Post-kala-azar dermal leishmaniasis (PKDL) occurs after kala-azar treatment and acts as a durable infection reservoir. On the basis of active case finding among 22,699 respondents, 813 (3.6%) had had kala-azar since 2002, of whom 79 (9.7%) developed PKDL. Eight additional patients with PKDL had no history of kala-azar. Annual kala-azar incidence peaked at 85 cases per 10,000 person-years in 2004 and fell to 46 cases per 10,000 person-years in 2007, but PKDL incidence rose from 1 case per 10,000 person-years in 2002-2004 to 21 cases per 10,000 person-years in 2007. The rising PKDL incidence threatens the regional visceral leishmaniasis elimination initiative and underscores the urgent need for more effective PKDL diagnosis and treatment.
Rahman KM, Islam S, Rahman MW, Kenah E, Ghalib CM, Galive CM, Zahid MM, Maguire J, Rahman M, Haque R, Luby SP, Bern C. (2010). Increasing incidence of post-kala-azar dermal leishmaniasis in a population-based study in Bangladesh. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 50(1)