Table 1.
Characteristics of PKDL in Southeast Asia Region (SEAR) and Eastern Africa (EA): factors related to epidemiology, clinical features, and management (adapted from [3].
Table 2.
Co-infections in VL and PKDL: groups of pathogens, interaction, presence of immunosuppression and country/region where reported.
Fig 1.
Adapted with permission from ref [81].
Hypothetical relationship between decreasing parasite load and increasing immunity. In case of downgrading of the immune response (red arrow), PKDL is likely to result in a macular rash first with stronger immune response (A, higher CMI*, scanty parasites) than a polymorphic or papulonodular rash (B, lower CMI*, higher number of parasites). In case of upgrading of the immune response the opposite would occur. * CMI cell-mediated immunity.
Fig 2.
Diagram showing the interrelationship and timing of manifestations that may follow after leishmania infection in Sudan and the upgrading of the immune response preceding PKDL.
The thickness of the lines corresponds with the likelihood of the occurrence of the following event (adapted with permission from reference [81].
Fig 3.
Diagram showing the interrelationship and timing of manifestations that may follow after leishmania infection in the SEAR and the downgrading of the immune response that may precede the onset of PKDL.
The thickness of the lines corresponds with the likelihood of the occurrence of the following event. Box A, B, and C constitute risk factors (previous drug treatment, genetic and environmental factors, immune suppression, others) that may be qualitatively different.