Pathology and Emerging Treatment of Leishmaniasis: The India Scenario

Leishmaniasis is a vector-borne parasitic disease caused by Leishmania protozoa and transmitted through sandfly bites. Recognized as a Neglected Tropical Disease (NTD) by the World Health Organization (WHO), it disproportionately affects marginalized populations in over 98 endemic countries. The disease manifests in three primary forms: visceral leishmaniasis (VL), the most severe and potentially fatal type; cutaneous leishmaniasis (CL), causing ulcerative skin lesions; and mucocutaneous leishmaniasis (MCL), leading to severe facial and nasal deformities. Despite elimination efforts, India remains a global hotspot, particularly for VL, with Bihar, Jharkhand, Uttar Pradesh, and West Bengal accounting for a significant disease burden. Challenges such as drug resistance, poor healthcare infrastructure, and a lack of vaccines hinder eradication efforts. Epidemiological data indicate an annual incidence of approximately 1 million cases, with 20,000 to 30,000 deaths worldwide. India has seen a decline in cases due to national control programs, yet socio-economic barriers and post-Kala-Azar dermal leishmaniasis (PKDL) continue to drive transmission. Addressing this disease requires sustained investment in research, affordable treatment strategies, and enhanced public health interventions.