Figure 3

Desired Algorithm for PKDL Diagnosis (not validated). Suspect cases are identified based on clinical symptoms, proximity to an endemic region, past VL treatment, and no loss of skin sensation. Confirmation of diagnosis should first be attempted using skin slit smear and parasitology; however, the technique used to obtain the skin slit impacts sensitivity of the method (currently 40-50%). Recommendations for obtaining a skin slit sample will improve sensitivity. *Approximately 10% of PKDL cases present without a history of VL. **Antigen detection and molecular tests are not yet available or are not yet validated. ***The indication for treatment may vary per endemic region.