Screening
Screening asymptomatic people for Leishmania infection is only relevant for research purposes (e.g., epidemiologic or vaccine studies).
High-risk population screening
There is no clinically validated screening test for asymptomatic cutaneous leishmaniasis or visceral leishmaniasis. For epidemiologic purposes, groups at increased risk in the population tested can be identified. Diagnostic testing is recommended in this same group of asymptomatic people one year later. Identifying those patients who seroconvert or whose interferon-gamma release assay becomes positive allows measurement of the incidence of new infections.[104][105]
Considering the high risk of developing or reactivating the disease during cell-mediated immunosuppression, providers might consider screening patients at risk for previous Leishmania infection (i.e., history of prolonged stay in an endemic area) if a validated screening test becomes available.[5][106]
Blood/organ/tissue donors or recipients
There are no international guidelines to screen for Leishmania infection in donors or recipients of blood, organs, or tissues, or in patients with immunosuppression. In the US, soldiers who were deployed to Afghanistan are ineligible to be blood donors for 12 months. Because of the possibility of infection following blood transfusion or organ/tissue donation, it is recommended that people with a history of leishmaniasis (particularly visceral leishmaniasis) do not donate blood, and if organ/tissue donation is contemplated (pre- or postmortem), the donor’s history of leishmaniasis should be considered.
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