Leishmaniasis are a group of diseases, endemic in many parts of the world.1,2) Leishmaniasis are mostly prevalent in poor developing countries evident by the growing number of cases seen in AIDS patients 3) and the occurrence of viscerotropic Leishmania tropica disease among Persian Gulf War Participants.2,3) The disease is transmitted by the members of the genus Leishmania which is a protozoal parasite. These parasitic protozoans are digenetic and have two distinct stages in their life cycle. The motile flagellated promastigote stage lives in the alimentary tract of the sand fly vector, while the non-motile amastigote stage resides inside the macrophages of mammalian hosts. 4)Leishmanial infections include three major syndromes: cutaneous, visceral and mucosal leishmaniasis. The basic treatment consists in the administration of sodium stibogluconate (pentostam), meglumine (glucantime) or pentamidine. Common problem with this basic treatment especially in Kalaazar, mucosal leishmaniasis is the developing drug resistance of the parasite.5) In addition, the low efficacy of pentavalent antimony in the treatment of patients coinfected with AIDS is often noticed.6) These problems prompted the development of new anti-leishmanial drugs. [7][8][9][10] Curcumin is a yellow-orange dye derived from the rhizome of the plant Curcuma longa. It has long been used as a naturally occurring medicine for the treatment of inflammatory diseases. Curcumin (difleruloyl methane) is a natural phenolic compound. It is a potent anti-tumor agent having anti-inflammatory and anti-oxidant properties. It induces apoptosis in cancer cells 11,12) and inhibits TPA-induced Protein kinase C (PKC) activity.13) It has also shown anti-bacterial, anti-fungal and anti-trypnosomal activity. 1,14,15) A recent study has also shown action against the promastigote forms of Leishmania major. 16)In this report we evaluated the actions of curcumin against the promastigote forms of different reference and local leishmanial strains in vitro. We also evaluated the activity of curcumin against the axenic amastigote like cells (AALC) of L. major in vitro. MATERIALS AND METHODSParasite Cultures All the promastigote cultures of both the reference and local Pakistani leishmanial strains were maintained in blood agar based bi-phasic Evan's modified Tobie's medium supplemented with RPMI-1640 with 25 mM TES at 25°C. The reference leishmanial strains were obtained from London School of Hygeine and Tropical Medicine. The reference strains of promastigotes that were used include L. major (JISH118), L. tropica (K27) and L. infantum (LEM3437). Local leishmanial strains used in this study include L. major (MHOM/PK/88/DESTO) in the promastigote and AALC stage (see below). Other local strains used in the promastigote stage include L. tropica and L. infantum. The long term continuous culture of axenic amastigote like cells (AALC) of L. major (MHOM/PK/88/DESTO) strain was successfully established. Briefly, AALC cells were obtained from the promastigotes by the gradual adaptation o...

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BackgroundThe tuberculosis (TB) bacillus and the Human Immunodeficiency Virus (HIV) have formed a powerful alliance and are together responsible for more than five million deaths per year. TB is leading to increased mortality rates among people living with HIV/acquired immunodeficiency syndrome (AIDS). The aim of this study was to investigate the geographical and temporal distribution of TB-HIV deaths in Africa in order to identify possible high-risk areas.MethodsTime trends in the 16-year study period from 1990 to 2005 were analyzed by multilevel Poisson growth curve models. Moran global and local indicators of spatial associations were used to test for evidence of global and local spatial clustering respectively.ResultsEastern, Southern, Western, and Middle Africa experienced an upward trend in the number of reported TB-HIV deaths. The spatial distribution of TB cases was non-random and clustered, with a Moran's I = 0.454 (p = .001). Spatial clustering suggested that 13 countries were at increased risk of TB-HIV deaths, and six countries could be grouped as "hot spots".ConclusionEvidence shows that there is no decline in growth in the number of deaths due to TB among HIV positive in most Africa countries. There is presence of 'hot-spots' and very large differences persist between sub-regions. Only by tackling TB and HIV together will progress be made in reversing the burden of both diseases. There is a great need for scale-up of preventive interventions such as the World Health Organization '3I's strategy' (intensified case finding, isoniazid preventive therapy and infection control).

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