WHO unveils safer, shorter treatment guidelines for Visceral Leishmaniasis

By Precious Mark

The World Health Organization (WHO) has released updated treatment guidelines for visceral leishmaniasis and post-kala-azar dermal leishmaniasis, introducing safer and shorter therapeutic regimens to enhance patient care across endemic regions.

The updated guidelines recommend regimens that eliminate the need for toxic, long-standing injectable drugs that have caused severe side effects in patients for decades.

Visceral leishmaniasis, commonly known as kala-azar or black fever, is a severe parasitic infection transmitted through the bite of infected sandflies. It is one of the world’s deadliest parasitic diseases after malaria, causing persistent high fever, significant weight loss, severe anemia, and organ enlargement. Without treatment, the condition is almost universally fatal.

The disease is endemic in 80 countries, causing an estimated 50,000 to 90,000 new infections annually, though public health experts estimate that fewer than half of all cases are officially reported.

A related post-recovery complication, post-kala-azar dermal leishmaniasis, causes widespread skin lesions. While not fatal, the condition leaves patients highly infectious and subject to social stigma.

Under the new protocols, patients in eastern Africa presenting with primary kala-azar will receive a 14-day combination therapy consisting of oral miltefosine and injectable paromomycin.

This replaces a 17-day regimen that required daily injections of sodium stibogluconate, significantly reducing toxicity and physical discomfort.

For post-kala-azar dermal complications, the WHO introduced shorter oral and combination therapies, ending prolonged hospital stays that previously lasted between one and three months.

The WHO Director of Malaria and Neglected Tropical Diseases, Dr. Daniel Ngamije Madandi, stated that the revised guidelines provide safer, more patient-friendly options that will accelerate efforts to eliminate the disease across Africa and Asia.

The newly recommended treatments were developed in collaboration with the Drugs for Neglected Diseases initiative and regional African research institutions. Endemic nations are expected to incorporate these revised protocols into their national health systems.