Neem derivatives in integrated control of vectors and pathogens of leishmaniasis: Current knowledge and computational insights for future perspectives

Leishmaniasis remains a major neglected tropical disease affecting millions of people worldwide, particularly in resource-limited regions where effective prevention and treatment options are often inaccessible. Current control strategies primarily rely on chemical insecticides for sandfly management and antileishmanial drugs for disease treatment. However, the emergence of insecticide and drug resistance, treatment-associated toxicity, environmental contamination, and limited affordability has created an urgent need for safer and more sustainable alternatives. In this context, plant-derived bioactive compounds have gained increasing attention as eco-friendly tools for the management of vector-borne diseases. Azadirachta indica A. Juss. (Neem) is a medicinal plant extensively used in traditional healthcare systems and recognized for its diverse pharmacological properties. This review critically examines the available literature on the efficacy of neem-derived products against sandfly and Leishmania spp. Growing evidence highlights neem as a unique dual-action intervention capable of targeting both the parasite and its vector, making it an attractive candidate for integrated leishmaniasis control. Nevertheless, challenges related to standardization, bioavailability, safety evaluation, and clinical validation remain substantial barriers to translation. Future integration of computational drug discovery, nanotechnology-based formulations, and multidisciplinary experimental approaches may facilitate the development of neem-based therapeutics and vector control strategies for sustainable leishmaniasis management.