VISCERAL LEISHMANIASIS – MODERN APPROACHES IN DIAGNOSIS AND TREATMENT: LITERATURE REVIEW

Resume. Visceral leishmaniasis (VL), or kala-azar, is a severe systemic parasitic disease caused predominantly by Leishmania donovani and Leishmania infantum. It continues to represent a significant public health burden in endemic regions, particularly in South Asia, East Africa, and the Mediterranean basin. This narrative review aims to critically summarize recent advances in the diagnosis and treatment of visceral leishmaniasis, with emphasis on clinically relevant and emerging approaches. Conventional parasitological techniques, including splenic and bone marrow aspiration, remain the diagnostic reference standard; however, their invasiveness and requirement for technical expertise limit widespread applicability. Serological assays, particularly rK39-based rapid diagnostic tests and the direct agglutination test, have significantly improved field diagnostics. In addition, molecular methods such as polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) provide enhanced sensitivity and specificity, facilitating early detection and monitoring. Emerging research on non-invasive antigen detection and host-derived biomarkers further expands diagnostic possibilities. Therapeutically, liposomal amphotericin B has become the cornerstone of VL management in many settings due to its superior efficacy and safety profile. Oral miltefosine and combination regimens offer alternative strategies, though concerns regarding resistance, relapse, and treatment accessibility persist. Ongoing research focuses on optimized combination therapies, novel pharmacological targets, and improved implementation strategies in resource-limited settings. Integrating advanced diagnostic modalities with evidence-based therapeutic approaches is essential for improving clinical outcomes and strengthening global control efforts against visceral leishmaniasis. Keywords: Visceral leishmaniasis; Kala-azar; Diagnosis; Treatment; Molecular diagnostics; Liposomal amphotericin B; Miltefosine

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