Evidence map›Paper›PMID 29145397›Full record

ReviewPLoS neglected tropical diseases2017

Post-kala-azar dermal leishmaniasis in the Indian subcontinent: A threat to the South-East Asia Region Kala-azar Elimination Programme.

Eduard E Zijlstra, Fabiana Alves, Suman Rijal, Byron Arana, Jorge Alvar

Open access · goldAbstract readReview
In one paragraph

Review in PLoS neglected tropical diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 3 pooled it
13.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 3 syntheses or guidelines pooled it, 143 citations in OpenAlex.

  1. Pooled it
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  4. Trial
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  6. Safety and immunogenicity of ChAd63-KH vaccine in post-kala-azar dermal leishmaniasis patients in Sudan.Molecular therapy : the journal of the American Society of Gene Therapy · 2021
    Trial
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  8. Review
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  10. Leishmaniasis.Nature reviews. Disease primers · 2025
    Review
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  13. Post kala-azar dermal leishmaniasis burden at the village level in selected high visceral leishmaniasis endemic upazilas in Bangladesh.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2024
    Article
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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

Eduard E ZijlstraDrugs for Neglected Diseases initiative, Geneva, Switzerland.
Fabiana AlvesDrugs for Neglected Diseases initiative, Geneva, Switzerland.
Suman RijalDrugs for Neglected Diseases initiative, India Office, New Delhi, India.
Byron AranaDrugs for Neglected Diseases initiative, Geneva, Switzerland.
Jorge AlvarDrugs for Neglected Diseases initiative, Geneva, Switzerland.
Drugs for Neglected Diseases Initiative · CHDrugs for Neglected Diseases Initiative India · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe South-East Asia Region Kala-azar Elimination Programme (KAEP) is expected to enter the consolidation phase in 2017, which focuses on case detection, vector control, and identifying potential sources of infection. Post-kala-azar dermal leishmaniasis (PKDL) is thought to play a role in the recurrence of visceral leishmaniasis (VL)/kala-azar outbreaks, and control of PKDL is among the priorities of the KAEP. METHODOLOGY AND PRINCIPAL FINDING: We reviewed the literature with regard to PKDL in Asia and interpreted the findings in relation to current intervention methods in the KAEP in order to make recommendations. There is a considerable knowledge gap regarding the pathophysiology of VL and PKDL, especially the underlying immune responses. Risk factors (of which previous VL treatments may be most important) are poorly understood and need to be better defined. The role of PKDL patients in transmission is largely unknown, and there is insufficient information about the importance of duration, distribution and severity of the rash, time of onset, and self-healing. Current intervention methods focus on active case detection and treatment of all PKDL cases with miltefosine while there is increasing drug resistance. The prevention of PKDL by improved VL treatment currently receives insufficient attention. CONCLUSION AND SIGNIFICANCE: PKDL is a heterogeneous and dynamic condition, and patients differ with regard to time of onset after VL, chronicity, and distribution and appearance of the rash, as well as immune responses (including tendency to self-heal), all of which may vary over time. It is essential to fully describe the pathophysiology in order to make informed decisions on the most cost-effective approach. Emphasis should be on early detection of those who contribute to transmission and those who are in need of treatment, for whom short-course, effective, and safe drug regimens should be available. The prevention of PKDL should be emphasised by innovative and improved treatment for VL, which may include immunomodulation.

Indexed as

Preventive Health ServicesAsia, SoutheasternDisease EradicationDisease OutbreaksFemaleHumansIndiaLeishmania donovaniLeishmaniasis, CutaneousLeishmaniasis, VisceralMalePrevalenceRecurrenceRisk Factors

Identifiers

PMID29145397
PMCPMC5689828
OpenAlexW2770374950

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.