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Artificial Intelligence in Health ChatGPT in visceral leishmaniasis diagnosis

3 Postgraduate Program in Rehabilitation and Functional Performance, Universidade de Pernambuco, Petrolina, Pernambuco, Brazil
4 Postgraduate Program in Health Sciences, Universidade de Pernambuco, Recife, Pernambuco, Brazil
5 Dr. Washington Antônio de Barros Teaching Hospital, Brazilian Hospital Services Company, Petrolina, Pernambuco, Brazil
6 Postgraduate Program on Management and Health Programs and Services, CEUMA University, São Luís, Maranhão, Brazil
7 Postgraduate Program in Information Technology, Federal Institute of Paraíba, João Pessoa, Paraíba, Brazil
8 College of Agricultural and Environmental Sciences, Federal University of Vale do São Francisco, Juazeiro, Bahia, Brazil

1. Introduction rates of morbidity and mortality, particularly in endemic
regions. 1-11 According to the World Health Organization
Visceral leishmaniasis (VL) is a serious parasitic disease Leishmaniasis Control Team, the disease remains a
9
caused by protozoa of the genus Leishmania. The primary leading cause of death, with mortality rates as high as
causative agents are Leishmania donovani in Africa and 90% in untreated cases. This stark reality highlights the
Asia; Leishmania infantum in Asia, Europe, and Africa; and urgent need for timely diagnosis and effective treatment
Leishmania chagasi in the Americas. These protozoans
1-3
exhibit pleomorphic characteristics, with promastigote interventions to reduce the devastating impact of the
and paramastigote forms developing in the digestive disease on vulnerable populations.
tracts of insect vectors, while amastigote forms reside and VL can be diagnosed by immunologic and
4
multiply in the phagocytic cells of vertebrate hosts. The parasitological methods. 9 Immunologic diagnosis
life cycle of Leishmania involves binary fission in both involves the detection of anti-Leishmania antibodies
hosts, highlighting the complex nature of the parasite using techniques such as indirect immunofluorescence
transmission and infection process. Molecular studies assay and rapid immunochromatographic tests, both
have shown that L. chagasi and L. infantum are considered of which are available through the Brazilian Unified
the same species, commonly known as L. infantum (syn. Health System (SUS). 11-13 Parasitological diagnosis, which
chagasi). 5 provides definitive evidence, involves the identification
The vectors responsible for the transmission of of amastigote forms of the parasite in biological samples,
4-6
Leishmania show significant regional variation. In typically obtained from bone marrow due to its relative
7,13,14
Europe, Asia, and Africa, species of the genus Phlebotomus safety. This process includes direct examination,
are the primary vectors, whereas species of the genus culture isolation (in vitro), and isolation from susceptible
Lutzomyia predominate in the Americas. 1-3,6 This animals (in vivo), as well as new diagnostic methods. 8,10,12
geographic differentiation in vector species underscores Effective management of VL relies on both vector
the importance of developing region-specific vector control strategies and targeted chemotherapeutic
control strategies, as the efficacy of such interventions may interventions. Vector control measures, such as insecticide
vary significantly depending on the local vector ecology. spraying, the use of insecticide-treated bed nets, and
VL is a severe zoonotic disease that primarily affects environmental management, are critical in reducing
6
impoverished regions and is endemic in approximately sandfly populations and interrupting transmission. On
one hundred countries. It has an alarming mortality the chemotherapeutic front, the primary treatments
1-3
rate in untreated cases, often due to complications such include the use of antimonial compounds, Amphotericin
as multi-organ failure and secondary infections. The B, and miltefosine. 5,7,8 Treatment regimens are tailored to
1-5
disease is transmitted to humans primarily through individual patients, taking into account drug resistance
biting by infected female sandflies, specifically Lutzomyia patterns and the patient’s overall health status to ensure
longipalpis in Brazil. These vectors belong to the order optimal outcomes. 8
6
Diptera, family Psychodidae, and subfamily Phlebotominae, Given the complexity of VL diagnosis, a comprehensive
and are characterized by their small size and pale-yellow approach that includes anamnesis, palpation, biological
coloration. 6-8 specimens, serological testing, and biomarkers is
12
The global burden of VL is significant, with millions essential. Healthcare professionals must consider
of people at risk, particularly in tropical and subtropical both endogenous and exogenous factors, including
regions. 9-11 The disease predominantly affects poor and environmental conditions, in the prevention and control
marginalized communities, exacerbating existing health of VL. 10,12,14 Effective prevention relies on vector control,
disparities and imposing a significant socioeconomic supported by community involvement in maintaining
burden. VL is also associated with alarmingly high environmental hygiene. 9,12,14
1-6

Volume 1 Issue 4 (2024) 98 doi: 10.36922/aih.3930