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A Novel Field-Deployable Point-of-Care Diagnostic Test for Cutaneous Leishmaniasis
Technical Report,30 Sep 2015,29 Sep 2016
The Henry M. Jackson for the Advancement of Military Medicine Bethesda United States
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Background. Leishmaniasis is caused by the protozoan Leishmania and is generally transmitted by the bite of sand flies of the genus Lutzomyia or Phlebotomus, The disease has significant global impact, producing 10-20 million cases of leishmaniasis worldwide. Cutaneous leishmaniasis CL is characterized by chronic skin ulcers that can impact the individuals functional status, lead to expensive and untimely treatment, and result in disfiguring scarring. Leishmaniasis causes a spectrum of diseases that include localized cutaneous leishmaniasis LCL, and destructive nasal and oropharyngeal lesions of mucosal leishmaniasis ML. LCL in the New World is most commonly caused by species of the Viannia subgenus L. braziliensis, L. panamensis, L. guyanensis, L. peruviana and to a lesser extent by species of the Leishmania subgenus L. mexicana, L. amazonensis. Historically, the leishmaniases have had significant impact on military operations. Thousands of cases of visceral and cutaneous leishmaniasis occurred in soldiers in World Wars I and II. Military training and combat operations resulted in cases of CL in soldiers USA, UK deployed to Central America. More recently 2003-2004, CL was reported in almost 1,200 members of the U.S. Armed Forces deployed to Iraq and Afghanistan, and the infection is an ongoing concern in the OEFOIF veteran population. Unpublished information indicates that the number of military personnel with cutaneous leishmaniasis could exceed 3,000. Rationale. A major challenge in the diagnosis of leishmaniasis is that the disease occurs in remote and resource-limited areas of the world with poor or inexistent primary health infrastructure. This also could be true during military field operations and training exercises where sophisticated laboratory equipment and medical personnel are scarce or not available.
APPROVED FOR PUBLIC RELEASE