Visceral Leishmaniasis and Arsenic: An Ancient Poison Contributing to Antimonial Treatment Failure in the Indian Subcontinent?
2011

Arsenic's Role in Treatment Failure of Leishmaniasis in India

publication Evidence: moderate

Author Information

Author(s): Perry Meghan R., Wyllie Susan, Prajapati Vijay Kumar, Feldmann Joerg, Sundar Shyam, Boelaert Marleen, Fairlamb Alan H.

Primary Institution: Division of Biological Chemistry and Drug Discovery, College of Life Sciences, University of Dundee, Dundee, Scotland, United Kingdom

Hypothesis

Chronic exposure to arsenic may contribute to the development of antimonial resistance in Leishmania parasites in Bihar, India.

Conclusion

The study suggests a significant link between arsenic contamination of groundwater and the development of high levels of resistance to antimonial compounds in the treatment of visceral leishmaniasis in Bihar.

Supporting Evidence

  • Antimonial preparations remain first-line drugs for visceral leishmaniasis, but cure rates have declined significantly in Bihar.
  • Chronic exposure to arsenic through contaminated drinking water may lead to the development of arsenic-resistant Leishmania strains.
  • The Indian subcontinent is the only place where visceral leishmaniasis and significant arsenic contamination coexist.

Takeaway

People in Bihar, India, are getting sick from a disease called leishmaniasis, and the medicine that usually helps isn't working as well because of arsenic in their drinking water.

Limitations

The study relies on retrospective clinical data and may not accurately reflect current resistance mechanisms.

Digital Object Identifier (DOI)

10.1371/journal.pntd.0001227

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