Leishmaniasis in Uganda: Historical account and a review of the literature

Visceral leishmaniasis (VL) or kala azar is a fatal and neglected disease caused by protozoan parasites. It occurs worldwide including north-eastern Uganda. This review gives a historical account of and reviews available literature on VL in Uganda to raise more awareness about the disease. Information was collected from: MEDLINE searches; records of Ministry of Health (Uganda), Amudat hospital records; records of NGOs and multilateral institutions; dissertations and personal communication. Results show that VL in Uganda was first reported in the 1950's, followed by almost four decades of neglect. Earlier records from the ministry of health and Amudat hospital on VL are also incomplete. From early 2000, reports mainly on the disease management and risk factors, started to appear in the literature. Management of VL has mainly been by NGOs and multilateral institutions including MSF Swiss. Currently DNDi is funding its management and clinical trials in Amudat hospital through LEAP. New cases of VL were reported recently from Moroto and Kotido districts and more patients continue to be received from these areas. In conclusion, management of VL is well established in Amudat hospital. However its sustainability and wider coverage remains a challenge. First-line drugs have now been registered in the country. Visceral leishmaniasis is apparently more widespread in north-eastern Uganda than originally thought. Research and surveillance on leishmaniasis is still weak. Strengthening the capacity of local institutions to; conduct surveillance and research, combined with effective management should mitigate VL in Uganda.