LEISHMANIASIS(kala azar).pptx community medicime

leishmaniasis
community medicine

1. EPIDEMIOLOGY AND TREATMENT OF LEISHMANIASIS

2. INTRODUCTION Leishmania is a vector-borne, obligate intracellular, protozoan parasite (family Trypanosomatidae ) It causes cutaneous, mucocutaneous, and visceral disease It is caused by multiple subspecies with diverse clinical manifestations

3. EPIDEMIOLOGY Leishmaniasis is a tropical disease throughout Asia, Africa, the Middle East, and Central and South America. Cutaneous leishmaniasis (CL) incidence range from 700,000 to 1.2 million cases per year Visceral leishmaniasis (VL) are currently less than 100,000 Risk factors include Poverty Population migration Malnutrition Poor hygiene Immunocompromised state

4. Over 20 species of the Leishmania parasite have been characterized Transmitted from approximately 70 different types of phlebotomine sand flies . Given the large variety of species, leishmaniasis has been divided geographically into the Old World and New World. The Old World, referring to the Eastern Hemisphere, includes Asia, the Middle East, Africa, and Southern Europe. Conversely, the New World refers to the Western Hemisphere specifically Mexico, Central America, South America, and the USA.

5. There are 22 species belonging to the genus Leishmania -further subdivided into the subgenera Leishmania and Viannia Each parasite species has specific geographical predilections, host factors, and symptom characteristics.

6. LIFE CYCLE

7. CLINICAL FEATURES Leishmaniasis can present with a variety of different clinical manifestations The main three phenotypic categories of disease Cutaneous (CL) Mucosal (ML) Visceral leishmaniasis (VL)

8. DIAGNOSIS

9. CONTROL MEASURES CONTROL OF RESERVOIR Single dose Liposomal Amphotericin B (LAMB) IV 10 mg/kg Miltefosine capsules -10 mg (paediatric) and 50 mg (adults) Amphotericin B deoxycholate IV 1 mg/kg on alternate days x 15 doses.

10. Combination - Paramomycin IM + Miltefosine 11mg/kg x 10 days HIV-coinfected patients - LAMB 40 mg/kg total dose - 3-5 mg/kg bw daily or intermittently for 10 doses, on days 1-5, 10, 17, 24, 31 and 38. PKDL- In order of preference: First drug of choice, miltefosine 100 mg orally per day x 12 weeks Amphotericin 'B' deoxycholate injection 1 mg/kg bw over 4 months in 60-80 doses.

11. 2. SANDFLY CONTROL Residual insecticides- DDT is the first choice Insecticide spraying should be undertaken in human dwellings, animal shelters and all other resting places BHC should be kept as a second line of defence. For long-lasting results, insecticidal spraying should be combined with sanitation measures Elimination of breeding places (e.g., cracks in mud or stone walls, rodent burrows, removal of firewood, bricks or rubbish around house) location of cattle sheds and poultry at a fair distance from human dwellings Improvement of housing and general sanitation.

12. 3. PERSONAL PROPHYLAXIS Health education Individual protective measures such as avoiding sleeping on floor, using fine-mesh nets around the bed. Insect repellents (in the form of lotions, creams, or sticks) for temporary protection and keeping the environment clean. There are no drugs for personal prophylaxis .