Vertical transmission of visceral leishmaniasis

advances, clinical and diagnostic challenges, and impacts on maternal-fetal health (literature review: 2019-2024)

Abstract

Introduction: Visceral leishmaniasis (VL) is a neglected disease with significant public health impact, particularly in endemic regions. Although vertical transmission is rare, its occurrence poses critical clinical implications for pregnant women and neonates. Objective: This study provides a narrative review of the literature on VL vertical transmission, focusing on clinical, diagnostic, and associated factors. Material and Methods: Six articles published between 2019 and 2024 were selected from PubMed and EBSCO databases, emphasizing evidence on biological mechanisms, diagnostic challenges, and maternal-fetal outcomes. Results: The findings indicate that transplacental transmission occurs under specific conditions influenced by immunological factors and HIV coinfection, which increases maternal and fetal susceptibility. Symptoms in pregnant women include persistent fever, splenomegaly, and anemia, while neonates may present prematurity, hepatosplenomegaly, and fever. Diagnosis is challenging due to nonspecific symptoms and the scarcity of studies focused on vertical transmission. Liposomal amphotericin B is recommended as the most effective and safe treatment for pregnant women. Conclusion: In conclusion, the rarity of VL vertical transmission, combined with the lack of systematic monitoring and limited evidence base, highlights the need for more comprehensive research and improved diagnostic approaches. This topic requires greater attention to prevent complications in pregnant women and neonates, as well as to enhance clinical management and control strategies for the disease.