From visceral to visible: A systematic review and meta-analysis of post-kala-azar dermal leishmaniasis incidence, risk factors, and treatment outcomes in Eastern Africa
PLOS Neglected Tropical Diseases·
- DOI
- 10.1371/journal.pntd.0014666
- PMID
- 42611892
- PMCID
- —
- OpenAlex
- W7203720391
- Study type
- Systematic review
- Publisher
- Public Library of Science (PLoS)
- Article type
- journal-article
- Integrity
- current
Why this research matters now
Consolidating regional outcome data helps identify modifiable therapeutic variables and highlights gaps in longitudinal tracking necessary for coordinated control initiatives.
Structured evidence summary
Research question
What is the aggregated incidence, associated demographic and clinical predictors, and therapeutic response profile of post-kala-azar dermal leishmaniasis among previously treated visceral leishmaniasis patients in Eastern Africa?
Study design
A peer-reviewed systematic review and meta-analysis adhering to PRISMA 2020 standards, utilizing random-effects modeling for incidence aggregation and narrative synthesis for secondary endpoints.
Population and setting
Cohorts of individuals with a history of visceral leishmaniasis residing in Sudan, Ethiopia, Kenya, and Uganda, tracked across multiple published reports.
Main findings
The pooled estimate for cumulative disease occurrence reached 18.2 percent, though confidence intervals were wide due to substantial cross-study variability. Reported rates differed markedly by country and calendar period, with earlier data showing higher frequencies that declined following modifications to initial drug protocols. Prior medication choices, younger age, regional location, and HIV status emerged as notable correlates, while a dual-drug combination regimen demonstrated superior clinical resolution in evaluated trials.
Public-health relevance
Consolidating regional outcome data helps identify modifiable therapeutic variables and highlights gaps in longitudinal tracking necessary for coordinated control initiatives.
Important limitations
Considerable statistical heterogeneity and inconsistent observation windows restrict the precision of pooled estimates. The reliance on disparate published reports rather than uniform prospective cohorts limits direct comparability.
GIDS interpretation
This work functions as a consolidated reference on historical disease patterns and intervention results within a specified geographic area, providing background context for trend analysis without indicating active case detection.
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 8 auditable classifier relationships to diseases, places, topics, and study design.