ABSTRACT
Leishmaniasis is due to a variety of Leishmania species. Sandflies transmit infection from an animal reservoir or from humans with a high burden of cutaneous parasite. Both Leishmania species and host immunity interplay in determining the clinical outcome of infection. Infection is principally intra-cellular within macrophages. Cell-mediated immunity including a Th-1 response and activation of macrophages is key to control. Clinical manifestations range from uncomplicated, self-healing skin lesions to destructive mucocutaneous disease around the mouth and nose to visceral disease. Diagnosis may be on clinical grounds for cutaneous lesions in endemic areas or require histology or serodiagnosis. Oral agents, such as miltefosine, are now available in addition to parenteral agents, such as sodium stibogluconate and amphotericin B. Vector control is the mainstay for public health measures.
