From infection to vaccination: reviewing the global burden, history of vaccine development, and recurring challenges in global leishmaniasis protection

• Published in: Expert review of vaccines Vol. 20; no. 11; p. 1431
• Main Authors: Volpedo, Greta, Huston, Ryan H, Holcomb, Erin A, Pacheco-Fernandez, Thalia, Gannavaram, Sreenivas, Bhattacharya, Parna, Nakhasi, Hira L, Satoskar, Abhay R
• Format: Journal Article
• Language: English
• Published: England 02-11-2021
• Subjects: Humans; Leishmaniasis - epidemiology; Leishmaniasis - prevention & control; Leishmaniasis Vaccines; Vaccination; Vaccine Development; Human Leishmaniasis; neglected tropical diseases; vaccines; Leishmania; DNA vaccines; genetically modified parasites; live-attenuated vaccines; prevention
• ISSN: 1744-8395
• DOI: 10.1080/14760584.2021.1969231

Leishmaniasis is a major public health problem and the second most lethal parasitic disease in the world due to the lack of effective treatments and vaccines. Even when not lethal, leishmaniasis significantly affects individuals and communities through life-long disabilities, psycho-sociological trauma, poverty, and gender disparity in treatment.
This review discusses the most relevant and recent research available on Pubmed and GoogleScholar highlighting leishmaniasis' global impact, pathogenesis, treatment options, and lack of effective control strategies. An effective vaccine is necessary to prevent morbidity and mortality, lower health care costs, and reduce the economic burden of leishmaniasis for endemic low- and middle-income countries. Since there are several forms of leishmaniasis, a pan-
vaccine without geographical restrictions is needed. This review also focuses on recent advances and common challenges in developing prophylactic strategies against leishmaniasis.
Despite advances in pre-clinical vaccine research, approval of a human leishmaniasis vaccine still faces major challenges - including manufacturing of candidate vaccines under Good Manufacturing Practices, developing well-designed clinical trials suitable in endemic countries, and defined correlates of protection. In addition, there is a need to explore Challenge Human Infection Model to avoid large trials because of fluctuating incidence and prevalence of leishmanasis.