{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:15:01Z","timestamp":1772496901831,"version":"3.50.1"},"reference-count":36,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","license":[{"start":{"date-parts":[[2024,4,3]],"date-time":"2024-04-03T00:00:00Z","timestamp":1712102400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,3]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>Post-kala-azar dermal leishmaniasis (PKDL), the dermal sequel to visceral leishmaniasis (VL), is characterized by hypopigmented macules (macular) and\/or papules and nodules (polymorphic). Post-kala-azar dermal leishmaniasis plays a significant role in disease transmission, emphasizing the need for monitoring chemotherapeutic effectiveness. Accordingly, this study aimed to quantify the parasite burden in PKDL patients after treatment with miltefosine by a quantitative polymerase chain reaction (qPCR). A <jats:italic>Leishmania<\/jats:italic> kinetoplastid gene-targeted qPCR was undertaken using DNA from skin biopsy specimens of patients with PKDL at three time points, i.e., at disease presentation (week 0, <jats:italic>n =<\/jats:italic> 157, group 1), upon completion of treatment (week 12, <jats:italic>n =<\/jats:italic> 39, group 2), and at any time point 6 months after completion of treatment (week \u226536, <jats:italic>n =<\/jats:italic> 54, group 3). A cycle threshold (<jats:italic>Ct<\/jats:italic>) &lt;30 was considered the cutoff for positivity, and load was quantified as the number of parasites\/\u00b5g genomic DNA (gDNA); cure was considered when samples had a <jats:italic>Ct<\/jats:italic> &gt;30. The parasite load at disease presentation (group 1) was 10,769 (1,339\u201380,441)\/\u00b5g gDNA (median [interquartile range]). In groups 2 and 3, qPCR results were negative in 35\/39 cases (89.7%) and 48\/54 cases (88.8%), respectively. In the 10\/93 (10.8%) qPCR-positive cases, the parasite burdens in groups 2 and 3 were 2,420 (1,205\u20135,661)\/\u00b5g gDNA and 22,195 (5,524\u2013100,106)\/\u00b5g gDNA, respectively. Serial monitoring was undertaken in 45 randomly selected cases that had completed treatment; all cases in groups 2 or 3 had a <jats:italic>Ct<\/jats:italic> &gt;30, indicating cure. Overall, qPCR confirmed an 89.2% cure (as 83\/93 cases showed parasite clearance), and the persistent qPCR positivity was attributed to nonadherence to treatment or unresponsiveness to miltefosine and remains to be investigated.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0197","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T19:29:02Z","timestamp":1709666942000},"page":"656-662","source":"Crossref","is-referenced-by-count":6,"title":["Monitoring the Long-Term Effectiveness of Miltefosine in Indian Post-Kala-Azar Dermal Leishmaniasis"],"prefix":"10.4269","volume":"110","author":[{"given":"Sutopa","family":"Roy","sequence":"first","affiliation":[{"name":"Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Srija","family":"Moulik","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhurima","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manab K.","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Tropical Medicine, School of Tropical Medicine, Kolkata, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Surya Jyati","family":"Chaudhuri","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Sarat Chandra Chattopadhyay Government Medical College and Hospital, Howrah, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dhruv K.","family":"Pandey","sequence":"additional","affiliation":[{"name":"Kala-Azar Elimination Programme, World Health Organization Country Office, New Delhi, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saurabh","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Argaw","family":"Dagne","sequence":"additional","affiliation":[{"name":"Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitali","family":"Chatterjee","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, India;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","year":"2023"},{"key":"b2","series-title":"PLoS Negl Trop Dis","first-page":"e0008221","article-title":"Post kala-azar dermal leishmaniasis: a threat to elimination program","volume":"14","author":"Gedda","year":"2020"},{"key":"b3","series-title":"J Clin Microbiol","first-page":"e0013221","article-title":"Utility of blood as the clinical specimen for the molecular diagnosis of post-kala-azar dermal leishmaniasis","volume":"59","author":"Dixit","year":"2021"},{"key":"b4","series-title":"Trans R Soc Trop Med Hyg","first-page":"S59","article-title":"Leishmaniasis in Sudan. 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