Kala azar.

Although visceral leishmaniasis (VL) or Kala-azar caused by Leishmania donovani (LD) is globally, a public health problem and its eradication is of high priority, yet until now, no animal reservoir has been found in India and transmission of Kala-azar occurs from man to man through the recognised vector P. argentipes. The cutaneous or dermal leishmaniasis is caused by L. tropica and this is restricted to Rajasthan where it is zoonotic. Investigation by Sharma et al revealed the presence of zoonotic reservoir in Indian desert gerbils, the rodent burrows of which yielded two species of sandfly.

Renal involvement in kala-azar.

Fifty one patients in a series of 1000 parasitologically confirmed patients of kala-azar showing proteinuria were studied from the point of view of renal involvement. Forty two out of these patients showed blood urea above 40 mg/dl and 12 had decreased glomerular filtration rate as well. Serum creatinine level was normal in all patients including those with blood urea of more than 100 mg/dl. It is therefore suggested that although there may be glomerular involvement in some patients of kala-azar, the changes are reversible.

Role of HLA-DR antigen on T-cell activation in visceral leishmaniasis.

Ability of peripheral blood monocytes in association with HLA-DR molecules to support T-cell activation in response to soluble Leishmania donovani antigen was investigated. Adherent cells were stained with monoclonal antibodies. The increased number of cells with DR expression was more efficient in presenting L. donovani antigen to sensitized T-cells. The results suggest that quantitative variation in monocytes with expression of DR molecules, correlates with their ability to support T-cell response to L. donovani antigen, in vitro, as assessed by migration inhibition factor (MIF). However, it is not clear whether this is due to only HLA-DR antigen on the surface or whether other factors are involved.