The post Kala-azar dermal leishmaniasis (PKDL) atlas

Overview

Post Kala-azar dermal leishmaniasis (PKDL) is a well-recognized complication of visceral leishmaniasis (VL) or kala-azar. It has been described since the beginning of the 20th century both in Asia and Africa, in areas where Leishmania donovani is the causative parasite. Its potential role in the transmission of kala-azar in particular in the interepidemic periods has been suggested many years ago and this was supported by feeding experiments in sandflies. Yet, PKDL has been neglected both from a clinical and an epidemiological point of view. This is partly caused by the difficulty in recognizing PKDL and making a firm diagnosis. The clinical spectrum varies and the list of differential diagnoses is extensive. We believe a reasonable diagnosis of PKDL can be made on clinical grounds only on the basis of a good clinical assessment by which differential diagnoses can be excluded.

This manual aims to be a guide to better and earlier recognition of PKDL by those who work in the field in remote areas. It may also be of use in the teaching of health workers at all levels.