WHO guidelines on leishmaniases: treatment of visceral leishmaniasis and post-kala-azar dermal leishmaniasis in eastern Africa and South-East Asia

Overview

These guidelines provide updated WHO recommendations on the pharmacological treatment of visceral leishmaniasis and post-kala-azar dermal leishmaniasis in eastern Africa and South-East Asia. They address treatment of visceral leishmaniasis in eastern Africa, relapse in South-East Asia, and post-kala-azar dermal leishmaniasis in both regions, incorporating new evidence from clinical trials and systematic reviews. Recommendations cover monotherapies and combination regimens involving paromomycin, miltefosine, sodium stibogluconate and liposomal amphotericin B, and apply to HIV-negative patients.

Developed according to WHO guideline methods, the recommendations consider efficacy and safety, certainty of evidence, values, resource implications, equity, acceptability and feasibility. The guidelines also provide implementation considerations on access to quality-assured medicines, pharmacovigilance, patient follow-up, monitoring and evaluation, prevention of antimicrobial resistance and programme coordination. They update the safety profile of miltefosine, including measures to minimize ocular adverse events, introduce weight-band-based allometric dosing, and identify priorities for further research.