Risk factors for post-kala-azar dermal leishmaniasis (PKDL): Challenges in understanding pathophysiology
PLOS Neglected Tropical Diseases·
- DOI
- 10.1371/journal.pntd.0013952
- PMID
- 41729910
- PMCID
- PMC12928490
- OpenAlex
- W7131110693
- Study type
- Journal article
- Publisher
- Public Library of Science (PLoS)
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The authors emphasize the need to integrate PKDL management within broader skin disease programs and to optimize VL treatment (e.g., multidrug regimens, immune modifiers) to potentially reduce PKDL incidence.
Structured evidence summary
Research question
The review examines host, parasite, treatment-related, environmental, and co-infection factors influencing the risk and pathophysiology of post-kala-azar dermal leishmaniasis in Eastern Africa and the Southeast Asia region.
Study design
A literature-based narrative review extracting data on risk factors, epidemiology, genetics, pathophysiology, immune responses, and co-infections associated with PKDL.
Population and setting
Populations affected by PKDL in Eastern Africa (notably Sudan) and the Southeast Asia region (including India and Bangladesh), spanning children, adolescents, and young adults with prior or concurrent visceral leishmaniasis.
Main findings
Young age and male gender were identified as host risk factors in Eastern Africa, while reduced IFNGR1 expression was noted in PKDL but not VL across both regions. Parasite strain differences and co-infection with Leptomonas seymouri were reported, and prior VL treatment was a major risk factor in Sudan, India, and Bangladesh. Environmental exposures such as naturally occurring arsenic and UV light, as well as co-infections potentially modulating immune responses, were also described.
Public-health relevance
The authors emphasize the need to integrate PKDL management within broader skin disease programs and to optimize VL treatment (e.g., multidrug regimens, immune modifiers) to potentially reduce PKDL incidence.
Important limitations
No explicit limitations are stated in the supplied abstract. The summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation.
GIDS interpretation
The article is discoverable through GIDS classifiers linking leishmaniasis to Bangladesh, India, and Sudan, with topical relevance to climate/environment and treatment. This entry characterizes the record's cataloging context and does not connect it to any active surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 7 auditable classifier relationships to diseases, places, topics, and study design.