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Visceral leishmaniasis control: a public health perspective

Author
Organization
Abstract
Visceral leishmaniasis (VL), also known as kala-azar, is a vector-borne disease caused by a protozoan of the Leishmania donovani complex. A phlebotomine sandfly transmits the parasite from person to person or via an animal reservoir. VL is a severe, debilitating disease, characterized by prolonged fever, splenomegaly, hypergammaglobulinaemia and pancytopenia. Patients become gradually ill over a period of a few months, and nearly always die if untreated. Case-fatality ratios are high even in treated patients. Worldwide an estimated 500000 VL cases occur each year. This study reviews clinical, epidemiological and public health aspects of the disease and shows how critical adequate case detection is for the success of VL control. Examination of the issue of VL diagnosis with respect to the global challenges in VL control leads to the observation that a sound diagnostic-therapeutic algorithm for the health services in endemic areas is badly needed. Serological tests could be an alternative to parasitological diagnosis and the direct agglutination test (DAT) was found to fulfil many criteria for a 'field test', including cost effectiveness. Although research needs on vaccine and better drugs continue to be high on the agenda, a VL test-treatment: strategy based on currently available highly sensitive serological tests, such as the DAT, should be introduced in the health services in endemic areas.
Keywords
AZAR DERMAL LEISHMANIASIS, DIRECT AGGLUTINATION-TEST, POLYMERASE CHAIN-REACTION, PLUS INTERFERON-GAMMA, ENDEMIC KALA-AZAR, SODIUM STIBOGLUCONATE, PENTAVALENT ANTIMONY, EASTERN SUDAN, PARASITOLOGICAL METHODS, COST-EFFECTIVENESS, visceral leishmaniasis, disease control, epidemiology, transmission, clinical aspects, diagnosis, chemotherapy

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Chicago
Boelaert, M, B Criel, J Leeuwenburg, W Van Damme, D Le Ray, and Patrick Van Der Stuyft. 2000. “Visceral Leishmaniasis Control: a Public Health Perspective.” Transactions of the Royal Society of Tropical Medicine and Hygiene 94 (5): 465–471.
APA
Boelaert, M., Criel, B., Leeuwenburg, J., Van Damme, W., Le Ray, D., & Van Der Stuyft, P. (2000). Visceral leishmaniasis control: a public health perspective. TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, 94(5), 465–471.
Vancouver
1.
Boelaert M, Criel B, Leeuwenburg J, Van Damme W, Le Ray D, Van Der Stuyft P. Visceral leishmaniasis control: a public health perspective. TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE. 2000;94(5):465–71.
MLA
Boelaert, M, B Criel, J Leeuwenburg, et al. “Visceral Leishmaniasis Control: a Public Health Perspective.” TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE 94.5 (2000): 465–471. Print.
@article{127869,
  abstract     = {Visceral leishmaniasis (VL), also known as kala-azar, is a vector-borne disease caused by a protozoan of the Leishmania donovani complex. A phlebotomine sandfly transmits the parasite from person to person or via an animal reservoir. VL is a severe, debilitating disease, characterized by prolonged fever, splenomegaly, hypergammaglobulinaemia and pancytopenia. Patients become gradually ill over a period of a few months, and nearly always die if untreated. Case-fatality ratios are high even in treated patients. Worldwide an estimated 500000 VL cases occur each year. This study reviews clinical, epidemiological and public health aspects of the disease and shows how critical adequate case detection is for the success of VL control. Examination of the issue of VL diagnosis with respect to the global challenges in VL control leads to the observation that a sound diagnostic-therapeutic algorithm for the health services in endemic areas is badly needed. Serological tests could be an alternative to parasitological diagnosis and the direct agglutination test (DAT) was found to fulfil many criteria for a 'field test', including cost effectiveness. Although research needs on vaccine and better drugs continue to be high on the agenda, a VL test-treatment: strategy based on currently available highly sensitive serological tests, such as the DAT, should be introduced in the health services in endemic areas.},
  author       = {Boelaert, M and Criel, B and Leeuwenburg, J and Van Damme, W and Le Ray, D and Van Der Stuyft, Patrick},
  issn         = {0035-9203},
  journal      = {TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE},
  keyword      = {AZAR DERMAL LEISHMANIASIS,DIRECT AGGLUTINATION-TEST,POLYMERASE CHAIN-REACTION,PLUS INTERFERON-GAMMA,ENDEMIC KALA-AZAR,SODIUM STIBOGLUCONATE,PENTAVALENT ANTIMONY,EASTERN SUDAN,PARASITOLOGICAL METHODS,COST-EFFECTIVENESS,visceral leishmaniasis,disease control,epidemiology,transmission,clinical aspects,diagnosis,chemotherapy},
  language     = {eng},
  number       = {5},
  pages        = {465--471},
  title        = {Visceral leishmaniasis control: a public health perspective},
  url          = {http://dx.doi.org/10.1016/S0035-9203(00)90055-5},
  volume       = {94},
  year         = {2000},
}

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