Relationship between treatment regimens for visceral leishmaniasis and development of post-kala-azar dermal leishmaniasis and visceral leishmaniasis relapse A cohort study from Bangladesh

摘要

Post-kala-azar Dermal Leishmaniasis (PKDL), a sequale of visceral leishmaniasis (VL), and reappearance VL (visceral leishmaniasis relapse, VLR) are intra-epidemic reservoirs of VL and threats control of VL in long run. Currently there is no strategy for prevention of PKDL and VLR. If a relationship between treatment for VL and development of PKDL and VLR is there, and then selection of proper treatment regimen for VL should prevent PKDL and VLR. So far no study has been carried out to investigate the relationship between treatment regimens for VL and development of PKDL and VLR. The study demonstrated that multi-dose liposomal amphotericin B (AmBisome) defined as MDAMB herein for VL results in least PKDL and VLR among all existing and recommended by WHO treatment regimens for VL. We recommend adaptation of MDAMB in the national visceral leishmaniasis elimination program for VL cases management during subsequent phases of the national program when VL burden is low and hospitalization of VL patients for 3-5-days is now feasible.