Epidemiological Insights: Unraveling Drug Resistance in Leishmania Species through Comprehensive Studies

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Abstract

Leishmaniasis, a neglected tropical disease caused by the protozoan parasite Leishmania, remains a significant public health concern in endemic regions. This disease manifests in various forms like cutaneous, mucocutaneous, and visceral leishmaniasis, each associated with specific Leishmania species and influenced by host immune responses. Over the past few decades, treatment for leishmaniasis has relied on a limited range of drugs, including Pentavalent Antimonials, Amphotericin B formulations, Miltefosine, and Paromomycin. However, widespread drug resistance has emerged, particularly in visceral leishmaniasis, threatening treatment efficacy and leading to increased cases of treatment failure. This review provides a comprehensive overview of the mechanisms underlying Leishmania drug resistance, including changes in parasite uptake and efflux, intracellular sequestration, and stress response modulation. Additionally, we examine the impact of environmental factors, such as arsenic exposure in endemic areas, on resistance development, and review recent studies exploring molecular and genomic markers associated with resistance. The review highlights the urgent need for new therapeutic strategies and emphasizes a multi-faceted approach to tackle resistance through surveillance, molecular insights, and global collaborations.

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