The leishmaniasis is endemic in 88 countries on five continents—Africa, Asia, Europe, North America and South America

1. Dr. Faten Abdo Hassan

2. The leishmaniasis is endemic in 88 countries
on five continents—Africa, Asia, Europe, North
America and South America.
350 million people at risk.
12 million people are affected by
leishmaniasis
1.5-2 million new cases of leishmaniasis
estimated to occur annually.
 500,000 new cases of VL which occur
annually
Geographical distribution

3. New world leishmaniasisOld world leishmaniasis
Leishmania braziliensis complexLeishmania donovani
Leishmania mexicana complexLeishmania infantum
Leishmania chagasiLeishmania tropica
Leishmania peruvianaLeishmania major
Leishmania aethiopica
Classification of Leishmania based on
Geographical Distribution

4. Three different diseases are caused by various species
of genus Leishmania. These are:
Visceral leishmaniasis: The species L. donovani
complex infecting internal organs (liver, spleen, and
bone marrow) of human is the causative parasite.
€Cutaneous leishmaniasis: The species L. tropica
complex, L. aethiopica, L. major and L. mexicana
complex are the causative parasite.
€Mucocutaneous leishmaniasis: It is caused by
the L. braziliensis complex .

5. The parasite exists in 2 forms:
Amastigote form: in humans and other mammals.
Promastigote form: in the sandfl y and in artificial
culture.
Morphology of Leishmania donovani. A. Amastigote, B. Promastigote
A B
polymorphomorphology

6. L. donovani completes its life cycle in 2 hosts.
Defi nitive host: Man, dog, and other mammals.
Vector: Female sandfl y (Phlebotomus species).
Infective form: Promastigote form present in
midgut of female sandfly.
Mode of transmission:
€Humans acquire by bite of an infected female
Sandfly(Phlebotomus and Lutzomyia).
. It can also be transmitted vertically from mother to
fetus, by blood transfusion, and accidental
inoculation in the laboratory.
Incubation period: Usually 2–6 months,
occasionally it may be as short as 10 days or as long as
2 years.
Life Cycle of Leishmania

7. Life Cycle of Leishmania

8. Infection with Leishmania species can result in 3 main
types of disease depending on the species, geographic
region and host immune response.
Leishmania donovani produces visceral
leishmaniasis (kala-azar). Symptoms include fever
(often 2 fever spikes per day), enlargement of the
spleen and liver, weakness, and progressive
emaciation. The disease is often fatal without
treatment, but survivors often develop immunity.
Symptoms/Pathology

9. Leishmania tropica and L. mexicana produce
cutaneous leishmaniasis which is characterized by skin
lesions (oriental sore). Infected macrophages
containing amastigotes are found primarily at the site
of infection around the sores. The sores are
chracterized by an elevated rim encircling the
lesion. The sores generally heal by themselves within a
year, but secondary bacterial infections are possible in
open sores.
Symptoms/Pathology

10. Leishmania braziliensis produces mucocutaneous
leishmaniasis, characterized by lesions near mucosal
membranes. The intitial site if infection is a small red
papule that ulcerates in a few weeks. The lesions are
flat (no raised rim) and often oozing. Infections of the
ear, nose and mouth area lead to degeneration of the
cartilage and soft tissues, resulting in disfigurement.
Symptoms/Pathology

11. By demonstrations of LD bodies in peripheral blood,
bone marrow aspirate, splenic aspirate, and lymph
node aspirate; culture done in NNN medium; aldehyde
test; detection of specifi c antigen and antibody by IIF,
ELISA,
DAT and rapid rk 39 antibody detection test.
Blood picture: Anemia, thrombocytopenia, leuco penia
 with relative lymphocytosis, and hypergammaglobulinemia
Sodium stibogluconate amphotericinB, and oral miltefosine.
Diagnosis:
Treatment:

12. Control of sandfly population by insecticides and
sanitation measures.
Personal protection by use of protective clothing and
use of insect repellants.
Elimination of mammalian reservoir.
Prophylaxis