Elimination of visceral leishmaniasis on the Indian subcontinent.
Visceral leishmaniasis is a serious public health problem on the Indian subcontinent, causing high morbidity and mortality. The governments in the region launched a visceral leishmaniasis elimination initiative in 2005. We review knowledge gaps and research priorities. Key challenges include low coverage of health services for those most at risk, drug resistance, the absence of a vaccine, and the complex biology of the sandfly-human host transmission cycle. Vector control is an essential component, but innovation in this field is insufficient. Substantial progress has been made in the area of diagnostic, therapeutic, and vaccine development, but there are still many hurdles to overcome. For visceral leishmaniasis elimination to become a reality, effective deployment of these existing and new tools is essential. A strong commitment at community level is imperative, and appropriate diagnostic and treatment services as well as effective epidemiological surveillance need to be ensured.
Infectious Disease Research Laboratory, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
Om Prakash
OP
Singh
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Epco
E
Hasker
Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium.
Marleen
M
Boelaert
Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India. Electronic address: drshyamsundar@hotmail.com.
Shyam
S
Sundar
D000666:Amphotericin B / Q000627:therapeutic use; D000818:Animals; D000981:Antiprotozoal Agents / Q000627:therapeutic use; D006297:Health Services Accessibility; D006801:Humans; D007194:India; D007300:Insect Control; D007303:Insect Vectors / Q000469:parasitology; D007898:Leishmaniasis, Visceral / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D058069:Neglected Diseases; D010767:Phosphorylcholine / Q000031:analogs & derivatives / Q000627:therapeutic use; D011576:Psychodidae / Q000469:parasitology; D011634:Public Health
D000981:Antiprotozoal Agents; D010767:Phosphorylcholine; C039128:miltefosine; D000666:Amphotericin B
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