ten years of kala-azar in west bengal, part i. did post-kala-azar dermal leishmaniasis initiate the outbreak in 24-parganas?following resurgence in bihar of epidemic kala-azar, outbreaks of the disease were identified simultaneously in two separate foci about 500 km apart in west bengal in 1980. while the outbreak in one of these foci, in northern west bengal, was the result of a direct extension of the bihar epidemic, the source of parasite in the other (in the village of bandipur in the south of west bengal) remained unknown until a case of nodulo-ulcerative post-kala-azar dermal leishmaniasis (pkdl) was located in ...19921638662
development of leishmania donovani in phlebotomus argentipes & ph. papatasi fed on kala-azar patients in bihar.a total of 258 laboratory bred ph. argentipes was fed on untreated parasitologically confirmed kala-azar patients. successful development of parasites was noted in 0.54 per cent ph. argentipes fed during the day and 5.33 per cent fed during the night. however, none of the 245 laboratory bred ph. papatasi fed on the same patients, was found positive for successful development of l. donovani in the foregut.19911937591
epidemiology of kala-azar in rural bihar (india) using village as a component unit of is assumed that some features like intra-macrophage habitat of the leishmania parasites, rare availability of infected macrophages in peripheral blood for vector sandflies to suck in, short flight range of sandflies, non-availability of an animal reservoir encountered in visceral leishmaniasis indicate slow and limited transmission potential and even so epidemics occur every 15 to 20 yr. to verify if these assumptions are true, the natural history of kala-azar was studied, using an endemic vi ...19911937592
observations on human bone-marrow for leishmania donovani.during the recent epidemic in north bihar, a total of 65 cases which were clinically designated as kala-azar had been subjected to bone-marrow aspiration from the iliac crest, out of which the l.d. body was demonstrated in 55 cases (84.61 per cent). culture analysis of bone-marrow on modified tobie's medium, revealed that ten cases (15.39 per cent) which were negative for l.d. body did not show any leptomonads, whereas out of 55 l.d. body positive cases, the promastigote forms developed in 22 ca ...19892632416
an analysis of t cell responsiveness in indian kala-azar.the inability of most untreated patients with kala-azar to control their visceral infections with leishmania donovani has been attributed to a defective cell-mediated immune response to leishmanial antigens. we examined the in vitro response of t cells, including leu-2+-depleted t cell populations, to determine whether unresponsiveness could be reversed. these studies on patients with visceral leishmaniasis in bihar, north india, support previous observations regarding t cell unresponsiveness in ...19873100620
a search for leishmania in normal skin and blood of kala-azar patients from bihar, india. 19883230291
record of flagellate infection in phlebotomus argentipes in some kala azar endemic areas of bihar, india. 19883271754
use of modified grace's insect medium for the primary isolation of leishmania donovani donovani in bihar, india.grace's insect medium, supplemented with 20% (v/v) heat-inactivated fetal bovine serum (fbs) and 15% defibrinated pooled rabbit blood is statistically shown to be more sensitive than modified nnn medium (p less than 0.05), grace's insect medium with 20% (v/v) and grace's insect medium with 30% (v/v) fbs (p less than 0.01) for in vitro primary isolation of promastigotes of leishmania donovani donovani from cultures of bone marrow aspirates. this medium has been found to be especially useful for p ...19863706619
amphotericin b in resistant kala-azar in bihar.during the recent epidemic of kala-azar in bihar, we identified a group of patients who were unresponsive to the two commonly used drugs--sodium stibogluconate and pentamidine. we evaluated the use of amphotericin b in these patients because it has been shown to be active in experimental animals against amastigotes and promastigotes, it has been found to be useful in south american patients and is now recommended by the world health organization as a second line drug.19938477209
evidence that the high incidence of treatment failures in indian kala-azar is due to the emergence of antimony-resistant strains of leishmania donovani.the possibility that the high frequency of treatment failures in indian kala-azar might be due to infection with antimony-resistant strains of leishmania donovani has not been experimentally addressed. l. donovani isolates were obtained from splenic aspiration smears of 24 patients in bihar, india, who either did not respond (15) or did respond (9) to 1 or more full courses of treatment with sodium antimony gluconate (sag). a strong correlation (p<.001) between clinical response and sag sensitiv ...199910395884
epidemiology of visceral leishmaniasis in india.kala-azar has re-emerged from near eradication. the annual estimate for the incidence and prevalence of kala-azar cases worldwide is 0.5 million and 2.5 million, respectively. of these, 90% of the confirmed cases occur in india, nepal, bangladesh and sudan. in india, it is a serious problem in bihar, west bengal and eastern uttar pradesh where there is under-reporting of kala-azar and post kala-azar dermal leishmaniasis in women and children 0-9 years of age. untreated cases of kala-azar are ass ...199910416321
leishmania donovani in blood smears of asymptomatic persons.leishmania amastigotes have been detected in the peripheral blood smears of indian kala-azar patients mostly during night. it was, therefore, thought worthwhile to find out whether such amastigotes could be shown in healthy subjects who did not have any symptoms by history or signs on clinical examination. leishmania-stained blood smears of 450 asymptomatic healthy individuals residing in an endemic village in bihar (india) were examined by oil-immersion microscopy for the detection of amastigot ...200010936579
relevance of direct agglutination test in seroepidemiological survey of kala-azar in epidemic foci of bihar.the performance of direct agglutination test (dat) was evaluated under field conditions in three endemic districts of bihar. in three villages of these districts, 197 households were surveyed with a population of 1167 individuals. out of 1167 individuals, 603 were clinically examined for vl and blood samples of each examined individual were collected for dat. the proportion of dat positivity in both males (32.33%) and females (32.94%) was statistically not significant (p > 0.05). the proportion ...200011198396
hepatitis b and c viral infections in indian kala-azar patients receiving injectable anti-leishmanial drugs: a community-based study.human immunodeficiency virus (hiv) and hepatitis b and hepatitis c viruses have emerged as major blood-borne infections. several cases of infections through the use of unsterile injection needles also are on record. kala-azar, or visceral leishmaniasis, is a hemoparasitic disease caused by leishmania donovani. all the anti-kala-azar medications require multiple intramuscular injections of the anti-leishmanial drugs. to find whether these patients were at higher risk of contracting blood-borne in ...200011231183
leishmania species, drug unresponsiveness and visceral leishmaniasis in bihar, india.sixteen isolates obtained, in january 1998-december 1999, from splenic aspirates from sodium stibogluconate-resistant cases of visceral leishmaniasis (vl; indian kala-azar) and drawn from different districts of bihar (india) were identified as leishmania donovani. by isoenzyme analysis, all the strains were found identical to the who reference strain l. donovani mon-2 and differed from l. tropica mon-5. this study suggested that resistant cases of vl in bihar were caused by l. donovani and not b ...200111355558
resistance to treatment in kala-azar: speciation of isolates from northeast india.kala-azar in india is becoming increasingly difficult to treat, which may be due to the presence of species other than leishmania donovani; leishmania tropica was reported to cause the same clinical syndrome in the area. over the past 3 years, we have collected samples from 241 patients with visceral leishmaniasis from across the region. of the 189 isolates that grew on diphasic medium, 159 were successfully transferred to liquid medium for typing. clinically, 80% of these were resistant to anti ...200111561703
drug resistance in indian visceral leishmaniasis.throughout the world, pentavalent antimonial compounds (sb(v)) have been the mainstay of antileishmanial therapy for more than 50 years. sb(v) has been highly effective in the treatment of indian visceral leishmaniasis (vl: kala-azar) at a low dose (10 mg/kg) for short durations (6-10 days). but in the early 1980s reports of its ineffectiveness emerged, and the dose of sb(v) was eventually raised to 20 mg/kg for 30-40 days. this regimen cures most patients with vl except in india, where the prop ...200111703838
vectorial efficacy of phlebotomus argentipes in kala-azar endemic foci of bihar (india) under natural and artificial conditions.ability of phlebotomus argentipes to acquire leishmania donovani the causative agent of indian kala-azar was evaluated in the laboratory. flies were fed artificially on infected blood suspensions, using a chick-skin-membrane feeding apparatus, and naturally on leishmania donovani infected mice. in addition flies collected from different endemic areas were dissected and examined for natural infection. flies fed on infected mice showed significantly higher feeding rate (14.4%, p < 0.01) compared t ...200112170928
visceral leishmaniasis and hiv coinfection in bihar, india. 200312514423
orally effective drugs for kala-azar (visceral leishmaniasis): focus on miltefosine and sitamaquine.currently there are no effective orally administered drugs or visceral leishmaniasis or kala-azar, a parasitic disease affecting about 0.5 million people a year, majority of whom are in india and adjacent areas of nepal. symptoms of affected patients are fever, cachexia, hepatosplenomegaly and pancytopenia. the disease is usually fatal, if left untreated. traditionally kala-azar is treated with four weeks of injections of sodium stibogluconate, a pentavalent antimonial. however, this treatment h ...200314621038
magnitude of unresponsiveness to sodium stibogluconate in the treatment of visceral leishmaniasis in bihar.the indian government proposes to eliminate kala-azar, which has been a serious public health problem in bihar. this study aimed to assess the magnitude of unresponsiveness to sodium stibogluconate in the treatment of new cases of visceral leishmaniasis and to identify the associated factors.200516130613
identification of new antigens in visceral leishmaniasis by expression cloning and immunoblotting with sera of kala-azar patients from bihar, india.sera of kala-azar patients from bihar, india, were used to identify leishmania donovani antigens encoded by a phage expression library. ten antigens were identified, five of which have not been described as leishmania antigens before. the antigens specifically react with sera of leishmania-infected patients but not of toxoplasma- or plasmodium-infected patients.200516177384
visceral leishmaniasis (kala-azar)--the bihar (india) perspective.from a hospital-based surveillance carried out in rajendra memorial research institute of medical sciences, patna, bihar, india, the socio-economic, demographic and treatment response information of 737 patients admitted with visceral leishmaniasis (vl) during january 2001-december 2003, were analysed. the disease was two times higher in males than in females because of several factors including clothing pattern, sleeping habits and occupation. in bihar, the second poorest state in india, povert ...200616269185
usefulness of the direct agglutination test in the early detection of subclinical leishmania donovani infection: a community-based study.the value of a direct agglutination test (dat) in the detection of subclinical infections with leishmania donovani has recently been investigated in the indian state of bihar, after the sensitivity and specificity of the test had been determined. when used to screen sera from 108 parasitologically confirmed cases of visceral leishmaniasis, 50 patients with active, non-leishmanial infection, and 641 healthy controls living close to, or distant from, an endemic area, the test was found to be 91.7% ...200516297287
treatment options for visceral leishmaniasis: a systematic review of clinical studies done in india, 1980-2004.the state of bihar in india carries the largest share of the world's burden of antimony-resistant visceral leishmaniasis. we analysed clinical studies done in bihar with different treatments between 1980 and 2004. overall, 53 studies were included (all but one published), of which 15 were comparative (randomised, quasi-randomised, or non-randomised), 23 dose-finding, and 15 non-comparative. data from comparative studies were pooled when appropriate for meta-analysis. overall, these studies enrol ...200516310148
visceral leishmaniasis (kala-azar): challenges ahead.indian visceral leishmaniasis (vl) is a parasitic disease caused by a haemoflagellete leishmania donovani and transmitted by the bite of sand fly phlebotomus argentipes. it affects various age groups. in india about 1,00,000 cases of vl are estimated to occur annually; of these, the state of bihar accounts for over than 90 per cent of the cases. diagnosis of vl typically relies on microscopic examination of tissue smears but serology and molecular methods are better alternatives currently. notwi ...200616778314
drug unresponsiveness & combination therapy for kala-azar.pentavalent antimonials (sbv) have been successfully used for treatment of kala-azar since last six decades. since 1970s its conventional dosages have failed to achieve with 60 per cent unresponsiveness reported with who regimen in bihar (india). pentamidine initially used as a second line of drug, acquired resistance (25%) even with prolonged dosage. newer oral drug miltefosine is a potent antileishmanial drug with longer half-life, a property likely to acquire resistance. paromomycin has under ...200616778318
genetic heterogeneity among visceral and post-kala-azar dermal leishmaniasis strains from eastern india and sudan, some patients of visceral leishmaniasis develop post-kala-azar dermal leishmaniasis (pkdl) while majority will not. similarly, the clinical manifestations and treatment outcome are reported to vary from district to district and state to state in india. present study is focused on to find out the genetic variations between vl & pkdl causing strains. nuclear dna from 24 strains of leishmania donovani, isolated from patients of visceral leishmaniasis (18) and pkdl (6) was extrac ...200717027344
proteophosphoglycan is differentially expressed in sodium stibogluconate-sensitive and resistant indian clinical isolates of leishmania donovani.leishmania produce several types of mucin-like glycoproteins called proteophosphoglycans (ppgs) some of which are secreted while others are found on the surface of promastigotes and amastigotes. these proteins are thought to be important in the transmission, invasion and subsequent intracellular survival of parasites. the structure and function of ppgs are species and stage-specific in the case of l. major and l. mexicana, but no such information has hitherto been available for l. donovani. this ...200717362540
sodium stibogluconate-sensitive visceral leishmaniasis in the non-endemic hilly region of uttarakhand, india.although visceral leishmaniasis (vl) is endemic in various parts of india, mainly bihar, west bengal and orissa, and neighbouring countries such as nepal and bangladesh, it is rarely reported from the hilly areas of india. we report on nine male vl cases from the non-endemic garhwal region of uttarakhand who were treated successfully with sodium stibogluconate. we conclude that sodium stibogluconate-sensitive vl is emerging in this region and that urgent and effective vector control measures may ...200717382981
injectable paromomycin for visceral leishmaniasis in india.visceral leishmaniasis (kala-azar) affects large, rural, resource-poor populations in south asia, africa, and brazil. safe, effective, and affordable new therapies are needed. we conducted a randomized, controlled, phase 3 open-label study comparing paromomycin, an aminoglycoside, with amphotericin b, the present standard of care in bihar, india.200717582067
amphotericin b treatment for indian visceral leishmaniasis: response to 15 daily versus alternate-day infusions.for patients with indian visceral leishmaniasis, amphotericin b deoxycholate is usually given as 15 alternate-day infusions of 1 mg/kg over 30 days (total dose, 15 mg/kg); daily treatment with 1 mg/kg for 20 days (total dose, 20 mg/kg) is also used. this study was done to address the unsettled therapeutic questions of administration schedule (alternate-day vs. daily administration) and dose (1 vs. 0.75 mg/kg) and to determine whether the duration of amphotericin b treatment in bihar, india, can ...200717682988
a new strategy for elimination of kala-azar from rural bihar.bihar state of india has been an endemic state for kala-azar. there has been many phases of ddt sprays for vector control. an outbreak of kala-azar occurred in goanpura, 6 km from patna, bihar, in 2003. we undertook this study with a new approach of kala-azar elimination in this village with priority to treatment of cases followed by supplementation with supervised ddt spray for vector control.200718160749
a community-based, comparative evaluation of direct agglutination and rk39 strip tests in the early detection of subclinical leishmania donovani the indian state of bihar, the sensitivities and specificities of direct agglutination tests (dat) and rk39 test strips for the detection of leishmania donovani infection in humans were explored and found to be generally good (92%-100%). when 172 asymptomatic individuals [16 'case-contacts' who lived in the same households as past or current, confirmed cases of visceral leishmaniasis (vl) and 156 other subjects from neighbouring households] were tested, the same 36 (21%) individuals, includin ...200818318933
vector control by insecticide-treated nets in the fight against visceral leishmaniasis in the indian subcontinent, what is the evidence?visceral leishmaniasis (vl) is a deadly vector-borne disease that causes an estimated 500 000 new cases a year. in india, nepal and bangladesh, vl is caused by leishmania donovani, which is transmitted from man to man by the sandfly phlebotomus argentipes. in 2005, these three countries signed a memorandum of understanding to eliminate vl from the region. integrated vector management is one of the pillars of this elimination strategy, alongside early case detection and treatment. we reviewed the ...200818564350
phlebotomus argentipes seasonal patterns in india and nepal.the current control of phebotomus argentipes (annandale and brunetti), the vector of leishmania donovani (laveran and mesnil), on the indian subcontinent is base on indoor residual spraying. the efficacy of this method depends, among other factors, on the timing and number of spraying rounds, which depend on the p. argentipes seasonality. to describe p. argentipes' seasonal patterns, six visceral leishmaniasis (vl) endemic villages, three in muzaffarpur and three in sunsari districts in india an ...201020380311
the epidemiology of leishmania donovani infection in high transmission foci in india.visceral leishmaniasis (vl) is highly prevalent in bihar, india. india and its neighbours aim at eliminating vl, but several knowledge gaps in the epidemiology of vl may hamper that effort. the prevalence of asymptomatic infections with leishmania donovani and their role in transmission dynamics are not well understood. we report data from a sero-survey in bihar.201020487420
influence of topography on the endemicity of kala-azar: a study based on remote sensing and geographical information system.kala-azar, a fatal infectious disease in many indian states, particularly in bihar, west bengal, uttar pradesh, and jharkhand, is caused by the protozoan parasite leishmania donovani and transmitted by the sandfly vector phlebotomus argentipes. the vector is distributed all over the country but the disease is confined to particular zones since before the last century. in this study, parameters such as altitude, temperature, humidity, rainfall and the normalized difference vegetation index (ndvi) ...201020503185
treatment of visceral leishmaniasis in 2010: direction from bihar state, india. 201020860475
insecticide susceptibility of phlebotomus argentipes in visceral leishmaniasis endemic districts in india and investigate the ddt and deltamethrin susceptibility of phlebotomus argentipes, the vector of leishmania donovani, responsible for visceral leishmaniasis (vl), in two countries (india and nepal) with different histories of insecticide exposure.201021049013
leishmania donovani: assessment of leishmanicidal effects of herbal extracts obtained from plants in the visceral leishmaniasis endemic area of bihar, obstacle faced in the effective control of visceral leishmaniasis (vl) is the limited number of available treatment options. furthermore, control efforts have been hindered further by the emergence of leishmania resistance to many of the available drugs. in this study, we investigated the anti-leishmanial properties of 30 medicinally important plants from the vl endemic area of bihar, india and compared them to two available anti-leishmanial drugs (sodium antimony gluconate and amphotericin ...201021070771
longlasting insecticidal nets for prevention of leishmania donovani infection in india and nepal: paired cluster randomised test the effectiveness of large scale distribution of longlasting nets treated with insecticide in reducing the incidence of visceral leishmaniasis in india and nepal.201021190965
incidence of visceral leishmaniasis in the vaishali district of bihar, india: spatial patterns and role of inland water bodies.the role of the distribution of inland water bodies with respect to the transmission of visceral leishmaniasis (vl) and its dominant vector, phlebotomous argentipes, has been studied at the regional scale in bihar, eastern india. the landsat tm sensor multispectral scanning radiometer, with a spatial resolution of 30 m in the visible, reflective-infrared and shortwave-infrared (swir) bands, was used to identify water bodies using the normalized differential pond index (ndpi) calculated as follow ...201121590671
the paratransgenic sand fly: a platform for control of leishmania transmission.abstract: background: leishmania donovani is transmitted by the bite of the sand fly, phlebotomus argentipes. this parasite is the agent of visceral leishmaniasis (vl), an endemic disease in bihar, india, where prevention has relied mainly on ddt spraying. pesticide resistance in sand fly populations, environmental toxicity, and limited resources confound this approach. a novel paratransgenic strategy aimed at control of vectorial transmission of l. donovani is presented using bacillus subtilis, ...201121595907
asymptomatic infection of visceral leishmaniasis in hyperendemic areas of vaishali district, bihar, india: a challenge to kala-azar elimination programmes.a cohort of 91 asymptomatic individuals with visceral leishmaniasis (vl) were identified during base line screening using recombinant 39-aminoacid antigen (rk-39) and polymerase chain reaction (pcr) conducted from december 2005 to june 2006 involving 997 individuals of two highly endemic villages of vaishali district, bihar. the point prevalence of asymptomatic infection was 98 per 1000 persons at baseline. there was no statistically significant difference between rk-39 and pcr positivity rate ( ...201121945327
Genome-wide SNP and microsatellite variation illuminate population-level epidemiology in the Leishmania donovani species complex.The species of the Leishmania donovani species complex cause visceral leishmaniasis, a debilitating infectious disease transmitted by sandflies. Understanding molecular changes associated with population structure in these parasites can help unravel their epidemiology and spread in humans. In this study, we used a panel of standard microsatellite loci and genome-wide SNPs to investigate population-level diversity in L. donovani strains recently isolated from a small geographic area spanning Indi ...201222119748
Genetic heterogeneity in clinical isolates of Leishmania donovani from India.Genetic diversity within 45 Indian Leishmania donovani isolates was analyzed using seven genetic markers. While kinetoplast DNA (kDNA) analysis revealed 15 genotypes, 8 genotypes were obtained by analysis of other markers. In contrast to earlier reports, our data suggest that significant genetic polymorphisms exist in L. donovani strains in Bihar, India. Our results confirm the presence of 2 zymodemes in India.201121865422
Mechanism of Amphotericin B Resistance in Clinical Isolates of Leishmania donovani.The clinical value of Amphotericin B, the mainstay therapy for Visceral Leishmaniasis in Sodium Antimony Gluconate nonresponsive zones of Bihar, is now threatened by the emergence of acquired drug resistance and a comprehensive understanding of the underlying mechanisms is the need of the hour. We have selected an Amphotericin B resistant clinical isolate which demonstrated 8 fold higher LD(50) compared to sensitive strain to explore the mechanism of Amphotericin B resistance. Fluoremetric analy ...201122123699
Characterisation of antimony-resistant Leishmania donovani isolates: Biochemical and biophysical studies and interaction with host cells.Recent clinical isolates of Leishmania donovani from the hyperendemic zone of Bihar were characterised in vitro in terms of their sensitivity towards sodium stibogluconate in a macrophage culture system. The resulting half maximal effective concentration (EC(50)) values were compared with those of known sensitive isolates. Fifteen of the isolates showed decreased sensitivity towards SSG with an average EC(50) of 25.7±4.5µg/ml pentavalent antimony (defined as antimony resistant), whereas nine sho ...201121920365
exposure to phlebotomus argentipes (diptera, psychodidae, phlebotominae) sand flies in rural areas of bihar, india: the role of housing conditions.visceral leishmaniasis (vl) is a vector-borne infectious disease, caused by the protozoan leishmania donovani, which is transmitted by phlebotomine sand flies. in an earlier study in bihar, india, we found an association between incidence of vl and housing conditions. in the current study we investigated the influence of housing structure and conditions in and around the house on the indoor abundance of phlebotomus argentipes, the vector of vl in this area.201425184542
reassessment of immune correlates in human visceral leishmaniasis as defined by cytokine release in whole blood.depressed cell-mediated immunity in human visceral leishmaniasis (vl) (also known as kala-azar), revealed as the inability of peripheral blood mononuclear cells (pbmcs) to respond to leishmania antigen, remains a hallmark of and is thought to underlie the progressive nature of this disease. we recently reported the ability of a whole-blood, gamma interferon (ifn-γ) release assay to detect subclinical infections among healthy individuals living in an area where kala-azar is endemic (bihar, india) ...201222539471
understanding the transmission dynamics of leishmania donovani to provide robust evidence for interventions to eliminate visceral leishmaniasis in bihar, india.visceral leishmaniasis (vl) is a neglected vector-borne disease. in india, it is transmitted to humans by leishmania donovani-infected phlebotomus argentipes sand flies. in 2005, vl was targeted for elimination by the governments of india, nepal and bangladesh by 2015. the elimination strategy consists of rapid case detection, treatment of vl cases and vector control using indoor residual spraying (irs). however, to achieve sustained elimination of vl, an appropriate post elimination surveillanc ...201626812963
seasonal variation in the prevalence of sand flies infected with leishmania donovani.visceral leishmaniasis (vl) is a life threatening neglected infectious disease in the indian subcontinent, transmitted by the bite of female sand flies. estimation of the infectivity in the vector population, collected in different seasons, may be useful to better understanding the transmission dynamics of vl as well as to plan vector control measures.201323585896
prevalence of sand flies and leishmania donovani infection in a natural population of female phlebotomus argentipes in bihar state, india.leishmaniasis is a vector-borne disease, and in the indian subcontinent the female phlebotomus argentipes is the vector for leishmania donovani. however, data on the extent of sand fly infection rates in natural settings using molecular methods have not been extensively reported in india. in this study a pcr technique was applied targeting the 18s rrna encoding region to determine the prevalence of leishmania infection in female p. argentipes captured in the field. for this study, sand flies wer ...201222217179
pharmacovigilance of miltefosine in treatment of visceral leishmaniasis in endemic areas of bihar, india.miltefosine, the only oral drug for visceral leishmaniasis (vl), is being used as the first-line drug under the vl elimination program in the indian subcontinent. miltefosine is an oral drug which was used as a topical application for skin metastasis of breast cancer. it was found to be effective against leishmania donovani the main adverse events (ae) reported previously with miltefosine use includes diarrhea, vomiting, and dehydration. other aes include, raised serum alanine transaminase/aspar ...201627645786
repeated training of accredited social health activists (ashas) for improved detection of visceral leishmaniasis cases in bihar, india.accredited social health activists (ashas) are incentive-based, female health workers responsible for a village of 1000 population and living in the same community and render valuable services towards maternal and child health care, polio elimination program and other health care-related activities including visceral leishmaniasis (vl). one of the major health concerns is that cases remain in the endemic villages for weeks without treatment causing increased likelihood to treatment failure and d ...201627077313
leishmania donovani: dynamics of l. donovani evasion of innate immune cell attack due to malnutrition in visceral leishmaniasis.malnutrition may be significant in the modulation of immune responses in visceral leishmaniasis (vl). data on the relationship between malnutrition and innate immune response in vl are limited. the aim of this study was to examine the effect of malnutrition on the profile of innate immune functions of polymorphonuclear neutrophil granulocytes (pmns) and monocytes through comparison of well-nourished and malnourished indian patients with vl.201424607302
post kala-azar dermal leishmaniasis following treatment with 20 mg/kg liposomal amphotericin b (ambisome) for primary visceral leishmaniasis in bihar, india.the skin disorder post kala-azar dermal leishmaniasis (pkdl) occurs in up to 10% of patients treated for visceral leishmaniasis (vl) in india. the pathogenesis of pkdl is not yet fully understood. cases have been reported in india following therapy with most available treatments, but rarely in those treated with liposomal amphotericin b (ambisome). between july 2007 and august 2012 with the support of the rajendra memorial research institute (rmri), médecins sans frontières (msf) supported a vl ...201424392171
five-year field results and long-term effectiveness of 20 mg/kg liposomal amphotericin b (ambisome) for visceral leishmaniasis in bihar, india.visceral leishmaniasis (vl; also known as kala-azar) is an ultimately fatal disease endemic in bihar. a 2007 observational cohort study in bihar of 251 patients with vl treated with 20 mg/kg intravenous liposomal amphotericin b (ambisome) demonstrated a 98% cure rate at 6-months. between july 2007 and august 2012, médecins sans frontières (msf) and the rajendra memorial research institute (rmri) implemented a vl treatment project in bihar, india-an area highly endemic for leishmania donovani-usi ...201424392168
chronic exposure to arsenic in drinking water can lead to resistance to antimonial drugs in a mouse model of visceral leishmaniasis.the indian subcontinent is the only region where arsenic contamination of drinking water coexists with widespread resistance to antimonial drugs that are used to treat the parasitic disease visceral leishmaniasis. we have previously proposed that selection for parasite resistance within visceral leishmaniasis patients who have been exposed to trivalent arsenic results in cross-resistance to the related metalloid antimony, present in the pentavalent state as a complex in drugs such as sodium stib ...201324167266
molecular and serological markers of leishmania donovani infection in healthy individuals from endemic areas of bihar, india.recent epidemiological reports indicate that asymptomatic human infections with leishmania donovani, the causative agent of visceral leishmaniasis or kala-azar (ka), occur frequently in india. we explored markers of infection.201323464581
latent infection with leishmania donovani in highly endemic villages in bihar, india.asymptomatic persons infected with the parasites causing visceral leishmaniasis (vl) usually outnumber clinically apparent cases by a ratio of 4-10 to 1. we describe patterns of markers of leishmania donovani infection and clinical vl in relation to age in bihar, india.201323459501
post-kala-azar dermal leishmaniasis in visceral leishmaniasis-endemic communities in bihar, india.we assessed the prevalence of post-kala-azar dermal leishmaniasis (pkdl), a late cutaneous manifestation of visceral leishmaniasis (vl), in 16 vl-endemic communities in bihar, india. the prevalence of confirmed pkdl cases was 4.4 per 10 000 individuals and 7.8 if probable cases were also considered. the clinical history and treatment of the post-kala-azar dermal leishmaniasis cases are discussed.201222882665
animal reservoirs of visceral leishmaniasis in india.visceral leishmaniasis (vl) is a disease that has both zoonotic and anthroponotic etiologies. in india, vl is endemic, considered to be anthroponotic, and caused by leishmania donovani . anthroponotic diseases are maintained by transmission from human to human and to a lesser extent from human to animals. serum samples from 1,220 animals from 7 human vl endemic districts of bihar, india, were tested for antibodies to a recombinant kinetoplast antigen (rk39 antigen) present in amastigotes of visc ...201322765517
serological and molecular analysis of leishmania infection in healthy individuals from two districts of west bengal, india, endemic for visceral leishmaniasis.abstractseveral epidemiological studies have indicated the presence of asymptomatic infections with leishmania donovani in the indian subcontinent, where parasite transmission is considered anthroponotic. in india, such asymptomatic leishmania cases have been identified in the state of bihar. we explored here, the presence of asymptomatic leishmania infection among healthy individuals living in two districts in the state of west bengal, india, using serological and molecular tests. blood samples ...201728719266
establishing, expanding, and certifying a closed colony of phlebotomus argentipes (diptera: psychodidae) for xenodiagnostic studies at the kala azar medical research center, muzaffarpur, bihar, india.this pilot project was preliminary and essential to a larger effort to define the ability of certain human-subject groups across the infection spectrum to serve as reservoirs of leishmania donovani infection to sand flies in areas of anthroponotic transmission such as in bihar state, india. this is possible only via xenodiagnosis of well-defined subject groups using live vector sand flies. the objective was to establish at the kala azar medical research center (kamrc), muzaffarpur, bihar, india, ...201728525618
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