Talk:Leishmaniasis

Cost of Treatment has not been mentioned
Under the Treatment section, it would be good if any of the experts could give details about how the few drugs against leishmaniasis, especially the visceral type, are too expensive for developing countries to afford. I was reading about it in a BBC article, but do not know enough details.Farazars (talk) 07:51, 25 July 2008 (UTC)

I
I own some dogs and live in the sicilian countryside (Iblei) particularly infested with leishmania. Up to 20 years ago the infected dogs died with lots of bleeding wounds. After I discovered Glucantime. But when I was finishing the therapy the insect would sting again and the dog was chronically with the illness. One day I noted that the dogs illnesses regressed when I put salt in the food that I prepared for them. After that I looked at the explanatory notes of the Glucantime medecine and I noted that all the elements were salts: Sodium Sulphite, potassium anhydrous-sulphite, (excipients) and N-metilglucammine antimoniate (active principle). In the latest explanatory notes is clearly stated that 30% of the active principle is made of salt (N-metilglucammine antimoniate). In fact the leishmania protozoan (the leishmania genus of parasitic flagellate, belonging to the trypanosomes and responsible for diseases such as leishmaniasis) transmitted by the fly doesn't find the suitable conditions for reproduction in the animal saltier blood and it could probably also arrive to die. I think the dog's nourishment with a salt presence helps the prevention of leishmania. Someone could ask how much salt you need in the animal nutrition but my experience tells me that the animal can be protected with a quantity of salt identically to the human one. I am looking for other dog owners that are looking for a cheaper ways to treat them.

Please contact me at maurice.carbonaro@gmail.com. Thanks.

Maurice Carbonaro

- I removed from the external links section:


 * "The all-embracing open-source encyclopedia Wikipedia doesn't have a dedicated page on kala-azar, or visceral leishmaniasis. But who cares? After all, the disease only transforms vast numbers of people in developing countries into walking skeletons carrying bellies bloated by an enlarging liver and spleen. With drugs costing up to US$200 a course, it often goes untreated, causing some 200,000 deaths each year. In the research and development (R&D) chains that lead to drugs, more attention is devoted to silicone breast implants and pills for erectile dysfunction than to the roughly 8,000 orphan diseases. These neglected diseases each touch up to just 2,000 people, but together they affect millions."

The critique is obvious, but the kind author misunderstood that not many contributors to Wikipedia will know much about visceral Leishmaniasis. If there is sufficient interest, I can dip into my textbooks, but I guess our medical contributors tend to focus on the diseases they deal with in daily life... JFW | T@lk  22:58, 2 Jun 2005 (UTC)

Names
The discovery section refers to a Captain Donovan and a Major Ross, without first names or any other indication of who these people are. this should be fixed. OcciMoron 21:20, 9 July 2007 (UTC)

kala-azar
I'm not sure why Kala-azar links here. Is Leishmaniasis = Kala-azar? It says here that Kala-azar is a symptom, but the dictionary says it's a disease. I'm confused --Quasipalm 20:14, 28 September 2005 (UTC)

kala azar is the same disease as leishmaniasis, it is simply known by multiple names.--Gozar 22:03, 28 September 2005 (UTC)


 * Some capitalisations of "Kala azar" link to the more specific article "Visceral leishmaniasis" (VL). I'm not sure if this is correct, but i've made them all link to it instead of this article. Please put them back if this is wrong. —Pengo talk · contribs 05:03, 24 July 2006 (UTC)


 * Kala-azar is the traditional Indian name for visceral leishmaniasis, taken from the blackened skin which is a symptom of the Indian strain (but is not seen in Africa and elsewhere).Dybryd 00:49, 7 August 2006 (UTC)

Trivia section?
This disease was mentioned in House episode Cursed when a concerned father surprisingly mentions it as a possible cause for his son's condition. Should a "trivia" section of some sort be added where this could be mentioned? --AlphaEtaPi 04:00, 26 December 2005 (UTC)

probably a little obscure to be making a whole section about--Gozar 04:58, 26 December 2005 (UTC)

Baghdad Boil
Should Baghdad boil redirect here too? Lizz612 22:47, 25 February 2006 (UTC)

Anybody want to merge/delete my content?
I've just put a whole bunch of content over on the visceral leishmaniasis page, not realizing that this main page for the whole disease-family existed. I now see that a lot of it is redundant with the material on this page.

I find this too depressing to do myself, so does somebody else want to check the two versions and decide what should be moved to this page and what should just be deleted? Thanks.

Dybryd 00:49, 7 August 2006 (UTC)

Help me understand something
Both of the articles contain the same statements, -- "Results of trials outside of India have been disappointing." -- "There are problems with toxicity (gastrointestinal and renal) as well as the rapid development of resistance."

This makes it seem, upon reading the article, as if the drug is ineffective. In fact, according to the article cited --Jha TK, Sundar S, Thakur CP et al. (1999). "Miltefosine, an oral agent, for the treatment of Indian visceral leishmaniasis". New Engl J Med 341: 1795–800.,-- the conclusion states: "Orally administered miltefosine appears to be an effective treatment for Indian visceral leishmaniasis." "Gastrointestinal side effects were frequent (occurring in 62 percent of patients) but mild to moderate in severity." in the (More, et al, 2003) citation, the NEJM gives an even more glowing testimony; "the initial parasitologic cure rate was 100%" and " Conclusion. Oral miltefosine was safe and ~90% effective in this initial clinical trial of childhood visceral leishmaniasis."

I've been unable to find any other information on the trials outside of india that were disapointing. I'm not saying that its untrue, but it goes against everything I have read (not a lot) so far.

Here is the summary from the Max Planck Institutefor biophysical Chemistry

Summary:


 * 1) Miltefosine is the first effective oral remedy against visceral leishmaniasis, a disease that often results in death.
 * 2) The healing process is practically complete in four weeks with a success rate of 98%.
 * 3) Success of the treatment does not depend on whether the patients are resistant to the conventional pentostam therapy. The healing process is already noticeable after three days: the fever drops and the patient regains strength.
 * 4) The side-effects are neglectable.
 * 5) Epidemics would be controllable with this oral treatment method.
 * 6) The active substance has a simple chemical structure and is producible in tonnes. It is cheap and can be stored indefinitely between 0 and 40 deg Celsius.
 * 7) 5.6 tonnes of miltefosine would be needed annually on the basis of about two million new infections per year and a necessary amount of about 2.8 g miltefosine per patient.

Granted, this information is from 2000. Perhaps your information is more current?

Where is Canada?
"Mexico, Central America, and South America—from northern Argentina to southern Texas (not in Uruguay, Chile, or Canada)" Am I the only one who is confused about this sentence? - ajf --144.32.177.102 (talk) 19:41, 18 March 2008 (UTC)

Hello
I am confused with this article because I am not sure how testing for Leishmaniasis is found. I have been searching for Leishmaniasis testing, and it never seems to come up in the articles.

I am doing a school project, and I was wondering if anyone knew what the testing for Leishmaniasis was besides on this page?

Thank you! —Preceding unsigned comment added by Goose9211 (talk • contribs) 21:43, 30 March 2008 (UTC)

My experience with testing
For what its worth, I have Leishmaniasis and they tested it by scraping the ulcer and spotting the organisms under a microscope. Once it appeared to be Leishmaniais they sent it off for DNA testing to determine the exact species. —Preceding unsigned comment added by Helsmack (talk • contribs) 04:22, 30 May 2008 (UTC)

Typographical error
Sorry, I can't find out to correct a typographical error in the second line of the main page. The error: "Dipter" should read "Diptera". —Preceding unsigned comment added by Clivian (talk • contribs)


 * Corrected, thank you. Tim Vickers (talk) 17:35, 28 December 2008 (UTC)

Fact and citation check
(Part of the WikiProject Medicine effort)

Background section:
Links were added to the wikis for sequence analysis and monoclonal antibodies.

Classification section:
It might be a good idea to specify in parentheses that visceral leishmaniasis is also called kala-azar leishmaniasis, to relate this version to the next one listed (post-kala-azar dermal leishmaniasis) and so people don't wonder if that's yet another version of the disease.

Signs and symptoms section:
This section did not cite any sources. I think the WHO was probably the main source, at least for the four main forms of leishmaniasis (http://www.who.int/topics/leishmaniasis/en/).

This section lists "four main forms" and the previous section lists five forms of the disease. The latter four are not all included in the earlier list of five (diffuse cutaneous leishmaniasis is in the list of four but not the list of five). It would be best if a (semi-)expert reconciled these two lists and decided how exactly to classify leishmaniasis. Perhaps simply add diffuse cutaneous to the first list? Then again, a few sources do not group "cutaneous" and "diffuse cutaneous" as different forms of the disease but rather group diffuse cutaneous as a subclass of cutaneous: http://www.who.int/leishmaniasis/disease_epidemiology/en/index.html, http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2805%2965022-2/. One study says diffuse cutaneous is "rare": http://www.ncbi.nlm.nih.gov/pubmed/19126013. Another study describes diffuse cutaneous as "atypical": http://www.ncbi.nlm.nih.gov/pubmed/17222299.

This would probably be another good source of information, though it only groups leishmaniasis into visceral and cutaneous forms, so it might not push us towards any consensus: Medical and Veterinary Entomology by Gary R. Mullen and Lance Durden (http://books.google.com/books?id=6R1v9o-uaI4C&lpg=PP1&dq=Medical%20and%20Veterinary%20Entomology%20%20%20By%20Gary%20R.%20Mullen%2C%20Lance%20Durden&pg=PA156#v=onepage&q=leishmania&f=false).

Diagnosis section:
According to Communicable disease control in emergencies: a field manual by M. A. Connolly, World Health Organization (pg. 153), 2005 (http://books.google.com/books?id=iLRA-5VTkZIC&lpg=PP1&dq=Communicable%20disease%20control%20in%20emergencies%3A%20a%20field%20manual&pg=PA153#v=onepage&q&f=false), no serological (antibody) test is available to diagnose Leishmania infection. The smear/stain test is described in the Diagnosis section, but it seems like it might be helpful to specify that no serological test can identify Leishmania.

Treatment section:
Originally, there was an unformatted reference sitting in the middle of this section, saying "(More, et al., 2003)", so I created a reference citation for that article.

There was a dead link about India's approval of paramomycin to treat leishmaniasis. This URL works - can't know whether it says the same as the original source: http://www.oneworldhealth.org/paromomycin

Re-worded the sentence about harmine so that it made sense.

Reference added: WHO Initiative for Vaccine Research - Leishmaniasis page (http://www.who.int/vaccine_research/diseases/soa_parasitic/en/index3.html).

Epidemiology section:
Somewhere, either in this section or maybe the Background, visceral leishmaniasis should be mentioned as an AIDS-opportunistic disease. This is mentioned in the background information of several primary-literature papers. This might be a good place to start, but it's probably too old to be the only source: http://data.unaids.org/publications/External-Documents-Restored/who_ctd_leish_98-9_add-1_en.pdf

Reference added to take the place of the dead Seattle Biomedical Research Institute link: http://www.who.int/leishmaniasis/burden/magnitude/burden_magnitude/en/index.html.

Reference added for where 90% of leishmaniasis is found: http://www.oneworldhealth.org/leishmaniasis

The three dead links about the Colombian army's infections with leishmaniasis might be partially replaced by this news story: http://www.chron.com/disp/story.mpl//6062971.html.

The WHO estimated that Afghanistan had about 200,000 cases of leishmaniasis as of 2004, but a cited e-Ariana article says the WHO estimated 200,000 cases in Kabul alone in 2002. Perhaps some clarification, cleanup, or rewording is necessary at this part (http://www.who.int/mediacentre/news/releases/2004/pr55/en/index.html). MotherShabubu (talk) 17:34, 5 May 2010 (UTC)

Distribution Map
On the epidemiology map, Laos is highlighted. I wasn't aware that the disease was prevalent there. Could that be double checked? — Preceding unsigned comment added by 109.243.2.26 (talk) 08:51, 23 August 2011 (UTC)

Prevention section
Other than the first (or perhaps the second) sentence, the rest of the description in the Preventin section is more appropriate in the Research section. Before a vaccine is developed and used, the only prevention is to limit the spread of the parasite by sandfly. Are there any reference there to eradicate (or at least control) these insect population by insecticides or other means?Ginger Maine Coon (talk) 15:08, 14 March 2012 (UTC)

Why does "Espundia" redirect here?
Not mentioned in article. 86.130.41.222 (talk) 13:40, 16 September 2014 (UTC)

Update
Syrian civil war has led to [][]Lihaas (talk) 10:16, 8 December 2015 (UTC)
 * Okay? Could be added to the epidemiology section. Doc James  (talk · contribs · email) 10:36, 9 December 2015 (UTC)

Lancet seminar
10.1016/S0140-6736(18)31204-2 JFW &#124; T@lk  12:18, 14 September 2018 (UTC)

New article - Leishmaniasis vaccine

 * Leishmaniasis vaccine

Please check it out.

I moved information from this article's "research" section to that article. I do not think I removed any information, but I did integrate it with that article and re-write some of it. Before rewriting, I copied all the text to that article.

This article's research section mostly talked about vaccines and the history of development. Other kinds of research which could be described, but which were not in this section at all, include research on treatment for people who already have the condition, social research which seems to be a big part of controlling the disease, and strategic research on regional and global eradication of the disease.  Blue Rasberry  (talk)  21:53, 6 February 2020 (UTC)

Discovery of organism
The history section currently says, "It remains unclear who discovered the organism". There are lots of papers and narratives here.

This source

Has a narrative of the discovery. I have not read all these papers to see if there is a consensus about who did what and when.  Blue Rasberry  (talk)  22:17, 6 February 2020 (UTC)