathy G, Sinha PK, Pandey K, Sundar S, Bimal S, Das PK, Choudhuri SK, Roy S (2008).
4068:"Increasing Failure of Miltefosine in the Treatment of Kala-azar in Nepal and the Potential Role of Parasite Drug Resistance, Reinfection, or Noncompliance" 2727:"Enhanced Lesional FoxP3 Expression and Peripheral Anergic Lymphocytes Indicate a Role for Regulatory T Cells in Indian Post-Kala-azar Dermal Leishmaniasis" 927:. Living conditions here have changed very little in the past century, and the people are not normally very mobile. Parts of South Sudan, in particular the 7063: 6290: 2384: 3452:"Rapid, noninvasive diagnosis of visceral leishmaniasis in India: comparison of two immunochromatographic strip tests for detection of anti-K39 antibody" 1095:
Contemporary life has made itself felt even here, however—not as "progress" but in the form of the many small wars of Africa's post-colonial era. In the
1316:"Epidemiologic Correlates of Mortality among Symptomatic Visceral Leishmaniasis Cases: Findings from Situation Assessment in High Endemic Foci in India" 5809:"Clinical and Laboratory Findings of Visceral Leishmaniasis in Children Hospitalized in Mashhad, Northeastern Iran: A Twenty-Year Retrospective Study" 5076:"IL-10- and TGF-B-Mediated Susceptibility in Kala-azar and Post-kala-azar Dermal Leishmaniasis: The Significance of Amphotericin B in the Control of 4176:"The safety and efficacy of miltefosine in the long-term treatment of post-kala-azar dermal leishmaniasis in South Asia - A review and meta-analysis" 2035:"Detection of Leptomonas seymouri narna-like virus in serum samples of visceral leishmaniasis patients and its possible role in disease pathogenesis" 1064:
Today, the name kala-azar is used interchangeably with the scientific name visceral leishmaniasis for the most acute form of the disease caused by
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Ratnapriya S, Keerti, Sahasrabuddhe AA, Dube A (12 June 2019). "Visceral leishmaniasis: An overview of vaccine adjuvants and their applications".
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Schaut RG, Lamb IM, Toepp AJ, Scott B, Mendes-Aguiar CO, Coutinho JF, Jeronimo SM, Wilson ME, Harty JT, Waldschmidt TJ, Petersen CA (2016-05-15).
1192: 911:) is the endemic zone of this disease. The disease is endemic in more than 70 countries. In Iran this includes Ardabil, Fars, and North Khorasan. 806:
antigens and anti-IL-12 inhibits proliferation and IFN-γ secretion by some cured PBMC. Other cytokines also appear to be important in immunity to
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Sukla S, Nath, Himadri, Kamran, Mohd., Ejazi, Sarfaraz Ahmad, Ali, Nahid, Das, Pradeep, Ravichandiran, V, Roy, Syamal, Biswas, Subhajit (2022).
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natural T reg, Tr1, CD8+ T reg, and B reg. All of these lymphocytes act, at least in part, by secreting IL-10 and other suppressive cytokines.
711:, and thus cannot be used without anticonception in women of child-bearing age for three months (in some cases, five months) after treatment. 6025: 2207: 1262: 1153: 5517:"Presence of Circulating Levels of Interferon-gamma, Interleukin-10 and Tumor Necrosis Factor-alpha in Patients with Visceral Leishmaniasis" 5024:-specific T Cells Expressing Interferon-gamma (IFN-γ) and IL-10 upon Activation Are Expanded in Individuals Cured of Visceral Leishmaniasis" 5558:"Immune Response in Human Visceral Leishmaniasis: Analysis of the Correlation between Innate Immunity Cytokine Profile and Disease Outcome" 4949:"A Historic Review of the Role of CD4+ T-Cell Subsets in Development of the Immune Responses against Cutaneous and Visceral Leishmaniases" 4565:
Carvalho E, Barral A, Pedral-Sampaio D, et al. (1992). "Immunologic Markers of Clinical Evolution in Children Recently Infected with
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These refugees, moving at foot-speed, carried the disease with them, and when it arrived it hit the Upper Nile with a force comparable to
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CD4+ T regs are present at increased frequency in the bone marrow of VL patients, are one source of IL-10, and proliferate in response to
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their host cell by sheer pressure of mass, but there is some recent speculation that they are able to leave the cell by triggering the
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Responses of Skin Test Positive Adults to Inhibit Peripheral Blood Mononuclear Cell Activities Associated with Visceral Leishmaniasis"
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Ilg T, Stierhof, YD, Wiese, M, McConville, MJ, Overath, P (1994). "Characterization of phosphoglycan-containing secretory products of
1112: 6331: 6015: 478:, particularly the spleen and liver. The free amastigotes in peripheral tissues are then ingested by sandfly to enter another cycle. 404:
Visceral Leishmaniasis/kala-azar samples from India revealed the presence of not only the primary causative protozoan parasite, i.e.
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are known to give rise to the visceral form of the disease. The species commonly found in East Africa and the Indian subcontinent is
7351: 6381: 6357: 5995: 5701:"Visceral Leishmaniasis: Epidemiology, Diagnosis, and Treatment Regimens in Different Geographical Areas with a Focus on Pediatrics" 4888:
Almeida FS, Vanderley SE, Comberlang FC, Andrade AG, Cavalcante-Silva LH, Silva ED, Palmeira PH, Amaral IP, Keesen TS (2023-05-15).
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Kämink S, Masih B, Ali N, Ullah A, Khan SJ, Ashraf S, Pylypenko T, Grobusch MP, Fernhout J, den Boer M, Ritmeijer K (January 2021).
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Chappuis F, Sundar, Shyam, Hailu, Asrat, Ghalib, Hashim, Rijal, Suman, Peeling, Rosanna W., Alvar, Jorge, Boelaert, Marleen (2007).
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Scarpini S, Dondi A, Totaro C, Biagi C, Melchionda F, Zama D, Pierantoni L, Gennari M, Campagna C, Prete A, Lanari M (2022-09-21).
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Rijal S, Ostyn B, Uranw S, Rai K, Bhattarai NR, Dorlo TP, Beijnen JH, Vanaerschot M, Decuypere S, Dhakal SS, Das ML (2013-06-01).
6494: 2768:"Splenic Accumulation of IL-10 mRNA T Cells Distinct from CD4+ CD25+ (FoxP3+) Regulatory T Cells in Human Visceral Leishmaniasis" 1381: 7056: 529: 6817:
Arzamani K, Fazeli R, Shirzadi MR, Raeghi S, Arzamani M, Alavinia SM. Visceral Leishmaniasis in North Khorasan Province, Iran.
1115:. The isolated people of the Upper Nile had no access to medicine or education about the new disease among them. Worse, their 1072:, where it was first discovered, but is seen at its most deadly in north and east Africa. It can also be found throughout the 7617: 3368:"A meta-analysis of the diagnostic performance of the direct agglutination test and rK39 dipstick for visceral leishmaniasis" 1041:, working independently of each other. As they published their discovery almost simultaneously, the species was named by Sir 880:
secretion by VL PBMC. The high level of immune complexes characteristic of VL have also been shown to increase IL-10 levels.
1128: 685:. Resistance is now common in India, and rates of resistance have been shown to be as high as 60% in parts of Bihar, India. 588: 6630:
den Boer, M.L., Alvar, J., Davidson, R.N., et al. (2009). "Developments in the treatment of visceral leishmaniasis".
5656:"Circulating Immune Complexes (IC) and IC-induced Levels of GM-CSF Are Increased in Sudanese Patients with Acute Visceral 718: 670:
works on the development of new treatments (combination treatments and new chemical entities) for visceral leishmaniasis.
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Gewurtz MS (2017-01-01). "Transnationalism in Missionary Medicine: The Case of Kala-azar in China and India, 1909–1946".
5985: 4235:"Miltefosine for visceral and cutaneous leishmaniasis: drug characteristics and evidence-based treatment recommendations" 7344: 1663:
Idris M, Farid J, Gul N, Anis-ur-Rehman n (2010). "Visceral leishmaniasis: adult population of Abbottabad at risk now".
475: 6313: 3029:"Leishmania specific CD4 T cells release IFNγ that limits parasite replication in patients with visceral leishmaniasis" 494:
is to suppress CMI enough to prevent tissue damage. However, an excessive regulatory response can prevent clearance of
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also produces inflammation. If the inflammation is excessive, it can cause tissue damage. The role of regulatory T and
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Kumar P, Shivam P, Mandal S, Prasanna P, Kumar S, Prasad SR, Kumar A, Das P, Ali V, Singh SK, Mandal D (2019-08-20).
5415:"In vivo Cytokine Profiles in Patients with Kala-azar. Marked Elevation of Both Interleukin-10 and Interferon-gamma" 3840:"Epidemiological, clinical & pharmacological study of antimony-resistant visceral leishmaniasis in Bihar, India" 7049: 6405: 3799:"Failure of pentavalent antimony in visceral leishmaniasis in India: report from the center of the Indian epidemic" 5181:
Infection Is Associated with CD8+ and Gamma-interferon and Interleukin-5 Producing CD4+ Antigen-specific T Cells"
3137:"Regulatory IgDhi B Cells Suppress T Cell Function via IL-10 and PD-L1 during Progressive Visceral Leishmaniasis" 3088:"Regulatory IgDhi B Cells Suppress T Cell Function Via IL-10 and PD-L1 during Progressive Visceral Leishmaniasis" 1814: 584: 247: 4466:"Cell Mediated Immunity in American Visceral Leishmaniasis: Reversible Immunosuppression during Acute Infection" 6989: 6510:"Cost-effectiveness projections of single and combination therapies for visceral leishmaniasis in Bihar, India" 2423: 1132: 1052: 760: 572: 6827:
Wyllie S, Thomas M, Patterson S, Crouch S, De Rycker M, Lowe R, Gresham S, Urbaniak MD, Otto TD (2018-07-25).
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2. Keep in mind that sand flies are much smaller than mosquitoes and therefore can get through smaller holes.
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New treatment for kala azar, the most deadly parasitic disease after malaria. ScienceDaily, 23 September 2011
1490:"Effects of Visceralising Leishmania on the Spleen, Liver, and Bone Marrow: A Pathophysiological Perspective" 7441: 7183: 7175: 7120: 1149: 1142: 1138: 1057: 334: 317: 296:. Misdiagnosis is dangerous, as without proper treatment the mortality rate for kala-azar is close to 100%. 264: 3995: 1754: 1183:
On 31 October 2023, Bangladesh has been declared to be the first country to totally eradicate the disease.
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Locally, the disease was called kala-azar or black fever, which is the meaning in the Hindustani language.
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and analogs of acyclovir had higher binding affinities than the real substrate (guanosine monophosphate).
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1. Avoid outdoor activities, especially from dusk to dawn, when sand flies generally are the most active.
553: 2726: 226:, and, if left untreated, will almost always result in the death of the host. Signs and symptoms include 7299: 7164: 6798: 6740: 6677: 6551: 4998: 1180:
at the School of Tropical Medicine at Calcutta to discover that kala-azar was transmitted by sandflies.
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During the nineteenth century, kala-azar was discovered near moving bodies of water in southeast Asia.
2663:"Regulatory T Cells Suppress T Cell Activation at the Pathologic Site in Human Visceral Leishmaniasis" 846:
VL patients are unable to clear their infections because they lack CMI. This anergy may be limited to
549: 69: 7313: 6840: 6376:. Shteir, Ann B.; Lightman, Bernard V. (1st ed.). Hanover, N.H.: Dartmouth College Press. 2006. 2674: 2046: 1225: 1002: 863: 31: 4011:"Why miltefosine-a life-saving drug for leishmaniasis-is unavailable to people who need it the most" 2988:"Role of CD8+ T Cells in Endogenous Interleukin-10 Secretion Associated with Visceral Leishmaniasis" 153: 7375: 7367: 7202: 7198: 7160: 7079: 6978: 4757:"Interleukin-12 Restores Interferon-γ Production and Cytotoxic Responses in Visceral Leishmaniasis" 1254: 1022: 971: 361: 355: 3773: 1060:
himself. The death rate is drastically declined from nearly 6300 to 750 within ten years in Assam.
333:, and occasionally causing blindness if they spread to the eyes. (This disease is not the same as 190:
and, without proper diagnosis and treatment, is associated with high fatality. Leishmaniasis is a
7168: 7114: 6917: 6728: 6665: 6539: 6399: 5587: 5395: 5125:-reactive TH1-like T Cell Clones from Individuals Who Have Recovered from Visceral Leishmaniasis" 4694: 4638: 3577: 2415: 2262: 2172: 2125: 2015: 1787: 1735: 1224:
There is no good vaccine candidate which prevents kala azar. A 2019 paper described designing an
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antigens than asymptomatic PBMC. IL-12 is important in the development and maintenance of Type 1
491: 419: 243: 7041: 5883: 466:, whose normal defensive response they are able to prevent. After repeated multiplication, they 320:
that are more likely to kill, flaring up in a host whose immune system has been weakened by the
4518:"Absence of gamma interferon and interleukin 2 production during active visceral leishmaniasis" 1314:
Das A, Karthick M, Dwivedi S, Banerjee I, Mahapatra T, Srikantiah S, Chaudhuri I (2016-11-01).
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Infection Undergoing Sodium Stibogluconate Treatment: Implications for Disease Pathogenesis"
5626: 5618: 5569: 5528: 5487: 5479: 5434: 5426: 5377: 5369: 5330: 5290: 5282: 5241: 5200: 5192: 5144: 5136: 5091: 5043: 5035: 4976: 4960: 4919: 4901: 4862: 4821: 4771: 4729: 4676: 4620: 4609:"Restoration of IFN-gamma Production and Lymphocyte Proliferation in Visceral Leishmaniasis" 4578: 4537: 4529: 4485: 4477: 4404: 4293: 4246: 4205: 4187: 4146: 4128: 4079: 4038: 4022: 3957: 3918: 3882: 3810: 3745: 3729: 3630: 3561: 3523: 3515: 3471: 3463: 3424: 3387: 3379: 3338: 3330: 3319:"Rapid tests for the diagnosis of visceral leishmaniasis in patients with suspected disease" 3283: 3246: 3230: 3164: 3148: 3107: 3099: 3058: 3040: 2999: 2953: 2945: 2897: 2889: 2839: 2831: 2787: 2779: 2738: 2692: 2682: 2630: 2612: 2571: 2553: 2512: 2504: 2463: 2399: 2357: 2293: 2244: 2195: 2156: 2107: 2062: 2054: 1999: 1950: 1903: 1866: 1848: 1769: 1711: 1635: 1619: 1578: 1560: 1519: 1501: 1464:"Upendranath Brahmachari—forgotten Bengali scientist behind kala-azar cure got 2 Nobel nods" 1434: 1345: 1327: 1246: 1026: 772: 752: 714:
Incomplete treatment has been cited as a major reason of death from visceral leishmaniasis.
97: 5271:"Cell-mediated Immune Response in Indian Kala-azar and Post-kala-azar Dermal Leishmaniasis" 4431: 4344: 4326: 3595: 3027:
Kumar R, Singh N, Gautam S, Singh OP, Gidwani K, Rai M, Sacks D, Sundar S, Nylén S (2014).
591:, is much more cumbersome to use and appears not to have any advantages over the K39 test. 7487: 7446: 7319: 7274: 7105: 7096: 6335: 4351: 3691: 3667: 1038: 654: 563: 312:
are omnipresent in the immuno-depressed regions where leishmaniasis thrives, and, as with
91: 4067: 1247: 6844: 6765:"Highly effective oral amphotericin B formulation against murine visceral leishmaniasis" 5807:
Shamsian SA, Fata A, Alinezhad R, Mohebali M, Sadabadi F, Moghaddas E, Fakhar M (2020).
4924: 4889: 4234: 3946:"Amphotericin B colloidal dispersion for the treatment of Indian visceral leishmaniasis" 2678: 2050: 1990:
narna-like virus 1 and not leishmaniaviruses detected in kala-azar samples from India".
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charitable organizations. Product Development Partnership, Drugs for Neglected Diseases
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antigen (endogenous) is inversely correlated with antigen specific IFN-γ secretion but
859: 791: 776: 689: 30:
This article is about visceral leishmaniasis in humans. For the disease in canids, see
7560:"Inhibition of ABC Transporters Abolishes Antimony Resistance in Leishmania Infection" 6983: 6157:
Ribeiro RR, Michalick MS, da Silva ME, Dos Santos CC, Frézard FJ, da Silva SM (2018).
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NEW CURE FOR DEADLY VISCERAL LEISHMANIASIS (KALA-AZAR) APPROVED BY GOVERNMENT OF INDIA
3922: 3886: 3287: 2958: 2934:"Potential Role for Interleukin-10 in the Immunosuppression Associated with Kala-azar" 2933: 2517: 2492: 1955: 1938: 1715: 1439: 1422: 450:. Promastigote is spindle-shaped, triple the size of the amastigote, and has a single 7606: 7146: 7087: 6921: 6526: 6509: 6295: 5869:
Life, Death and Aid: The Médecins Sans Frontières Report on World Crisis Intervention
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testing is much more frequently used in areas where leishmaniasis is endemic. A 2014
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Gillespie PM, Beaumier CM, Strych U, Hayward T, Hotez PJ, Bottazzi ME (2016-06-03).
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itself is not usually the direct cause of death in people with kala-azar, however.
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Combination drug therapies are currently under investigation, particularly by the
1127:, the doctor who led relief efforts in the Upper Nile for the French organization 6994: 4625: 4608: 4368:
Saha S, Mondal S, Banerjee, et al. (2006). "Immune Responses in Kala-azar".
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antigen stimulation of PBMC from cured patients show a mixed T helper cell and
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Parasitology (protozoology and helminthology) in relation to clinical medicine
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The treatment of choice for visceral leishmaniasis acquired in India is now
451: 439: 391: 309: 301: 195: 7593: 7544: 6913: 6878: 6790: 6724: 6661: 6592: 6535: 6445: 6261: 6202: 6175: 6143: 5850: 5793: 5744: 5685: 5583: 5391: 5334: 5214: 5105: 5057: 4990: 4933: 4874: 4866: 4835: 4416: 4381: 4313: 4281: 4266: 4219: 4160: 4101: 4052: 3971: 3894: 3858: 3824: 3759: 3652: 3573: 3537: 3485: 3436: 3401: 3352: 3303: 3260: 3178: 3121: 3072: 3013: 2911: 2853: 2801: 2752: 2706: 2644: 2585: 2477: 2411: 2369: 2305: 2258: 2217: 2121: 2076: 2011: 1972: 1923: 1880: 1783: 1731: 1684: 1649: 1592: 1533: 1448: 1359: 6715: 6699:"Single-dose liposomal amphotericin B for visceral leishmaniasis in India" 6698: 6234: 6084: 6043:"The identification of kala-azar and the discovery of Leishmania donovani" 5640: 5542: 5501: 5448: 5342: 5304: 5255: 5158: 4785: 4741: 4690: 4634: 4590: 4551: 4499: 3930: 3619:"Status of vaccine research and development of vaccines for leishmaniasis" 2967: 2526: 2168: 279:
When people develop visceral leishmaniasis, the most typical symptoms are
7575: 7466: 7408: 7383: 7076: 6291:"As South Sudan implodes, America reconsiders its support for the regime" 4964: 4250: 4084: 2783: 2743: 1168: 1157: 1108: 1100: 998: 851: 787: 559: 231: 198: 17: 7525: 6951: 6829:"Cyclin-dependent kinase 12 is a drug target for visceral leishmaniasis" 6652: 2249: 2232: 1774: 1084:, is responsible for leishmaniasis in the new world. Several species of 833:
cell clones from cured patients. Neither study revealed the presence of
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may be depleted in VL patient PBMC. Since IL-10 is known to suppress
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Kala-azar first came to the attention of Western doctors in 1824 in
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and the species found in Europe, North Africa, and Latin America is
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suggest that among all of the computationally screened compounds,
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Of particular concern, according to the 152: 41: 7583: 7534: 7524: 6868: 6780: 6714: 6651: 6525: 6435: 6251: 6233: 6192: 6174: 6133: 6115: 6074: 5987:Framework for Industrialization in Africa 5840: 5783: 5734: 5716: 5675: 5630: 5573: 5532: 5515:Medeiros I, Castelo A, Salomão R (1998). 5491: 5438: 5381: 5294: 5245: 5204: 5148: 5095: 5069: 5067: 5047: 4980: 4923: 4905: 4825: 4775: 4680: 4654: 4652: 4624: 4541: 4489: 4209: 4191: 4150: 4132: 4083: 4042: 3961: 3814: 3749: 3634: 3527: 3475: 3391: 3342: 3250: 3168: 3111: 3062: 3044: 3003: 2957: 2901: 2843: 2813: 2811: 2791: 2742: 2696: 2686: 2634: 2616: 2575: 2557: 2516: 2467: 2445: 2443: 2248: 2192:Molecular Mechanisms of Parasite Invasion 2111: 2066: 1954: 1870: 1852: 1773: 1639: 1582: 1564: 1523: 1505: 1438: 1349: 1331: 27:Human disease caused by protist parasites 4894:Tropical Medicine and Infectious Disease 1056:The miracle of urea stibamine, drawn by 962:gave kala-azar one of its common names, 7499: 5170: 5168: 4009:Sunyoto T, Potet J, Boelaert M (2018). 1237: 1193:Drugs for Neglected Diseases initiative 341:genus which also causes skin lesions.) 6796: 6738: 6675: 6549: 6397: 5937: 5895: 4996: 3502:Lockwood DN, Sundar S (October 2006). 2656: 2654: 779:(IL-12) secretion by peripheral blood 7564:Antimicrobial Agents and Chemotherapy 7513:International Journal of Nanomedicine 5963:Merriam-Webster's online dictionary. 1841:Journal of Global Infectious Diseases 1154:Nobel Prize in Physiology or Medicine 7: 6338:. Vigyan Prasar: Government of India 3554:Eur. J. Clin. Microbiol. Infect. Dis 1374:"Leishmaniasis and HIV co-infection" 1309: 1307: 1305: 1303: 7241:Primary amoebic meningoencephalitis 3994:FDA News Release (19 March 2014). 3217:Thakur S, Joshi J, Kaur S (2020). 743:is determined by the interplay of 673:The traditional treatment is with 250:(WHO), is the emerging problem of 25: 4358:Press Release, September 8, 2006. 3288:10.1016/j.actatropica.2020.105599 1956:10.1016/j.actatropica.2010.10.012 1896:Medical and Veterinary Entomology 1612:Current Tropical Medicine Reports 77:Amastigotes in a chorionic villus 6632:Expert Opinion on Emerging Drugs 6527:10.1111/j.1365-3156.2009.02306.x 6017:Textbook of Medical Parasitology 5623:10.1046/j.1365-2249.1998.00468.x 5575:10.1111/j.1365-3083.2005.01686.x 5197:10.1128/IAI.67.11.5559-5566.1999 5040:10.1046/j.1365-2249.1999.00918.x 4180:PLOS Neglected Tropical Diseases 4121:PLOS Neglected Tropical Diseases 3033:PLOS Neglected Tropical Diseases 2894:10.1111/j.1365-2249.2006.03171.x 2605:PLOS Neglected Tropical Diseases 2113:10.1046/j.1462-5822.2001.00115.x 1753:Chappuis F, et al. (2007). 1320:PLOS Neglected Tropical Diseases 1148:The Indian medical practitioner 244:swelling of the liver and spleen 96: 68: 5813:Iranian Journal of Parasitology 5764:Iranian Journal of Parasitology 5534:10.1590/S0036-46651998000100007 5141:10.1128/IAI.61.3.1069-1073.1993 4827:10.1590/S0074-02761999000100013 3005:10.1590/s0074-02762000000200013 1908:10.1111/j.0269-283x.2004.0487.x 532:receptors on B cells increased 6585:10.1016/j.ijbiomac.2012.01.010 6100:"The history of leishmaniasis" 5718:10.3390/microorganisms10101887 4280:Sindermann H, Engel J (2006). 3335:10.1002/14651858.CD009135.pub2 1279:"WHO | Visceral leishmaniasis" 186:", is the most severe form of 1: 6906:10.1016/j.vaccine.2019.04.092 6163:BioMed Research International 5287:10.1128/IAI.42.2.702-707.1983 4482:10.1128/IAI.33.2.498-500.1981 4397:Trans. R. Soc. Trop. Med. Hyg 4356:Institute for OneWorld Health 3923:10.1016/S0035-9203(96)90271-0 3911:Trans. R. Soc. Trop. Med. Hyg 3887:10.1016/S0035-9203(99)90037-8 3875:Trans. R. Soc. Trop. Med. Hyg 3636:10.1016/j.vaccine.2015.12.071 3468:10.1128/JCM.44.1.251-253.2006 3417:Trans. R. Soc. Trop. Med. Hyg 3223:Journal of Parasitic Diseases 1716:10.1016/S0140-6736(18)31204-2 1507:10.3390/microorganisms9040759 1440:10.1016/S0035-9203(01)90223-8 1253:. Saunders Elsevier. p.  719:Institute for OneWorld Health 6461:Social Sciences and Missions 4626:10.4049/jimmunol.152.12.5949 4409:10.1016/0035-9203(61)90078-5 4298:10.1016/j.trstmh.2006.02.010 4239:Clinical Infectious Diseases 4193:10.1371/journal.pntd.0007173 4134:10.1371/journal.pntd.0008988 4072:Clinical Infectious Diseases 3429:10.1016/j.trstmh.2005.08.018 3046:10.1371/journal.pntd.0003198 2688:10.1371/journal.pone.0031551 2618:10.1371/journal.pntd.0002914 2469:10.1016/j.immuni.2015.04.005 2362:10.1016/0035-9203(60)90057-2 2298:10.1016/0035-9203(60)90057-2 2200:10.1007/978-0-387-78267-6_14 1807:Emerging Infectious Diseases 1333:10.1371/journal.pntd.0005150 1088:serve as reservoir hosts of 1068:. The disease is endemic in 942:Leishmaniasis § History 476:mononuclear phagocyte system 7190:Mucocutaneous leishmaniasis 6098:Steverding D (2017-02-15). 5677:10.4049/jimmunol.178.8.5383 5521:Rev Inst Med Trop Sao Paulo 5097:10.4049/jimmunol.179.8.5592 4682:10.4049/jimmunol.154.9.4623 4567:Leishmania donovani chagasi 3722:BMJ (Clinical Research Ed.) 3520:10.1136/bmj.38989.567083.BE 3384:10.1136/bmj.38917.503056.7C 3193:"Leishmaniasis - Diagnosis" 2237:Nature Reviews Microbiology 1762:Nature Reviews Microbiology 1402:. World Health Organization 1021:means fever in Persian and 661:) effective and affordable 7639: 5374:10.1016/j.clim.2005.06.015 4953:Iranian Biomedical Journal 4907:10.3390/tropicalmed8050276 3668:"Preventing Leishmaniasis" 3323:Cochrane Database Syst Rev 3235:10.1007/s12639-020-01212-w 2450:Rosser E, Mauri C (2015). 2059:10.1038/s41598-022-18526-9 1624:10.1007/s40475-021-00232-7 1566:10.1186/s40794-023-00203-y 939: 887: 455:locally at the bite site. 29: 7442:African sleeping sickness 6853:10.1038/s41586-018-0356-z 6644:10.1517/14728210903153862 6473:10.1163/18748945-03001001 6117:10.1186/s13071-017-2028-5 6059:10.1017/s0025727300042691 4777:10.1093/infdis/173.6.1515 4027:10.1136/bmjgh-2018-000709 3774:"DNDi Annual Report 2015" 3566:10.1007/s10096-005-1342-6 2559:10.1186/s13071-016-1412-x 2392:Nature Reviews Immunology 2161:10.1017/s0031182000075739 2004:10.1007/s00705-017-3559-y 1817::10.3201/eid0812.010485. 389:in the Old World, and of 285:enlargement of the spleen 248:World Health Organization 76: 67: 5825:10.18502/ijpa.v15i4.4854 4734:10.1093/infdis/167.2.411 4583:10.1093/infdis/165.3.535 3734:10.1136/bmj.326.7385.377 3696:www.medicalnewstoday.com 3153:10.4049/jimmunol.1502678 3104:10.4049/jimmunol.1502678 1462:Hazra K (July 7, 2023). 1133:South Sudanese Civil War 1129:Médecins Sans Frontières 573:latex agglutination test 482:Regulatory T and B cells 318:opportunistic infections 289:enlargement of the liver 182:, "black sickness") or " 7488:Priority review voucher 7176:Cutaneous leishmaniasis 7121:African trypanosomiasis 6420:"Dr. L. Everard Napier" 6104:Parasites & Vectors 4967:(inactive 2024-06-06). 4814:Mem. Inst. Oswaldo Cruz 2992:Mem. Inst. Oswaldo Cruz 2546:Parasites & Vectors 1854:10.4103/0974-777X.62866 1150:Upendranath Brahmachari 1143:Upendranath Brahmachari 1058:Upendranath Brahmachari 1031:Dumdum, Calcutta, India 966:. Another common name, 842:Non-protective immunity 794:(IL-10) in response to 675:pentavalent antimonials 335:cutaneous leishmaniasis 265:Upendranath Brahmachari 45:Visceral leishmaniasis 7210:Visceral leishmaniasis 6573:Int. J. Biol. Macromol 6424:Indian Medical Gazette 6404:: CS1 maint: others ( 6348:Christensen E (2005). 5335:10.1006/cyto.1995.0088 4867:10.1006/cyto.2000.0694 4430:Manson-Bahr P (1967). 1152:was nominated for the 1145: 1061: 1037:) and Irish physician 850:antigens or extend to 783:(PBMC) in response to 757:cell-mediated immunity 164:Visceral leishmaniasis 7618:Insect-borne diseases 7300:Trichomonas vaginalis 6716:10.1056/NEJMoa0903627 6352:. MQUP. p. 195. 6235:10.3390/vetsci9080387 3141:Journal of Immunology 2836:10.1093/infdis/jit401 2319:Chatterjee K (2009). 2100:Cellular Microbiology 1384:on February 19, 2007. 1141: 1090:L. infantum (chagasi) 1055: 997:which means black in 683:meglumine antimoniate 679:sodium stibogluconate 600:erythrosalicylic acid 568:immunochromatographic 530:programmed cell death 398:Lutzomyia longipalpis 7576:10.1128/aac.01196-07 7314:Dientamoeba fragilis 6430:(5): 252. May 1943. 6176:10.1155/2018/3296893 4965:10.52547/ibj.26.2.99 2784:10.1084/jem.20061141 2744:10.1038/jid.2009.393 1992:Archives of Virology 1400:WHO Fact sheet N°375 1226:immunologic adjuvant 1001:, as well as in the 761:skin test positivity 554:bone marrow aspirate 418:narna-like virus 1 ( 32:canine leishmaniasis 7526:10.2147/IJN.S196421 7376:Diseases of poverty 7368:Diseases of poverty 6845:2018Natur.560..192W 6514:Trop Med Int Health 6222:Veterinary Sciences 6014:Paniker CJ (2013). 5758:Mohebali M (2013). 5658:Leishmania donovani 5466:Leishmania donovani 5358:Leishmania donovani 5179:Leishmania infantum 5123:Leishmania donovani 5080:Infection in India" 5078:Leishmania donovani 4663:Leishmania donovani 4292:(Suppl 1): S17–20. 2731:J. Invest. Dermatol 2679:2012PLoSO...731551R 2346:Leishmania donovani 2282:Leishmania donovani 2250:10.1038/nrmicro1748 2051:2022NatSR..1214436S 1988:Leptomonas seymouri 1835:Claborn DM (2010). 1775:10.1038/nrmicro1748 1421:Desjeux P. (2001). 1047:Leishmania donovani 1005:from it, including 1003:languages descended 993:), is derived from 950:, British Raj (now 899:, India (including 735:Protective immunity 506:antigen. Levels of 416:Leptomonas seymouri 411:Leptomonas seymouri 406:Leishmania donovani 269:Leishmania donovani 148:Infectious diseases 7424:Neglected diseases 7409:Diarrheal diseases 7016:External resources 6607:"Portfolio – DNDi" 6334:2018-12-25 at the 6299:. 12 October 2017. 6041:Gibson ME (1983). 5611:Clin. Exp. Immunol 5234:Clin. Exp. Immunol 5028:Clin. Exp. Immunol 4804:Holaday B (1999). 4718:Leishmania chagasi 4350:2007-07-06 at the 4251:10.1093/cid/civ004 4085:10.1093/cid/cit102 3847:Indian J. Med. Res 3666:CDC (2024-03-11). 3598:. January 10, 2013 3456:J. Clin. Microbiol 2986:Holaday B (2000). 2882:Clin. Exp. Immunol 2876:Leishmania chagasi 2383:Belkaid Y (2007). 2039:Scientific Reports 1710:(10151): 951–970. 1146: 1062: 917:South Sudan, Sudan 890:Kala azar in India 492:regulatory B cells 430:The life cycle of 275:Signs and symptoms 254:/VL co-infection. 242:, and substantial 7496: 7495: 7334: 7333: 7330: 7329: 7251: 7250: 7235:Naegleria fowleri 7220: 7219: 7073:Parasitic disease 7039: 7038: 6900:(27): 3505–3519. 6839:(7717): 192–197. 6027:978-93-5090-534-0 5562:Scand. J. Immunol 5484:10.1172/JCI116570 5431:10.1172/JCI116372 4534:10.1172/JCI112209 4436:E. African Med. J 4078:(11): 1530–1538. 4015:BMJ Global Health 3950:Clin. Infect. Dis 3803:Clin. Infect. Dis 3728:(7385): 377–382. 3629:(26): 2992–2995. 3147:(10): 4100–4109. 2950:10.1172/JCI116878 2509:10.1172/JCI113969 2209:978-0-387-78266-9 2155:(Suppl): S63-71. 2090:Sacks DL (2001). 1813:(12): 1480–1485. 1264:978-0-7216-2921-6 1045:for both of them— 1033:- hence the name 989: 981: 818:regulatory T cell 781:mononuclear cells 759:(CMI), including 745:white blood cells 170:), also known as 161: 160: 39:Medical condition 16:(Redirected from 7630: 7598: 7597: 7587: 7570:(3): 1080–1093. 7555: 7549: 7548: 7538: 7528: 7504: 7361: 7354: 7347: 7338: 7262: 7206: 7172: 7157:Leishmania major 7102: 7093: 7066: 7059: 7052: 7043: 6943: 6926: 6925: 6889: 6883: 6882: 6872: 6824: 6818: 6815: 6809: 6808: 6802: 6794: 6784: 6757: 6751: 6750: 6744: 6736: 6718: 6694: 6688: 6687: 6681: 6673: 6655: 6627: 6621: 6620: 6618: 6617: 6603: 6597: 6596: 6568: 6562: 6561: 6555: 6547: 6529: 6505: 6499: 6498: 6491: 6485: 6484: 6456: 6450: 6449: 6439: 6416: 6410: 6409: 6403: 6395: 6370: 6364: 6363: 6345: 6339: 6324: 6318: 6310:Nobel Foundation 6307: 6301: 6300: 6287: 6281: 6280: 6272: 6266: 6265: 6255: 6237: 6213: 6207: 6206: 6196: 6178: 6154: 6148: 6147: 6137: 6119: 6095: 6089: 6088: 6078: 6038: 6032: 6031: 6011: 6005: 6004: 5984:Taku TA (1999). 5981: 5975: 5974: 5972: 5971: 5960: 5954: 5953: 5943: 5935: 5933: 5932: 5921: 5912: 5911: 5901: 5893: 5891: 5890: 5879: 5873: 5872: 5864: 5855: 5854: 5844: 5804: 5798: 5797: 5787: 5755: 5749: 5748: 5738: 5720: 5696: 5690: 5689: 5679: 5651: 5645: 5644: 5634: 5602: 5596: 5595: 5577: 5553: 5547: 5546: 5536: 5512: 5506: 5505: 5495: 5459: 5453: 5452: 5442: 5410: 5404: 5403: 5385: 5353: 5347: 5346: 5318: 5309: 5308: 5298: 5266: 5260: 5259: 5249: 5225: 5219: 5218: 5208: 5172: 5163: 5162: 5152: 5116: 5110: 5109: 5099: 5090:(8): 5592–5603. 5071: 5062: 5061: 5051: 5015: 5009: 5008: 5002: 4994: 4984: 4944: 4938: 4937: 4927: 4909: 4885: 4879: 4878: 4846: 4840: 4839: 4829: 4801: 4790: 4789: 4779: 4761: 4752: 4746: 4745: 4709: 4703: 4702: 4684: 4656: 4647: 4646: 4628: 4604: 4595: 4594: 4562: 4556: 4555: 4545: 4528:(6): 2066–2069. 4513: 4504: 4503: 4493: 4461: 4452: 4451: 4427: 4421: 4420: 4392: 4386: 4385: 4370:Indian J Med Res 4365: 4359: 4342: 4336: 4335:, July 31, 2006. 4324: 4318: 4317: 4277: 4271: 4270: 4245:(9): 1398–1404. 4230: 4224: 4223: 4213: 4195: 4171: 4165: 4164: 4154: 4136: 4112: 4106: 4105: 4087: 4063: 4057: 4056: 4046: 4006: 4000: 3999: 3991: 3985: 3982: 3976: 3975: 3965: 3941: 3935: 3934: 3905: 3899: 3898: 3869: 3863: 3862: 3844: 3835: 3829: 3828: 3818: 3794: 3788: 3787: 3785: 3784: 3778: 3770: 3764: 3763: 3753: 3713: 3707: 3706: 3704: 3703: 3688: 3682: 3681: 3679: 3678: 3663: 3657: 3656: 3638: 3614: 3608: 3607: 3605: 3603: 3592: 3586: 3585: 3548: 3542: 3541: 3531: 3499: 3490: 3489: 3479: 3447: 3441: 3440: 3412: 3406: 3405: 3395: 3363: 3357: 3356: 3346: 3314: 3308: 3307: 3271: 3265: 3264: 3254: 3214: 3208: 3207: 3205: 3204: 3189: 3183: 3182: 3172: 3132: 3126: 3125: 3115: 3083: 3077: 3076: 3066: 3048: 3024: 3018: 3017: 3007: 2983: 2972: 2971: 2961: 2929: 2916: 2915: 2905: 2869: 2858: 2857: 2847: 2815: 2806: 2805: 2795: 2763: 2757: 2756: 2746: 2722: 2711: 2710: 2700: 2690: 2658: 2649: 2648: 2638: 2620: 2596: 2590: 2589: 2579: 2561: 2537: 2531: 2530: 2520: 2488: 2482: 2481: 2471: 2447: 2438: 2437: 2435: 2434: 2428: 2422:. Archived from 2389: 2380: 2374: 2373: 2341: 2335: 2334: 2316: 2310: 2309: 2277: 2271: 2270: 2252: 2228: 2222: 2221: 2187: 2181: 2180: 2140: 2134: 2133: 2115: 2087: 2081: 2080: 2070: 2030: 2024: 2023: 1983: 1977: 1976: 1958: 1934: 1928: 1927: 1891: 1885: 1884: 1874: 1856: 1832: 1826: 1802: 1796: 1795: 1777: 1759: 1750: 1744: 1743: 1695: 1689: 1688: 1660: 1654: 1653: 1643: 1603: 1597: 1596: 1586: 1568: 1544: 1538: 1537: 1527: 1509: 1485: 1479: 1478: 1476: 1474: 1459: 1453: 1452: 1442: 1418: 1412: 1411: 1409: 1407: 1392: 1386: 1385: 1380:. Archived from 1370: 1364: 1363: 1353: 1335: 1326:(11): e0005150. 1311: 1298: 1297: 1295: 1294: 1289:on July 15, 2013 1285:. Archived from 1275: 1269: 1268: 1252: 1242: 1174:Ernest Struthers 1113:American Indians 1027:William Leishman 983: 975: 773:interferon gamma 753:immune complexes 696:(DNDi) in 2010. 550:splenic aspirate 365:, also known as 157: 156: 133: 132: 129: 128: 125: 122: 119: 115: 114: 111: 108: 105: 102: 95: 72: 42: 21: 7638: 7637: 7633: 7632: 7631: 7629: 7628: 7627: 7603: 7602: 7601: 7557: 7556: 7552: 7506: 7505: 7501: 7497: 7492: 7471: 7457:River blindness 7447:Schistosomiasis 7418: 7370: 7365: 7335: 7326: 7320:Dientamoebiasis 7285: 7275:Giardia lamblia 7247: 7216: 7196: 7184:L. braziliensis 7154: 7141: 7106:Trypanosomiasis 7097:Trypanosomatida 7082: 7070: 7040: 7035: 7034: 7011: 7010: 6954: 6940: 6930: 6929: 6891: 6890: 6886: 6826: 6825: 6821: 6816: 6812: 6795: 6759: 6758: 6754: 6737: 6696: 6695: 6691: 6674: 6629: 6628: 6624: 6615: 6613: 6605: 6604: 6600: 6570: 6569: 6565: 6548: 6507: 6506: 6502: 6493: 6492: 6488: 6458: 6457: 6453: 6418: 6417: 6413: 6396: 6384: 6372: 6371: 6367: 6360: 6347: 6346: 6342: 6336:Wayback Machine 6325: 6321: 6308: 6304: 6289: 6288: 6284: 6274: 6273: 6269: 6215: 6214: 6210: 6156: 6155: 6151: 6097: 6096: 6092: 6047:Medical History 6040: 6039: 6035: 6028: 6013: 6012: 6008: 5998: 5983: 5982: 5978: 5969: 5967: 5962: 5961: 5957: 5936: 5930: 5928: 5923: 5922: 5915: 5894: 5888: 5886: 5881: 5880: 5876: 5866: 5865: 5858: 5806: 5805: 5801: 5757: 5756: 5752: 5698: 5697: 5693: 5653: 5652: 5648: 5604: 5603: 5599: 5555: 5554: 5550: 5514: 5513: 5509: 5461: 5460: 5456: 5419:J. Clin. Invest 5412: 5411: 5407: 5355: 5354: 5350: 5320: 5319: 5312: 5268: 5267: 5263: 5227: 5226: 5222: 5191:(11): 5559–66. 5174: 5173: 5166: 5118: 5117: 5113: 5073: 5072: 5065: 5017: 5016: 5012: 4995: 4946: 4945: 4941: 4887: 4886: 4882: 4848: 4847: 4843: 4803: 4802: 4793: 4759: 4754: 4753: 4749: 4711: 4710: 4706: 4658: 4657: 4650: 4619:(12): 5949–56. 4606: 4605: 4598: 4564: 4563: 4559: 4522:J. Clin. Invest 4515: 4514: 4507: 4463: 4462: 4455: 4429: 4428: 4424: 4394: 4393: 4389: 4367: 4366: 4362: 4352:Wayback Machine 4343: 4339: 4325: 4321: 4279: 4278: 4274: 4232: 4231: 4227: 4186:(2): e0007173. 4173: 4172: 4168: 4127:(1): e0008988. 4114: 4113: 4109: 4065: 4064: 4060: 4008: 4007: 4003: 3993: 3992: 3988: 3983: 3979: 3943: 3942: 3938: 3907: 3906: 3902: 3871: 3870: 3866: 3842: 3837: 3836: 3832: 3796: 3795: 3791: 3782: 3780: 3776: 3772: 3771: 3767: 3715: 3714: 3710: 3701: 3699: 3690: 3689: 3685: 3676: 3674: 3665: 3664: 3660: 3616: 3615: 3611: 3601: 3599: 3594: 3593: 3589: 3550: 3549: 3545: 3514:(7571): 711–2. 3501: 3500: 3493: 3449: 3448: 3444: 3414: 3413: 3409: 3378:(7571): 723–6. 3365: 3364: 3360: 3329:(6): CD009135. 3316: 3315: 3311: 3273: 3272: 3268: 3216: 3215: 3211: 3202: 3200: 3191: 3190: 3186: 3134: 3133: 3129: 3085: 3084: 3080: 3026: 3025: 3021: 2985: 2984: 2975: 2938:J. Clin. Invest 2931: 2930: 2919: 2871: 2870: 2861: 2817: 2816: 2809: 2765: 2764: 2760: 2724: 2723: 2714: 2660: 2659: 2652: 2598: 2597: 2593: 2539: 2538: 2534: 2497:J. Clin. Invest 2490: 2489: 2485: 2449: 2448: 2441: 2432: 2430: 2426: 2404:10.1038/nri2189 2387: 2382: 2381: 2377: 2343: 2342: 2338: 2331: 2318: 2317: 2313: 2279: 2278: 2274: 2230: 2229: 2225: 2210: 2189: 2188: 2184: 2142: 2141: 2137: 2089: 2088: 2084: 2032: 2031: 2027: 1998:(12): 3827–35. 1985: 1984: 1980: 1936: 1935: 1931: 1893: 1892: 1888: 1834: 1833: 1829: 1803: 1799: 1757: 1752: 1751: 1747: 1700:"Leishmaniasis" 1697: 1696: 1692: 1662: 1661: 1657: 1605: 1604: 1600: 1546: 1545: 1541: 1487: 1486: 1482: 1472: 1470: 1461: 1460: 1456: 1420: 1419: 1415: 1405: 1403: 1396:"Leishmaniasis" 1394: 1393: 1389: 1372: 1371: 1367: 1313: 1312: 1301: 1292: 1290: 1277: 1276: 1272: 1265: 1244: 1243: 1239: 1234: 1189: 1039:Charles Donovan 944: 938: 892: 886: 844: 820:response. Both 737: 732: 655:trypanosomiasis 651: 608: 564:Cochrane review 542: 484: 428: 376:are species of 349:Two species of 347: 277: 151: 137: 116: 99: 90: 89: 46: 40: 35: 28: 23: 22: 15: 12: 11: 5: 7636: 7634: 7626: 7625: 7620: 7615: 7605: 7604: 7600: 7599: 7550: 7498: 7494: 7493: 7491: 7490: 7485: 7479: 7477: 7473: 7472: 7470: 7469: 7464: 7459: 7454: 7452:Dracunculiasis 7449: 7444: 7439: 7437:Chagas disease 7434: 7428: 7426: 7420: 7419: 7417: 7416: 7411: 7406: 7401: 7396: 7391: 7386: 7380: 7378: 7372: 7371: 7366: 7364: 7363: 7356: 7349: 7341: 7332: 7331: 7328: 7327: 7325: 7324: 7323: 7322: 7310: 7309: 7308: 7306:Trichomoniasis 7295: 7293: 7291:Trichomonadida 7287: 7286: 7284: 7283: 7270: 7268: 7259: 7253: 7252: 7249: 7248: 7246: 7245: 7244: 7243: 7230: 7228: 7226:Schizopyrenida 7222: 7221: 7218: 7217: 7215: 7214: 7213: 7212: 7194: 7193: 7192: 7180: 7179: 7178: 7151: 7149: 7143: 7142: 7140: 7139: 7138: 7137: 7135:Chagas disease 7125: 7124: 7123: 7110: 7108: 7099: 7090: 7084: 7083: 7071: 7069: 7068: 7061: 7054: 7046: 7037: 7036: 7033: 7032: 7020: 7019: 7017: 7013: 7012: 7009: 7008: 6997: 6986: 6971: 6955: 6950: 6949: 6947: 6946:Classification 6939: 6938:External links 6936: 6928: 6927: 6884: 6819: 6810: 6782:10.1086/600105 6752: 6709:(6): 504–512. 6689: 6638:(3): 395–410. 6622: 6598: 6563: 6520:(8): 918–925. 6500: 6486: 6467:(1–2): 30–43. 6451: 6411: 6382: 6365: 6358: 6340: 6319: 6302: 6282: 6267: 6208: 6149: 6090: 6053:(2): 203–213. 6033: 6026: 6006: 5996: 5976: 5955: 5913: 5874: 5856: 5819:(4): 495–499. 5799: 5770:(3): 348–358. 5750: 5705:Microorganisms 5691: 5670:(8): 5383–89. 5646: 5597: 5568:(5): 487–495. 5548: 5507: 5454: 5405: 5348: 5310: 5261: 5220: 5164: 5135:(3): 1069–73. 5111: 5063: 5010: 4939: 4880: 4861:(8): 1228–31. 4841: 4791: 4764:J. Infect. Dis 4747: 4722:J. Infect. Dis 4704: 4648: 4596: 4571:J. Infect. Dis 4557: 4505: 4476:(2): 498–502. 4453: 4422: 4387: 4360: 4337: 4332:New York Times 4319: 4272: 4225: 4166: 4107: 4058: 4021:(3): e000709. 4001: 3986: 3977: 3963:10.1086/500138 3936: 3900: 3864: 3830: 3816:10.1086/318121 3789: 3765: 3708: 3683: 3658: 3609: 3587: 3543: 3491: 3442: 3407: 3358: 3309: 3266: 3229:(2): 253–272. 3209: 3184: 3127: 3098:(10): 4100–9. 3078: 3019: 2973: 2944:(6): 2626–32. 2917: 2859: 2824:J. Infect. Dis 2807: 2758: 2737:(4): 1013–22. 2712: 2650: 2591: 2532: 2483: 2439: 2398:(11): 875–88. 2375: 2356:(2): 191–196. 2336: 2329: 2311: 2272: 2243:(11): S7–S16. 2223: 2208: 2182: 2135: 2082: 2025: 1978: 1949:(3): 204–208. 1929: 1886: 1847:(2): 127–134. 1827: 1797: 1768:(11): 873–82. 1745: 1690: 1671:(2): 214–215. 1655: 1618:(2): 121–132. 1598: 1539: 1494:Microorganisms 1480: 1454: 1413: 1387: 1365: 1299: 1270: 1263: 1236: 1235: 1233: 1230: 1188: 1185: 1117:immune systems 937: 934: 885: 882: 860:Memory T cells 843: 840: 792:interleukin 10 777:interleukin 12 736: 733: 731: 728: 717:The nonprofit 690:amphotericin B 650: 647: 633: 632: 617: 616: 607: 604: 541: 538: 483: 480: 427: 424: 346: 343: 316:, it is these 276: 273: 159: 158: 145: 139: 138: 136: 135: 85: 83: 79: 78: 74: 73: 65: 64: 55: 51: 50: 38: 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 7635: 7624: 7621: 7619: 7616: 7614: 7613:Leishmaniasis 7611: 7610: 7608: 7595: 7591: 7586: 7581: 7577: 7573: 7569: 7565: 7561: 7554: 7551: 7546: 7542: 7537: 7532: 7527: 7522: 7519:: 6073–6101. 7518: 7514: 7510: 7503: 7500: 7489: 7486: 7484: 7481: 7480: 7478: 7476:Miscellaneous 7474: 7468: 7465: 7463: 7462:Leishmaniasis 7460: 7458: 7455: 7453: 7450: 7448: 7445: 7443: 7440: 7438: 7435: 7433: 7430: 7429: 7427: 7425: 7421: 7415: 7412: 7410: 7407: 7405: 7402: 7400: 7397: 7395: 7392: 7390: 7387: 7385: 7382: 7381: 7379: 7377: 7373: 7369: 7362: 7357: 7355: 7350: 7348: 7343: 7342: 7339: 7321: 7318: 7317: 7316: 7315: 7311: 7307: 7304: 7303: 7302: 7301: 7297: 7296: 7294: 7292: 7288: 7281: 7277: 7276: 7272: 7271: 7269: 7267: 7266:Diplomonadida 7263: 7260: 7258: 7254: 7242: 7239: 7238: 7237: 7236: 7232: 7231: 7229: 7227: 7223: 7211: 7208: 7207: 7205: 7204: 7200: 7195: 7191: 7188: 7187: 7186: 7185: 7181: 7177: 7174: 7173: 7171: 7170: 7166: 7165:L. aethiopica 7162: 7158: 7153: 7152: 7150: 7148: 7147:Leishmaniasis 7144: 7136: 7133: 7132: 7131: 7130: 7126: 7122: 7119: 7118: 7117: 7116: 7112: 7111: 7109: 7107: 7103: 7100: 7098: 7094: 7091: 7089: 7088:Discicristata 7085: 7081: 7078: 7074: 7067: 7062: 7060: 7055: 7053: 7048: 7047: 7044: 7031: 7027: 7026: 7022: 7021: 7018: 7014: 7007: 7003: 7002: 6998: 6996: 6992: 6991: 6987: 6985: 6981: 6980: 6976: 6972: 6970: 6966: 6965: 6961: 6957: 6956: 6953: 6948: 6944: 6937: 6935: 6933: 6923: 6919: 6915: 6911: 6907: 6903: 6899: 6895: 6888: 6885: 6880: 6876: 6871: 6866: 6862: 6858: 6854: 6850: 6846: 6842: 6838: 6834: 6830: 6823: 6820: 6814: 6811: 6806: 6800: 6792: 6788: 6783: 6778: 6775:(3): 357–60. 6774: 6770: 6766: 6762: 6756: 6753: 6748: 6742: 6734: 6730: 6726: 6722: 6717: 6712: 6708: 6704: 6700: 6693: 6690: 6685: 6679: 6671: 6667: 6663: 6659: 6654: 6649: 6645: 6641: 6637: 6633: 6626: 6623: 6612: 6608: 6602: 6599: 6594: 6590: 6586: 6582: 6579:(3): 637–49. 6578: 6574: 6567: 6564: 6559: 6553: 6545: 6541: 6537: 6533: 6528: 6523: 6519: 6515: 6511: 6504: 6501: 6496: 6490: 6487: 6482: 6478: 6474: 6470: 6466: 6462: 6455: 6452: 6447: 6443: 6438: 6433: 6429: 6425: 6421: 6415: 6412: 6407: 6401: 6393: 6389: 6385: 6383:1-58465-602-6 6379: 6375: 6369: 6366: 6361: 6359:9780773572591 6355: 6351: 6344: 6341: 6337: 6333: 6330: 6329: 6323: 6320: 6317: 6316: 6311: 6306: 6303: 6298: 6297: 6296:The Economist 6292: 6286: 6283: 6278: 6271: 6268: 6263: 6259: 6254: 6249: 6245: 6241: 6236: 6231: 6227: 6223: 6219: 6212: 6209: 6204: 6200: 6195: 6190: 6186: 6182: 6177: 6172: 6168: 6164: 6160: 6153: 6150: 6145: 6141: 6136: 6131: 6127: 6123: 6118: 6113: 6109: 6105: 6101: 6094: 6091: 6086: 6082: 6077: 6072: 6068: 6064: 6060: 6056: 6052: 6048: 6044: 6037: 6034: 6029: 6023: 6019: 6018: 6010: 6007: 6003: 5999: 5997:9780275964986 5993: 5989: 5988: 5980: 5977: 5966: 5959: 5956: 5951: 5947: 5941: 5927: 5920: 5918: 5914: 5909: 5905: 5899: 5885: 5878: 5875: 5870: 5863: 5861: 5857: 5852: 5848: 5843: 5838: 5834: 5830: 5826: 5822: 5818: 5814: 5810: 5803: 5800: 5795: 5791: 5786: 5781: 5777: 5773: 5769: 5765: 5761: 5754: 5751: 5746: 5742: 5737: 5732: 5728: 5724: 5719: 5714: 5710: 5706: 5702: 5695: 5692: 5687: 5683: 5678: 5673: 5669: 5665: 5661: 5659: 5650: 5647: 5642: 5638: 5633: 5628: 5624: 5620: 5616: 5612: 5608: 5601: 5598: 5593: 5589: 5585: 5581: 5576: 5571: 5567: 5563: 5559: 5552: 5549: 5544: 5540: 5535: 5530: 5526: 5522: 5518: 5511: 5508: 5503: 5499: 5494: 5489: 5485: 5481: 5477: 5473: 5472:J Clin Invest 5469: 5467: 5458: 5455: 5450: 5446: 5441: 5436: 5432: 5428: 5425:(4): 1664–8. 5424: 5420: 5416: 5409: 5406: 5401: 5397: 5393: 5389: 5384: 5379: 5375: 5371: 5368:(2): 182–91. 5367: 5363: 5362:Clin. Immunol 5359: 5352: 5349: 5344: 5340: 5336: 5332: 5328: 5324: 5317: 5315: 5311: 5306: 5302: 5297: 5292: 5288: 5284: 5280: 5276: 5275:Infect. Immun 5272: 5265: 5262: 5257: 5253: 5248: 5243: 5240:(2): 207–14. 5239: 5235: 5231: 5224: 5221: 5216: 5212: 5207: 5202: 5198: 5194: 5190: 5186: 5185:Infect. Immun 5182: 5180: 5171: 5169: 5165: 5160: 5156: 5151: 5146: 5142: 5138: 5134: 5130: 5129:Infect. Immun 5126: 5124: 5115: 5112: 5107: 5103: 5098: 5093: 5089: 5085: 5081: 5079: 5070: 5068: 5064: 5059: 5055: 5050: 5045: 5041: 5037: 5033: 5029: 5025: 5023: 5014: 5011: 5006: 5000: 4992: 4988: 4983: 4978: 4974: 4970: 4966: 4962: 4959:(2): 99–109. 4958: 4954: 4950: 4943: 4940: 4935: 4931: 4926: 4921: 4917: 4913: 4908: 4903: 4899: 4895: 4891: 4884: 4881: 4876: 4872: 4868: 4864: 4860: 4856: 4852: 4845: 4842: 4837: 4833: 4828: 4823: 4819: 4815: 4811: 4809: 4800: 4798: 4796: 4792: 4787: 4783: 4778: 4773: 4770:(6): 1515–8. 4769: 4765: 4758: 4751: 4748: 4743: 4739: 4735: 4731: 4728:(2): 411–17. 4727: 4723: 4719: 4715: 4708: 4705: 4700: 4696: 4692: 4688: 4683: 4678: 4675:(9): 4623–9. 4674: 4670: 4666: 4664: 4655: 4653: 4649: 4644: 4640: 4636: 4632: 4627: 4622: 4618: 4614: 4610: 4603: 4601: 4597: 4592: 4588: 4584: 4580: 4577:(3): 535–40. 4576: 4572: 4568: 4561: 4558: 4553: 4549: 4544: 4539: 4535: 4531: 4527: 4523: 4519: 4512: 4510: 4506: 4501: 4497: 4492: 4487: 4483: 4479: 4475: 4471: 4470:Infect. Immun 4467: 4460: 4458: 4454: 4449: 4445: 4442:(4): 177–82. 4441: 4437: 4433: 4426: 4423: 4418: 4414: 4410: 4406: 4403:(6): 550–55. 4402: 4398: 4391: 4388: 4383: 4379: 4376:(3): 245–66. 4375: 4371: 4364: 4361: 4357: 4353: 4349: 4346: 4341: 4338: 4334: 4333: 4328: 4323: 4320: 4315: 4311: 4307: 4303: 4299: 4295: 4291: 4287: 4283: 4276: 4273: 4268: 4264: 4260: 4256: 4252: 4248: 4244: 4240: 4236: 4229: 4226: 4221: 4217: 4212: 4207: 4203: 4199: 4194: 4189: 4185: 4181: 4177: 4170: 4167: 4162: 4158: 4153: 4148: 4144: 4140: 4135: 4130: 4126: 4122: 4118: 4111: 4108: 4103: 4099: 4095: 4091: 4086: 4081: 4077: 4073: 4069: 4062: 4059: 4054: 4050: 4045: 4040: 4036: 4032: 4028: 4024: 4020: 4016: 4012: 4005: 4002: 3997: 3990: 3987: 3981: 3978: 3973: 3969: 3964: 3959: 3956:(5): 608–13. 3955: 3951: 3947: 3940: 3937: 3932: 3928: 3924: 3920: 3917:(3): 319–22. 3916: 3912: 3904: 3901: 3896: 3892: 3888: 3884: 3881:(3): 319–23. 3880: 3876: 3868: 3865: 3860: 3856: 3853:(3): 166–72. 3852: 3848: 3841: 3834: 3831: 3826: 3822: 3817: 3812: 3809:(4): 1104–7. 3808: 3804: 3800: 3793: 3790: 3775: 3769: 3766: 3761: 3757: 3752: 3747: 3743: 3739: 3735: 3731: 3727: 3723: 3719: 3712: 3709: 3697: 3693: 3687: 3684: 3673: 3672:Leishmaniasis 3669: 3662: 3659: 3654: 3650: 3646: 3642: 3637: 3632: 3628: 3624: 3620: 3613: 3610: 3597: 3591: 3588: 3583: 3579: 3575: 3571: 3567: 3563: 3559: 3555: 3547: 3544: 3539: 3535: 3530: 3525: 3521: 3517: 3513: 3509: 3505: 3498: 3496: 3492: 3487: 3483: 3478: 3473: 3469: 3465: 3461: 3457: 3453: 3446: 3443: 3438: 3434: 3430: 3426: 3422: 3418: 3411: 3408: 3403: 3399: 3394: 3389: 3385: 3381: 3377: 3373: 3369: 3362: 3359: 3354: 3350: 3345: 3340: 3336: 3332: 3328: 3324: 3320: 3313: 3310: 3305: 3301: 3297: 3293: 3289: 3285: 3281: 3277: 3270: 3267: 3262: 3258: 3253: 3248: 3244: 3240: 3236: 3232: 3228: 3224: 3220: 3213: 3210: 3198: 3194: 3188: 3185: 3180: 3176: 3171: 3166: 3162: 3158: 3154: 3150: 3146: 3142: 3138: 3131: 3128: 3123: 3119: 3114: 3109: 3105: 3101: 3097: 3093: 3089: 3082: 3079: 3074: 3070: 3065: 3060: 3056: 3052: 3047: 3042: 3039:(10): e3198. 3038: 3034: 3030: 3023: 3020: 3015: 3011: 3006: 3001: 2998:(2): 217–20. 2997: 2993: 2989: 2982: 2980: 2978: 2974: 2969: 2965: 2960: 2955: 2951: 2947: 2943: 2939: 2935: 2928: 2926: 2924: 2922: 2918: 2913: 2909: 2904: 2899: 2895: 2891: 2888:(1): 124–32. 2887: 2883: 2879: 2877: 2868: 2866: 2864: 2860: 2855: 2851: 2846: 2841: 2837: 2833: 2830:(2): 290–99. 2829: 2825: 2821: 2814: 2812: 2808: 2803: 2799: 2794: 2789: 2785: 2781: 2778:(4): 805–17. 2777: 2773: 2769: 2762: 2759: 2754: 2750: 2745: 2740: 2736: 2732: 2728: 2721: 2719: 2717: 2713: 2708: 2704: 2699: 2694: 2689: 2684: 2680: 2676: 2673:(2): e31551. 2672: 2668: 2664: 2657: 2655: 2651: 2646: 2642: 2637: 2632: 2628: 2624: 2619: 2614: 2610: 2606: 2602: 2595: 2592: 2587: 2583: 2578: 2573: 2569: 2565: 2560: 2555: 2551: 2547: 2543: 2536: 2533: 2528: 2524: 2519: 2514: 2510: 2506: 2502: 2498: 2494: 2487: 2484: 2479: 2475: 2470: 2465: 2462:(4): 607–12. 2461: 2457: 2453: 2446: 2444: 2440: 2429:on 2018-10-18 2425: 2421: 2417: 2413: 2409: 2405: 2401: 2397: 2393: 2386: 2379: 2376: 2371: 2367: 2363: 2359: 2355: 2351: 2347: 2340: 2337: 2332: 2330:9788123918105 2326: 2322: 2315: 2312: 2307: 2303: 2299: 2295: 2291: 2287: 2283: 2276: 2273: 2268: 2264: 2260: 2256: 2251: 2246: 2242: 2238: 2234: 2227: 2224: 2219: 2215: 2211: 2205: 2201: 2197: 2193: 2186: 2183: 2178: 2174: 2170: 2166: 2162: 2158: 2154: 2150: 2146: 2139: 2136: 2131: 2127: 2123: 2119: 2114: 2109: 2106:(4): 189–96. 2105: 2101: 2097: 2095: 2086: 2083: 2078: 2074: 2069: 2064: 2060: 2056: 2052: 2048: 2044: 2040: 2036: 2029: 2026: 2021: 2017: 2013: 2009: 2005: 2001: 1997: 1993: 1989: 1982: 1979: 1974: 1970: 1966: 1962: 1957: 1952: 1948: 1944: 1940: 1933: 1930: 1925: 1921: 1917: 1913: 1909: 1905: 1901: 1897: 1890: 1887: 1882: 1878: 1873: 1868: 1864: 1860: 1855: 1850: 1846: 1842: 1838: 1831: 1828: 1824: 1820: 1816: 1812: 1808: 1801: 1798: 1793: 1789: 1785: 1781: 1776: 1771: 1767: 1763: 1756: 1749: 1746: 1741: 1737: 1733: 1729: 1725: 1721: 1717: 1713: 1709: 1705: 1701: 1694: 1691: 1686: 1682: 1678: 1674: 1670: 1666: 1659: 1656: 1651: 1647: 1642: 1637: 1633: 1629: 1625: 1621: 1617: 1613: 1609: 1602: 1599: 1594: 1590: 1585: 1580: 1576: 1572: 1567: 1562: 1558: 1554: 1550: 1543: 1540: 1535: 1531: 1526: 1521: 1517: 1513: 1508: 1503: 1499: 1495: 1491: 1484: 1481: 1469: 1465: 1458: 1455: 1450: 1446: 1441: 1436: 1433:(3): 239–43. 1432: 1428: 1424: 1417: 1414: 1401: 1397: 1391: 1388: 1383: 1379: 1375: 1369: 1366: 1361: 1357: 1352: 1347: 1343: 1339: 1334: 1329: 1325: 1321: 1317: 1310: 1308: 1306: 1304: 1300: 1288: 1284: 1280: 1274: 1271: 1266: 1260: 1256: 1251: 1250: 1241: 1238: 1231: 1229: 1227: 1222: 1218: 1214: 1212: 1208: 1205:, 1,3-dinitro 1204: 1200: 1199: 1194: 1186: 1184: 1181: 1179: 1178:Lionel Napier 1175: 1170: 1165: 1162: 1159: 1155: 1151: 1144: 1140: 1136: 1134: 1130: 1126: 1122: 1118: 1114: 1110: 1105: 1102: 1098: 1093: 1091: 1087: 1083: 1079: 1075: 1071: 1067: 1059: 1054: 1050: 1048: 1044: 1040: 1036: 1032: 1028: 1024: 1020: 1016: 1012: 1008: 1004: 1000: 996: 992: 987: 979: 974:: काला आज़ार 973: 969: 965: 961: 957: 953: 949: 943: 935: 933: 930: 926: 922: 918: 912: 910: 906: 902: 898: 891: 883: 881: 878: 874: 869: 865: 861: 857: 853: 849: 841: 839: 836: 831: 827: 823: 819: 815: 811: 809: 805: 801: 800:T helper cell 797: 793: 789: 786: 782: 778: 775:(IFN-γ), and 774: 770: 769:interleukin 2 766: 765:proliferation 762: 758: 754: 750: 746: 742: 734: 729: 727: 724: 720: 715: 712: 710: 704: 701: 697: 695: 691: 686: 684: 680: 676: 671: 669: 664: 660: 656: 648: 646: 642: 639: 636: 630: 629: 628: 624: 620: 614: 613: 612: 605: 603: 601: 596: 592: 590: 586: 581: 576: 574: 569: 565: 561: 557: 555: 551: 547: 539: 537: 535: 531: 525: 522: 518: 513: 509: 505: 500: 497: 493: 489: 481: 479: 477: 473: 469: 465: 464:phagolysosome 461: 456: 453: 449: 448:promastigotes 445: 441: 437: 433: 425: 423: 421: 417: 413: 412: 407: 402: 400: 399: 394: 393: 388: 387: 383: 379: 375: 370: 368: 364: 363: 358: 357: 352: 344: 342: 340: 336: 332: 326: 323: 319: 315: 311: 307: 303: 299: 295: 290: 286: 282: 274: 272: 270: 266: 262: 260: 255: 253: 249: 245: 241: 237: 233: 229: 225: 221: 217: 213: 208: 206: 205: 201:of the genus 200: 197: 193: 189: 188:leishmaniasis 185: 181: 177: 173: 169: 165: 155: 149: 146: 144: 140: 131: 93: 87: 86: 84: 82:Pronunciation 80: 75: 71: 66: 63: 59: 56: 52: 49: 43: 37: 33: 19: 7567: 7563: 7553: 7516: 7512: 7502: 7483:Malnutrition 7461: 7394:Tuberculosis 7312: 7298: 7273: 7233: 7209: 7197: 7182: 7155: 7127: 7113: 7023: 6999: 6988: 6973: 6958: 6934: 6931: 6897: 6893: 6887: 6836: 6832: 6822: 6813: 6799:cite journal 6772: 6769:J Infect Dis 6768: 6761:Wasan, K. M. 6755: 6741:cite journal 6706: 6703:N Engl J Med 6702: 6692: 6678:cite journal 6653:10144/127729 6635: 6631: 6625: 6614:. Retrieved 6611:www.dndi.org 6610: 6601: 6576: 6572: 6566: 6552:cite journal 6517: 6513: 6503: 6489: 6464: 6460: 6454: 6427: 6423: 6414: 6373: 6368: 6349: 6343: 6327: 6322: 6314: 6305: 6294: 6285: 6276: 6270: 6225: 6221: 6211: 6166: 6162: 6152: 6107: 6103: 6093: 6050: 6046: 6036: 6016: 6009: 6001: 5986: 5979: 5968:. Retrieved 5958: 5929:. Retrieved 5887:. 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Retrieved 1287:the original 1282: 1273: 1248: 1240: 1223: 1219: 1215: 1196: 1190: 1182: 1169:Dr. Jean Dow 1166: 1147: 1111:hitting the 1106: 1094: 1089: 1081: 1077: 1065: 1063: 1046: 1035:dumdum fever 1034: 1018: 994: 990: 967: 963: 945: 919:, Ethiopia, 913: 893: 884:Epidemiology 876: 872: 855: 847: 845: 829: 813: 812: 807: 803: 795: 784: 740: 739:Immunity to 738: 716: 713: 705: 698: 693: 687: 672: 667: 663:chemotherapy 652: 643: 640: 637: 634: 625: 621: 618: 609: 597: 593: 579: 577: 558: 543: 533: 526: 520: 516: 511: 503: 501: 495: 487: 485: 457: 435: 431: 429: 415: 409: 405: 403: 396: 390: 384: 371: 366: 360: 354: 350: 348: 338: 327: 321: 306:tuberculosis 297: 278: 268: 263: 256: 209: 202: 183: 179: 171: 167: 163: 162: 88:Kala-azar: ( 62:Dumdum fever 61: 57: 47: 36: 7199:L. donovani 7161:L. mexicana 6169:: 3296893. 5965:"kala-azar" 5926:"kala-azar" 5884:"kala-azar" 5617:(1): 64–9. 5527:(1): 31–4. 5468:Infections" 5383:1874/380043 4665:Infections" 3197:www.cdc.gov 1468:theprint.in 1283:www.who.int 1203:pentamidine 1198:L. donovani 1125:Jill Seaman 1078:L. infantum 1070:West Bengal 1066:L. donovani 1043:Ronald Ross 1017:; the word 964:Assam fever 723:paromomycin 709:teratogenic 700:Miltefosine 560:Serological 546:amastigotes 460:macrophages 420:Lepsey NLV1 386:Phlebotomus 372:The insect 362:L. infantum 356:L. donovani 322:L. donovani 298:L. donovani 232:weight loss 224:bone marrow 184:black fever 58:Black fever 54:Other names 7607:Categories 7280:Giardiasis 7169:L. tropica 7075:caused by 7001:DiseasesDB 6616:2020-02-13 6228:(8): 387. 5970:2010-01-21 5931:2010-01-21 5889:2010-01-21 5664:J. Immunol 5084:J. Immunol 5022:Leishmania 4900:(5): 276. 4808:Leishmania 4714:Leishmania 4669:J. Immunol 4613:J. Immunol 3783:2016-09-19 3702:2024-06-06 3677:2024-06-06 3282:: 105599. 3203:2022-04-20 2878:Infection" 2433:2018-10-17 2145:Leishmania 2094:Leishmania 1704:The Lancet 1500:(4): 759. 1293:2015-10-05 1232:References 1207:adamantane 1158:antimonial 1082:L. chagasi 1023:Hindustani 982:کالا آزار 978:Devanagari 972:Hindustani 952:Bangladesh 940:See also: 929:Upper Nile 909:Kishanganj 888:See also: 877:Leishmania 873:Leishmania 858:antigens. 856:Leishmania 848:Leishmania 830:Leishmania 814:Leishmania 808:Leishmania 804:Leishmania 796:Leishmania 785:Leishmania 741:Leishmania 694:initiative 668:initiative 649:Treatments 606:Prevention 534:Leishmania 521:Leishmania 517:Leishmania 512:Leishmania 504:Leishmania 496:Leishmania 488:Leishmania 472:exocytosis 468:break down 444:amastigote 436:Leishmania 432:Leishmania 426:Life cycle 367:L. chagasi 351:Leishmania 339:Leishmania 204:Leishmania 194:caused by 7404:Pneumonia 7257:Trichozoa 7115:T. brucei 7030:emerg/296 7025:eMedicine 6922:159039859 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cruzi 7080:protozoa 7077:Excavata 6914:31103364 6879:30046105 6791:19545212 6725:20147716 6670:32952275 6662:19708817 6593:22327112 6544:29278489 6536:19563434 6446:29012190 6392:70673140 6332:Archived 6262:36006301 6203:29789784 6144:28202044 5940:cite web 5898:cite web 5851:33884006 5794:24454426 5745:36296164 5686:17404324 5592:25506998 5584:16305646 5392:16125466 5323:Cytokine 5215:10531200 5106:17911647 5058:10361241 4991:35090305 4934:37235324 4925:10222886 4875:10930301 4855:Cytokine 4836:10029912 4699:37383454 4643:31372945 4417:14469435 4382:16778308 4348:Archived 4314:16730362 4267:25601455 4220:30742620 4161:33507944 4102:23425958 4053:29736277 3972:16447104 3895:10492770 3859:15489554 3825:11049798 3760:12586674 3653:26973063 3582:26991291 3574:15928908 3538:17023436 3486:16390983 3437:16325874 3402:16882683 3372:Br Med J 3353:24947503 3304:32592684 3261:32419743 3179:27076677 3122:27076677 3073:25275531 3014:10733741 2912:16968407 2854:23922369 2802:17389235 2753:20032994 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