Barriers to the effective management and prevention of post kala-azar dermal leishmaniasis (PKDL) in the Indian subcontinent

Biplab Pal; Sweta Kumari; Manpreet Kaur; Pankaj Wadhwa; Krishna Murti; Rishikesh Kumar; Krishna Pandey; Niyamat Ali Siddiqui; Sameer Dhingra; Somanaboina Padmakar

doi:10.1016/j.mjafi.2023.03.010

Barriers to the effective management and prevention of post kala-azar dermal leishmaniasis (PKDL) in the Indian subcontinent

Med J Armed Forces India. 2023 Sep-Oct;79(5):500-505. doi: 10.1016/j.mjafi.2023.03.010. Epub 2023 May 15.

Authors

Affiliations

¹ Assistant Professor, School of Pharmaceutical Science, Lovely Professional University, Punjab, India.
² Student, School of Pharmaceutical Science, Lovely Professional University, Punjab, India.
³ Associate Professor, School of Pharmaceutical Science, Lovely Professional University, Punjab, India.
⁴ Assistant Professor (Pharmacy Practice), National Institute of Pharmaceutical Education and Research, Hajipur, Bihar, India.
⁵ Consultant (Biostatistics), Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India.
⁶ Director, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India.
⁷ Scientist E, (Biostatistics), Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India.
⁸ Associate Professor (Pharmacy Practice), National Institute of Pharmaceutical Education and Research, Hajipur, Bihar, India.
⁹ PhD Scholar, School of Pharmaceutical Science, Lovely Professional University, Punjab, India.

PMID: 37719909
PMCID: PMC10499647 (available on 2024-09-01)
DOI: 10.1016/j.mjafi.2023.03.010

Abstract

Post kala-azar dermal leishmaniasis (PKDL) is a skin disease that usually occurs among individuals with a past history of visceral leishmaniasis (VL). PKDL cases act as a reservoir of parasites and may play a significant role in disease transmission. Hence, prompt detection and complete treatment of PKDL cases are crucial for the control and elimination of VL. The purpose of this review was to highlight the barriers to effective control and prevention of VL/PKDL as well as potential solutions in India. Main obstacles are lack of knowledge about the disease and its vector, poor treatment-seeking behaviours, ineffective vector control measures, lack of confirmatory diagnostics in endemic areas, limited drug choices, treatment noncompliance among patients, drug resistance, and a lack of an adequate number of trained personnel in the health system. Therefore, in order to control and successfully eliminate VL in the Indian subcontinent, early detection of PKDL cases, improved diagnosis and treatment, raising awareness, and effective vector control mechanisms are necessary.

Keywords: Challenge; Kala-azar; Post kala-azar dermal leishmaniasis; Visceral leishmaniasis elimination.

Publication types

Review