Biopharmaceutical Solutions

Background information

• What is Leishmaniasis?
  Leishmaniasis is a widespread parasitic disease that affects the skin, mucosa, and internal organs, resulting in severe disfigurement, disability, or death.
• Global burden
  Worldwide there are 12 million people infected with Leishmania parasites. An estimated 350 million people are at risk for infection. There are approximately 1.7 million new cases and 45,000 deaths each year.
• Geographic distribution
  Leishmaniasis is found in 88 countries, 72 of which are low-income countries. More than 90 percent of all cases of cutaneous leishmaniasis, the most common form of the disease, are found in Afghanistan, Brazil, Iran, Peru, Saudi Arabia, and Syria. Approximately 90 percent of all cases of visceral leishmaniasis, a less common but deadlier form of the disease, occur in Bangladesh, India, Nepal, Sudan, and Brazil.
• Causative agent/transmission
  The leishmaniases are caused by approximately 20 different species of protozoa that belong to the genus Leishmania. The parasites are transmitted by the bite of the female phlebotomine sandfly. Within the vertebrate host, parasites invade and replicate inside white blood cells such as macrophages and inside dendritic cells. Leishmania are related to the trypanosomes that cause human African trypanosomiasis and Chagas disease.

Presentation

Leishmania diseases can be classified into one of four forms: (1) visceral leishmaniasis (VL), commonly known as Kala-azar, which is fatal if left untreated; (2) cutaneous leishmaniasis (CL), the most common form, hich is marked by a proliferation of self-healing skin lesions that produce significant scarring; (3) mucocutaneous leishmaniasis (MCL), which is an ulcerative Leishmania infection that results in destruction of the mucosal membranes of the nose and mouth; and (4) diffuse cutaneous leishmaniasis (DCL), the most difficult Leishmania manifestation to treat, which causes chronic ulcers and skin lesions resulting in severe disfigurement.

Trends

There is a profound need for safe, effective therapeutics and vaccines to combat the leishmaniases. Indeed, over the last 10 years, regions endemic for leishmaniasis have been growing, and there has been a sharp increase in the number of recorded cases of the disease. It is likely that a substantial number of cases are never recorded because declaration is compulsory in only 32 of the 88 countries affected by the disease.

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