Abstract:

Abstract: Visceral leishmaniasis (VL) of genus L. donovani is a known cause of Kala-azar/VL, agent phlebotomus species. Vectors of public health importance includes, P. martini that engulfed South Sudan bordering counties with Kenya whereas P. orientalis dominance in northern parts of South Sudan and in Sudan. It exhibits rare behavioral characteristics of outer door bites. South Sudan is highly endemic area in Eastern African countries, Massive and frequent outbreak witnessed in endemic counties known as “Kala-azar zones”. More than 1/3 of the total population is at risks of infections. This review aimed to evaluate current diagnosis, treatment and risk factors associated with epidemic and dying from the VL in the two Sudan’s. Methodology and Objective: Literatures published in SCI Journals, pub med, and science direct, Google, WHO reports, MSF, and CDC websites were searched starting from 1945 to 2018. VL diagnostic tools, treatment regimens and associated risk factors were keys words used. This is to analyze the current correlation between disease burden and associated factors for outbreaks. Findings: Several risk factors contributed in frequency of VL outbreaks, chronic wars, malnutrition, co-infections of VL with HIV/Hepatitis B/C is a new emerging public health concern, poverty and socio-cultural characteristics of the local population. Government effort is lacking with negligible resources allocation. Acacia trees harbor sand fly as resting and hiding places. K39/K26 or rk39/rk28 dipstick is a field base diagnostic tool commonly used. Treatment’s regimen liposomal AmporicinB, SSG + PM recently recommended. Areas formerly free of Kala-zar had experience recurrent epidemic. Conclusion: VL in South Sudan remains highly isolated from clinical diagnosis, treatment, and control even routine data for surveillance is nonexistence. National guidelines and protocols for treatment, management and vector control remain at standstill. Resistance of visceral leishmania to drugs at static or in an increasing threshold required more researches. There is close relationship between frequent outbreaks and internal conflicts, poor malnutrition, poverty and displacement to high transmission zones, individuals who are new in sand fly infested areas are at greater risks, including children, old age and pregnant women.