Leishmaniasis

Project portfolio

Research Catalyse development Guide use and policy Accelerate Access
Technologies  Specimen bank Point of care diagnosis & treatment monitoring Good Clinical Laboratory Practices
Enabling Environment TPPs & NTD need prioritization Advocacy with community & health personnel
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Leishmaniasis is a complex group of vector-borne infections caused by protozoan parasites of the genus Leishmania, which are transmitted by female sandflies. The disease is present in 98 countries in Africa, Asia, Europe, and the Americas, where it affects some of the world’s poorest people. Major risk factors include malnutrition and displacement, as well as environmental changes like deforestation and urbanization.

Leishmaniasis manifests in clinically and epidemiologically diverse forms. Two of the main variations of the disease are:

1) Cutaneous leishmaniasis (CL), the most common form, causes skin ulcers on exposed areas of the body that leave scars and often lead to disability.
2) Visceral leishmaniasis (VL), also known as kala azar, causes fever, weight loss, enlargement of the spleen and liver, and anemia. It is fatal if left untreated. Following treatment, some patients develop post-kala-azar dermal leishmaniasis (PKDL), pleomorphic skin manifestations that are potential sources of VL transmission.

Each year, leishmaniasis causes over 1.3 million new infections and 20,000 – 30,000 deaths. Of new infections, an estimated 200,000 – 400,000 are VL, and 0.7 – 1.2 million CL.

The diagnostic landscape
FIND's strategic approach

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FIND aims to address the following unmet needs: i) a POC test to detect actual infection in VL patients, and that could be used for treatment monitoring; ii) better tools for CL diagnosis at the POC, like RDTs and improved microscopy protocols;

iii) molecular test for confirmation of CL and VL accessible to decentralized laboratories; iv) assessment of the performance of the different RDTs available for VL diagnosis in Eastern African countries.

1. Antigen detection POC test for VL
2. Antigen detection RDT for CL
3. iLED microscopy for CL
4. LAMP for CL and VL
5. Evaluation of antibody detection RDT for VL

VL is highly endemic in Eastern Africa. Challenges to control the disease include the remoteness of, and difficult access to, endemic areas, insecurity, and the difficulties of transporting diagnostic tests and medicines for case management. FIND is aiming to strengthening diagnostic laboratory capacity for VL diagnosis in

Kenya and Uganda by mapping and characterizing health centres, harmonizing diagnostic procedures, building capacity, and implementing guidelines and quality assurance protocols.

Specimen banks are a critical tool to accelerate development of diagnostic tests. The difficulty of accessing samples for test evaluations is a challenge to develop new diagnostic tests.

In the frame of our different projects, specimen banking is considered as one of the key activities. This is critical for both proof-of-concept studies and quality assurance activities.