Visceral Leishmaniasis in Children: Diagnosis, Treatment, and Prevention

Leishmaniasis is a neglected tropical parasitic disease caused by an obligate intracellular protozoan of the genus Leishmania . The disease is transmitted by the bite of infected sand flies ( Phlebotomus species) and affects all ages and both genders. Nearly half of the visceral leishmaniasis (VL) cases occur in children. The clinical manifestations of pediatric leishmaniasis may be different from the adults associated with host-related factors. In this review, only the visceral form is covered. Confirmation of diagnosis is made by the parasitological, immunological, or by molecular methods. Sodium antimony gluconate (stibogluconate) has been the drug of choice for more than 60 years. However, in last three decades, its efficacy against leishmaniasis has gone significantly down especially in the Indian subcontinent where most cases of VL are seen. Therefore, other drugs, such as pentamidine-isothionate, paromomycin, amphotericin B, and miltefosine, are being used as alternative drugs for VL treatment. In the absence of an effective vaccine for VL, control measures are based on the prevention of disease transmission via vector control and community awareness. The present review focuses on the current state of the leishmaniasis, its diagnosis, treatment, and prevention with emphasis on pediatric leishmaniasis.