WHO has issued major updates to its leishmaniasis treatment guidelines, specifically for visceral leishmaniasis (VL, also known as kala-azar) and post-kala-azar dermal leishmaniasis (PKDL) in eastern Africa and South-East Asia. The new recommendations aim to significantly improve patient care by offering shorter, safer, and more effective regimens. For VL in eastern Africa, the guidelines now advocate for SSG-free regimens: an oral drug, miltefosine, is recommended in combination with a paromomycin injection. This approach reduces the number of injections (from 34 over 17 days to 14 over 14 days), shortens hospitalization, and lowers the risk of developing PKDL. For PKDL in eastern Africa, the updated guidelines also promote miltefosine combined with paromomycin. In South-East Asia, new options include liposomal amphotericin B alone or in combination with a short, time-limited course of miltefosine — this helps limit exposure to miltefosine and reduce concerns about ocular toxicity. Additionally, the guidelines provide clearer recommendations for managing relapses in VL patients in South-East Asia. Many of these therapies were developed by the non-profit organization Drugs for Neglected Diseases initiative (DNDi) and partners. Countries affected by these diseases are expected to incorporate the new treatments into their national protocols soon.
About the Author
