If the leishmaniasis parasite (visceral leishmaniasis) existence is not that much clear in the blood. how the transmission between humans occurs. I mean from where the sand fly can take the amastigotes if it is not available in the blood? For example in Syria it is proved that the the visceral leishmaniasis type is only L.infantum. But we are facing big problems because in spite of spraying the epidemic areas we have 2-3 new cases weekly that means that we have another forms like donovani or tropica that causes VL and the reservoir is human. The other question, Should we treat asymptomatic VL or not.
L. infantum is usually zoonotic so you need to identify the reservoir mainly from canine family, L. tropica does not seem to be the causative agent of VL, you need to do identification of leishmania and we can help you since you can send samples to Iran.
Treatment of asymptomatic VL I do not think is needed.
Man is the accidental host in leishmaniases. The sand flies pick up the parasites from the canine reservoir hosts and pass them to human. If the parasites are not found in peripheral blood of VL victims, it could mean that they are there only when the human host is at rest or when the sand flies get the chance to probe the skin avidly.
VLC is not transmitted from human to human.
But be transferred from dogs to humans.
The parasites enter the skin cells dogs.
Tropica in Syria could be causing visceral leishmaniasis.
The epidemic to humans and reservoirs (dogs) treatment.
Mosquito nets impregnated with deltamethrin should be used for protection.
If antibody titers are above 3200. Can be cured.
In order to diagnose blood associated parasites you should perform a more sensetive techniques like PCR and western blot; because it is very low in concentration you need to concentrate WBC associated parasites. The parasite may reside in the liver, spleen, bone marrow and langerhance (skin associated macrophages); the vector may easly pick the parasite from langerhance (skin associated macrophages).
The increment in the incidence of visceral leishmanaisis is depending on these points
The treatment of VL with antimonates, or other antiprotozoal drugs is very expensive and have side effects; so, rather than treatment you should avoid the predisposing factors like malnutrion, stress,...
Treatment of asymptomatic cases is not recommended for many reasons: drug is toxic, asymptomatic can remain without development of any clinical manifestations for the rest of their live so they dont have the disease and they should not be treated.
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