Talk:Visceral leishmaniasis

Nature
It may be of interest to Wikipedians that the journal Nature (20 April 2005) published an editorial on the (widely ignored) importance of articles on this (type of) topic:
 * 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 [...]. [...] 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. [...]
 * [....]
 * A round table on neglected diseases [...] in Lyon, France, last week, left a depressing sense of how far we have all got to go [...].
 * [....]

— Reference: "Wanted: social entrepreneurs";  Nature;  434 (7036) : pp.941–941 Note to all bush lawyers: it is generally acceptable use to copy (verbatim) extracts from (copyrighted) publications, hence the ellipsis above. See also Avoid_self-references

— DIV (128.250.204.118 07:50, 1 July 2007 (UTC))


 * In 2005 Wikipedia had been in existence for&mdash;what&mdash;four years? Rome wasn't built in a day, nor is Wikipedia a complete model of human knowledge in, well, ever. This is rather like mocking the editors of the Oxford English Dictionary for not having any entries past C after four years. Nor did the situation last: Looking at the article history, Visceral leishmaniasis was created about six months after the editorial in question - by an anonymous editor no less. (See also: Eventualism). -- MarcoTolo 02:23, 2 July 2007 (UTC)

— Joe —Preceding unsigned comment added by 68.238.13.11 (talk) 01:48, 25 September 2007 (UTC)


 * Can't help but notice that the sandfly vector is "3-6 micrometers long by 1.5-3 micrometers in diameter" yet the infectious protozoan is "only three to seven micrometers in diameter". How can this be?  The protozoan is larger than the sandfly.  Should the sandfly be in millimeters?  If I knew, I would edit this, but I have no expertise on this - I only read this article because B. Gates was talking about this disease today.

How can the mortality be virtually 100% deadly, yet only 32% require treatment? Is it 1. "non-progressive", i.e like some with HIV, or 2. The test itself is highly sensitive but not specific (high false positive), or what? — Preceding unsigned comment added by 110.174.174.88 (talk) 04:34, 4 July 2011 (UTC)

More pictures
Come on, folks! Help to become this article better. Add some figure, specially in life-cycle. Retornaire (talk) 10:20, 17 February 2008 (UTC)

Kala-azar
The statement that kala-azar is Sanskrit term is supported by a reference to a reliable source on the WHO website. Merely changing it to Assamese, Hindi or any other language contradicts the cited reference, so is unacceptable. Because the used reference is considered reliable, I also don't think deleting it is justified.

If you wish to state that kala-azar means "black fever" not only in Sanskrit but also in other languages, please add your statements after the cited reference, and document them with relevant references. Please note that I do believe what you say is correct. My objection is that it is not properly referenced. --Abanima (talk) 16:16, 20 January 2010 (UTC)

Kala-azar: Corrections
I have quoted two references as suggested, viz. Collins English Dictionary and the Medical Dictionary. These, I strongly believe, should clear any doubts whatsoever that you may have been harboring about the origin of the word "azar". "Azar" as a word has no connections with the Sanskrit language. If at all, for references sake, it does show its inclination towards Persian apart from Assamese(check references).

I have provided the justification behind the corrections I have made and I trust they will not be undone again.

Hope that suffices. Killerdove 11:57, 21 January 2010 (UTC)


 * I am rewriting the sentence so that the references verify the different statements. In addition, I am removing the WHO reference. The languages are sorted as follows: first Sanskrit, because it is ancient and is the source, then the modern languages in alphabetical order. Hope this is acceptable, although probably etymology is a bit over-represented now... --Abanima (talk) 13:33, 21 January 2010 (UTC)

The current revision is very satisfactory in my opinion. Thanks for this final effort.

Killerdove 15:25, 21 January 2010 (UTC) —Preceding unsigned comment added by Killerdove (talk • contribs)

Immunity
This section updates the Disease Progression section:

People with a history of infection bystrains of leishmania that cause visceral leishmaniasis show a continuum of immune responses from protective to non-protective. Those who acquired protective immunity (skin test positive) without ever having visceral leishmaniasis have a strong type 1 CD4+ response to leishmania antigens. Antigen specific interferon-gamma and proliferation, as well as the ability to kill intracellular leishmania, are hallmarks of protective immunity.[1,2] Because visceral leishmaniasis patients lack these responses to leishmania and other antigens, they usually die of secondary infections unless treated. In addition, increased interleukin-10 secretion is characteristic of the disease[3-5]. Addition of interleukin-12, anti-interleukin-10, or anti-interleukin-4 to peripheral blood mononuclear cells from acute patients sometimes increases interferon-gamma secretion and proliferation.[6-8] Acute patient peripheral blood mononuclear cells include CD8+ T regulatory cells that decrease interferon-gamma secretion and proliferation responses to leishmania and other antigens and increase interleukin-10 secretion when added to autologous peripheral blood mononuclear cells harvested after successful treatment.[5,9] Thus, the CD8+ T regulatory cells reproduce the immune response characteristic of visceral leishmaniasis. CD8+ T regulatory cells are also associated with post kala azar dermal leishmaniasis.[10] Addition of interleukin-12 or interferon-gamma does not prevent CD8+ T regulatory activity. The dominance of type 1 CD4+ T cells in skin test positive adults maybe explained by their secretion of factors that inhibit and kill CD8+ T regulatory cells.[8,9] Successfully treated patients rarely develop visceral leishmaniasis a second time. Their peripheral blood mononuclear cells show a mixed T1/T2 CD4+ and CD8+ T suppressor response but do have the ability to kill intracellular leishmania.[1,9,11]

Holaday B (2000) “Role of CD8+ T Cells in Endogenous Interleukin-10 Secretion Associated with Visceral Leishmaniasis” Mem Inst Oswaldo Cruz 95: 217-220. PMID: 10733741 Sudipto Ganguly S, Mukhopadhyay D, Das N, Chaduvula M,Sadhu S, Chatterjee U, Rahman M, Goswami R, Guha S, Modak D, Sudeshna Mallik S, Debananda Gonju DPramanik NBarbhuiya J, Bibhuti Saha B, Chatterjee M (2010) “Enhanced Lesional Foxp3 Expression and Peripheral Anergic Lymphocytes Indicate a Role for Regulatory T Cells in Indian Post-Kala-Azar Dermal Leishmaniasis”. J Invest Dermatol 130: 1013-1022. PMID: 20032994

Kemp M, Kurtzhals J, Bendtzen K, Poulsen L, Hansen M, Koech D, Kharazmi A,Theander R (1993) “Leishmania donovani-Reactive Thl- and Th2-Like T-Cell Clones from Individuals Who Have Recovered from Visceral Leishmaniasis” Infect Immun 1069-1073. PMID: 8432588

Necessary hosts?
I would like to se (for all dseases) information of which hosts that are necessary for survival of the disease. If only humans and human controlled animals are necessary, then it is in theory possible to eradicate that disease, but if it can survive outside that it is difficult or impossible to eradicate that disease. Cholera is one example, it survives outside humans in tropical waters and are thus next to impossible toeradicate now In Haiti. Seniorsag (talk) 13:39, 9 June 2017 (UTC)

New article - Kala azar in India

 * Kala azar in India

I made a version of the disease as it exists in India. I would appreciate comments either here or on that article's talk page. It seems to be the case this disease can come from different parasites through different species of fly. Because of this variation, the disease can spread in different ways and have different treatment in different places. I would appreciate anyone's thoughts on managing articles for regional variation

I found this to be a challenging topic to enter.  Blue Rasberry  (talk)  01:55, 24 February 2020 (UTC)