Visceral leishmaniasis is found in all age groups in India and Brazil, where an animal reservoir has not been identified. In areas with known animal reservoirs, such as the Mediterranean Basin, visceral leishmaniasis mainly affects children, with devastating outcomes (eg, L infantum primarily affects children aged 1-4 y). This apparent predilection for the young appears to occur in highly endemic areas because of what may be protective immunity reducing the risk of reinfection in adults. Untreated visceral leishmaniasis in a pregnant mother can also have consequences on the fetus or result in congenital visceral leishmaniasis.
Athletes, like all others, may have illnesses or conditions that require them to take particular medications. If the medication an athlete is required to take to treat an illness or condition happens to fall under the prohibited list, a therapeutic use exemption may give that athlete the authorization to take the needed medicine. Criteria for granting a therapeutic use exemption are 1.) The athlete would experience significant health problems without taking the prohibited substance or method, 2.) The therapeutic use of the substance would not produce significant enhancement of performance, and 3.) There is no reasonable therapeutic alternative to the use of the otherwise prohibited substance or method. Note hormone replacement therapy (HRT), . supplementing with prescribed testosterone in any form to raise testosterone levels due to natural decreases that occur with aging (even if to just elevate levels to within ‘normal’ ranges), is NOT considered a medicinal exception. Persons using HRT would not be eligible for WPA/NANBF/IPE competition.