Patients who have been successfully cured of visceral leishmaniasis can continue to infect hundreds of people for years, if they develop a skin condition known as post-kala-azar dermal leishmaniasis (PKDL).
In the largest study to date of patients with PKDL published in July 2019 issue of the journal Clinical Infectious Diseases, researchers found that 60% of people with the skin condition passed the leishmaniasis parasite on to sandflies. This means the insects could then go on to infect more people with the potentially deadly disease.
“PKDL is a rash, it is not a life threatening skin condition, so it is often ignored. But patients are transmitting the parasite, they’re a huge reservoir of the disease,” Dr Jorge Alvar, senior leishmaniasis advisor at the Drugs for Neglected Diseases initiative (DNDi) and co-principal investigator of the study.
The study recommends that active PKDL case detection and prompt treatment should be instituted and maintained as an integral part of visceral leishmaniasis control and elimination programs.
The disease is endemic in Bangladesh, India and Nepal. The South-East Asia Region Kala-azar Elimination Programme, a joint initiative of Bangladesh, India, and Nepal focuses on control of PKDL as a priority strategy.