New challenges in the epidemiology and treatment of visceral leishmaniasis in periurban areas.

Visceral leishmaniasis (VL) represents a major public health problem in many areas of the world. This review focuses on the impact of periurbanization on the epidemiology and treatment of VL, using Brazil as an example. VL continues to be primarily a disease of poverty with impact on families. However, the disease has expanded in Latin America, with foci reported as far south as Argentina. There is an increasing overlap of Leishmania infantum chagasi and human immune deficiency virus (HIV) infections and other immunosuppressive conditions, resulting in the emergence of VL as an opportunistic infection. This new setting poses new challenges for VL disease control and patient management. Drug Dev Res 72:451-462, 2011. (C) 2011 Wiley-Liss, Inc.