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4 - Genetic Susceptibility to Visceral Leishmaniasis

Published online by Cambridge University Press:  02 December 2019

By
Hiba S. Mohamed ,
Muntaser E. Ibrahim  and
Jenefer M. Blackwell
Edited by
Muntaser E. Ibrahim  and
Charles N. Rotimi
Muntaser E. Ibrahim
Affiliation:
University of Khartoum
Charles N. Rotimi
Affiliation:
National Human Genome Research Institute/NIH
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Summary

The leishmaniases are a group of related diseases caused by parasites of the genus Leishmania (Order Kinetoplastidae, family Trypansomatidae). The clinical presentations of leishmaniasis include visceral leishmaniasis (VL) or kala-azar, post-kala-azar dermal leishmaniasis (PKDL), localized cutaneous leishmaniasis (LCL), disseminated cutaneous leishmaniasis (DCL), and mucosal leishmaniasis (ML). These different clinical patterns of infection are principally related to the species of Leishmania. All species of Leishmania are transmitted by sand flies; Phlebotomus spp. in the Old World and Lutzomyia longipalpis in the New World. Humans, wild animals, and domestic animals are known to act as reservoir hosts. Visceral leishmaniasis is associated with infection by members of the L. donovani species complex, including L. donovani sensu strictu, L. infantum, and L. aethiopica, and is characterized by fever, weight loss, epistaxis, pancytopenia, anorexia, abdominal pain, cough, diarrhea, nausea and vomiting, weakness, fatigue, splenomegaly, hepatomegaly, and lymphadenopathy. Other clinical signs of VL can include edema, neurological changes, and, less frequently, psychosis and jaundice (Zijlstra and el-Hassan 2001b). As well as being a severe systemic infection, a proportion of patients treated for VL go on to present with cutaneous disease, termed PKDL (Zijlstra and el-Hassan 2001a; Zijlstra et al. 1994). Recent analysis by the WHO estimates that 200,000–400,000 new cases occur annually, 90 percent of which are in India, Bangladesh, Sudan, South Sudan, Ethiopia, and Brazil (Alvar et al. 2012). In Africa, the highest incidence rate was reported in the East African region, with estimated annual incidence of 29,400–56,700. The reported VL cases per year in the region is 8560, of which Sudan, South Sudan, and Ethiopia have the highest incidence rates, in that order. A small number of cases have been reported from Somalia, Uganda, Kenya, and Eritrea. Visceral leishmaniasis is also present in other foci in Africa, such as Morocco, Algeria, and Tunisia, with estimated annual incidence rate of 300, 130, and 110 cases, respectively (Alvar et al. 2012).

Type
Chapter
Information
The Genetics of African Populations in Health and Disease , pp. 71 - 85
Publisher: Cambridge University Press
Print publication year: 2019

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