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Table 1 PKDL - differences between Africa and Asia

From: The immunology of post-kala-azar dermal leishmaniasis (PKDL)

 

Asia

Africa

Clinical type most common

macular

papular

Frequency after VL

10–20 %

50–60 %

Infective to sand flies

yes

yes

Transmission of VL

anthroponotic

anthroponotic and zoonotic

Interval after VL

0–3 years, or morea

0–13 months

Self-cure

yes, probably

yes

Occurs without previous VL

yes

yes

Occurs with VL simultaneouslyb

yes

yes

Occurs with mucosal involvement

yes

yes

Treatment policy

all are treated

chronic > 6 months or severe PKDL are treated

Treatment

miltefosine

SSG or AmBisome

Marker for cure

clinical

clinical

  1. arecent data show that up to 30 % of PKDL in Asia occurs within 12 months after treatment for VL
  2. bthis is also called para-kala-azar dermal leishmaniasis