Barriers to the effective management and prevention of post kala-azar dermal leishmaniasis (PKDL) in the Indian subcontinent.

Post kala-azar dermal leishmaniasis (PKDL) is a skin disease that usually occurs among individuals with a past history of visceral leishmaniasis (VL). PKDL cases act as a reservoir of parasites and may play a significant role in disease transmission. Hence, prompt detection and complete treatment of PKDL cases are crucial for the control and elimination of VL. The purpose of this review was to highlight the barriers to effective control and prevention of VL/PKDL as well as potential solutions in India. Main obstacles are lack of knowledge about the disease and its vector, poor treatment-seeking behaviours, ineffective vector control measures, lack of confirmatory diagnostics in endemic areas, limited drug choices, treatment noncompliance among patients, drug resistance, and a lack of an adequate number of trained personnel in the health system. Therefore, in order to control and successfully eliminate VL in the Indian subcontinent, early detection of PKDL cases, improved diagnosis and treatment, raising awareness, and effective vector control mechanisms are necessary.

A Systematic Review on Prevalence and Assessment of Sexual Dysfunction in Vitiligo.

OBJECTIVE: Vitiligo is a common depigmenting disorder with significant psychosocial consequences. Vitiligo has been associated with psychological disorders such as depression, low self-esteem, anxiety, and sexual dysfunction (SD). In recent years, there is an increase in the number of studies looking into the impact of vitiligo on sexual functions. This systematic review investigates the assessment and prevalence of SD in vitiligo patients. MATERIALS AND METHODS: We carried out a systematic search for observational studies on the prevalence of SD in vitiligo patients. The Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines were used to prepare this systematic review. We searched PubMed, Scopus, Google Scholar, and the Cochrane Library databases. RESULTS: We observed 308 studies for screening. Finally, 12 studies that meet the eligibility criteria were included in this study. The prevalence of SD ranged from 2.7 to 82.0%. Most of the studies used the dermatology life quality index (DLQI) to assess SD. Our findings also show that vitiligo patients were more probably experience symptoms of depression and anxiety, one of the risk factors for SD. CONCLUSION: Psychological comorbidities are related to a high risk of SD in vitiligo patients. Further prospective longitudinal studies are required to investigate the causal factors for SD in vitiligo patients.