Visceral leishmaniasis in humans

Abstract

Objective: To analyze advances in knowledge regarding the clinical approach to visceral leishmaniasis, with emphasis on epidemiological, diagnostic, and therapeutic aspects, contributing to the improvement of disease management strategies. Literature review: Visceral leishmaniasis is a neglected systemic parasitic disease, endemic in Brazil. Transmitted by phlebotomine sandflies, it involves a complex pathophysiology with invasion and multiplication of Leishmania in macrophages, modulating the immune response. Clinically, it presents a variable spectrum, with prolonged fever, anemia, weight loss, and hepatosplenomegaly, and can lead to death, especially in immunocompromised individuals. Diagnosis integrates clinical, epidemiological, and laboratory criteria, including parasitological, serological, and molecular methods. Early treatment with antimonials or amphotericin B, and epidemiological surveillance are essential to reduce morbidity and mortality and strengthen integrated One Health actions in national control. Final considerations: Visceral leishmaniasis requires an integrated One Health approach, with research, surveillance, effective treatment, and public policies to reduce its impact. Therefore, continued research efforts, along with strengthened public health policies, are important to improve the impact of visceral leishmaniasis.