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Tesfaye S, Getu T, Yohannes T, Bekele D. Sero-Prevalence of Visceral Leishmaniasis and Associated Risk Factors among Febrile Patients Attending Metema Hospital, West Gondar Zone, North West Ethiopia. Acta Parasitol 2024; 69:1621-1629. [PMID: 39162925 DOI: 10.1007/s11686-024-00882-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/30/2024] [Indexed: 08/21/2024]
Abstract
INTRODUCTION In Ethiopia, visceral leishmaniasis (VL) is a public health concern that has been spreading to new endemic foci in recent years. An estimated 3.2 million people are at risk of infection, with 3700-7400 new cases yearly. Thus, the study aimed to determine the prevalence of VL and associated risk factors among febrile patients attending Metema Hospital, North West Ethiopia. METHODS A hospital-based cross-sectional study was conducted on 404 febrile patients attending Metema Hospital from February 2021 to June 2021. The test for VL was done using an immune-chromatographic test (RK39) according to the manufacturer's instructions (InBios International Inc., USA). An interviewer-administered, pretested questionnaire was used to collect data on risk factors associated with VL. Logistic regression and Chi-square assessed the association between VL and the associated risk factors. REULTS The overall prevalence of visceral leishmaniasis was 18.8% (76/404), with a higher prevalence of VL in males, in the age category between 21 and 30, in study participants who completed elementary school, and in those who earned less than 500 birr monthly compared to their counterparts. Houses with thatched roofs (adjusted odd ratio (AOR) = 17.648, 95CI = 6.549,47.563), houses with mud walls (AOR = 2.538, 95% CI = 1.187-5.411), cattle ownership (AOR = 3.173, 95% CI = 1.286-7.826), dog ownership (AOR = 2,533, 95% CI = 1.256-5.111), presence of Acacia trees near houses (AOR = 1.975, 95% CI:1.004-3.886), presence of Balanites tree (AOR = 3.015, 95% CI = 1.610-5.992), and outdoor sleeping (AOR = 2.259, 95% CI: 1.107-14.607) were the predictors of VL in the present study. CONCLUSIONS In the study area, VL is still very common. Thus, preventing and controlling infection in the area is largely dependent on raising community awareness of VL prevention and control measures and implementing the necessary interventions on the determinants that have been identified.
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Affiliation(s)
- Solomon Tesfaye
- Department of Biology, College of Natural & Computational Sciences, University of Gondar, 196, Maraki, Amhara, 251, Ethiopia, Gondar.
| | - Tibebnesh Getu
- Department of Biology, College of Natural & Computational Sciences, University of Gondar, 196, Maraki, Amhara, 251, Ethiopia, Gondar
| | - Tilahun Yohannes
- Department of Biology, College of Natural & Computational Sciences, University of Gondar, 196, Maraki, Amhara, 251, Ethiopia, Gondar
| | - Damtew Bekele
- Department of Biology, College of Natural & Computational Sciences, Ambo University, 19, Asosa street, Oromia, 251, Ambo, Ethiopia
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Wangdi T, Senanayake S, Dorjee S, Tobgay T, Zhou G, Piyasiri SB, Weerasinghe WMLI, Karunaweera N. Distribution and Seasonal Variation of Phlebotomus and Sergentomyia Sand Fly Populations in Bhutan. Am J Trop Med Hyg 2024; 110:1117-1126. [PMID: 38593793 PMCID: PMC11154039 DOI: 10.4269/ajtmh.23-0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 11/26/2023] [Indexed: 04/11/2024] Open
Abstract
Leishmaniasis is considered one of the neglected tropical diseases in the world. Although Bhutan is a member of the visceral leishmaniasis elimination consortium in South Asia, not much attention has been accorded to the disease because of its low incidence. The vector that transmits Leishmania remains poorly understood. In this backdrop, sand-fly surveys were regularly conducted at multiple sites where leishmaniasis cases have been reported in Bhutan. Collections were made using CDC light traps and cattle-baited net traps in 15 villages from February 2019 to May 2022. Six species of Phlebotomus and four species of Sergentomyia were identified from these sites that included two Phlebotomus and three Sergentomyia species discovered for the first time in Bhutan. Sand-fly density varied significantly from village to village, and it showed strong seasonality with peak numbers collected from June to October and almost zero from December to February. Overall, sand-fly density was highest in the basements of the houses and were higher outdoors than indoors. Cattle-baited net traps collected few sand flies during the surveillance period. This work constituted the first systematic sand-fly population surveillance conducted in Bhutan and will provide a baseline for future vector ecology and Leishmania epidemiological studies.
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Affiliation(s)
- Tenzin Wangdi
- Vector Borne Disease Control Programme, Ministry of Health, Gelephu, Bhutan
| | - Sanath Senanayake
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Sithar Dorjee
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Tashi Tobgay
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Guofa Zhou
- Program in Public Health, University of California, Irvine, California
| | - Sachee B. Piyasiri
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | - Nadira Karunaweera
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Joshi AB, Banjara MR, Das ML, Bist NR, Pant KR, Pyakurel UR, Dahal G, Paudel KP, Das CL, Kroeger A, Aseffa A. Follow-up assessment of visceral leishmaniasis treated patients and the impact of COVID-19 on control services in Nepal. Trop Med Health 2023; 51:57. [PMID: 37864251 PMCID: PMC10588092 DOI: 10.1186/s41182-023-00549-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/06/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Follow-up assessment of visceral leishmaniasis (VL) treated cases is important to monitor the long term effectiveness of treatment regimens. The main objective of this study was to identify the gaps and challenges in the follow-up of treated VL cases, to monitor treatment outcome and to assess the impact of COVID-19 on VL elimination services and activities. METHODS Clinicians treating VL patients, district focal persons for VL, and patients treated for VL in seven high endemic districts in Nepal during 2019-2022 were interviewed to collect data on challenges in the follow-up of VL treated patients as per national strategy. RESULTS Follow up status was poor in two districts with the largest number of reported cases. The majority of cases were children under 10 years of age (44.2%). Among 104 VL treated cases interviewed, 60.6% mentioned that clinicians had called them for follow-up but only 37.5% had complied. Among 112 VL treated cases followed up, 8 (7.14%) had relapse and 2 (1.8%) had PKDL. Among 66 cases who had VL during the COVID-19 lock down period, 32 (48.5%) were diagnosed within 1 week; however, 10 (15.1%) were diagnosed only after 4 weeks or more. During the COVID-19 pandemic, there was no active search for VL because of budget constraints and lack of diagnostic tests, and no insecticide spraying was done. CONCLUSION Relapses and PKDL are challenges for VL elimination and a matter of concern. Successful implementation of the national strategy for follow up of treated VL cases requires addressing elements related to patients (awareness, transport, communication) clinicians (compliance) and organization of service delivery (local health worker training and deployment). COVID-19 did not have much impact on VL diagnosis and treatment; however, public health programmes including active case detection and insecticide spraying for vector control were severely reduced.
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Affiliation(s)
- Anand Ballabh Joshi
- Public Health and Infectious Disease Research Center (PHIDReC), Kathmandu, Nepal
| | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, 44601, Nepal.
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland.
| | - Murari Lal Das
- Public Health and Infectious Disease Research Center (PHIDReC), Kathmandu, Nepal
| | - Nav Raj Bist
- Public Health and Infectious Disease Research Center (PHIDReC), Kathmandu, Nepal
| | - Krishna Raj Pant
- Public Health and Infectious Disease Research Center (PHIDReC), Kathmandu, Nepal
| | - Uttam Raj Pyakurel
- Epidemiology and Disease Control Division, Department of Health Services, Teku, Kathmandu, Nepal
| | - Gokarna Dahal
- Epidemiology and Disease Control Division, Department of Health Services, Teku, Kathmandu, Nepal
| | - Krishna Prasad Paudel
- Epidemiology and Disease Control Division, Department of Health Services, Teku, Kathmandu, Nepal
| | - Chuman Lal Das
- Epidemiology and Disease Control Division, Department of Health Services, Teku, Kathmandu, Nepal
| | - Axel Kroeger
- Centre for Medicine and Society/Institute for Infection Prevention, Albert-Ludwigs-University, Freiburg, Germany
| | - Abraham Aseffa
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland
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Ismail A, Yared S, Dugassa S, Abera A, Animut A, Erko B, Gebresilassie A. Sero-prevalence of visceral leishmaniasis and its associated factors among asymptomatic individuals visiting Denan health center, southeastern Ethiopia. Trop Dis Travel Med Vaccines 2023; 9:8. [PMID: 37430336 DOI: 10.1186/s40794-023-00196-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/12/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND In the Somali region of Ethiopia, visceral leishmaniasis (VL) is a public health concern. However, VL epidemiology and sand fly vectors have not been well studied in various areas of the regional state, including Denan district. Therefore, this study was conducted to determine the sero-prevalence, associated factors, and distribution of sand fly vectors of VL in Denan district, south-eastern Ethiopia. METHODS A facility-based cross-sectional study was conducted from April to September 2021 among VL patients with classic signs and symptoms visiting Denan Health Center in south-eastern Ethiopia. Using a convenience sampling method, 187 blood samples were collected from individuals who visited Denan Health Center during the study period. Blood samples were subjected to Direct Agglutination Test for the detection of antibodies to VL. A pre-tested structured questionnaire was also used to gather information on risk factors and other characteristics of knowledge and attitude assessment. Sand flies were also collected from indoor, peri-domestic, mixed forest, and termite mounds using light and sticky traps to determine the fauna and abundance. RESULTS The overall sero-prevalence rate was 9.63% (18/187). The sero-prevalence was significantly associated with outdoor sleeping (OR = 2.82), the presence of damp floors (OR = 7.76), and sleeping outdoor near animals (OR = 3.22). Around 53.48% of the study participants had previously heard about VL. Study participants practiced different VL control methods, including bed nets (42%), insecticide spraying (32%), smoking plant parts (14%), and environmental cleaning (8%). In total, 823 sand fly specimens, comprising 12 species in two genera (Phlebotomus and Sergentomyia), were trapped and identified. The most abundant species was Sergentomyia clydei (50.18%), followed by Phlebotomus orientalis (11.42%). Also, a higher proportion of P. orientalis was found in termite mounds (65.43%), followed by mixed forest (37.8%) and peri-domestic (20.83%) habitats. CONCLUSION The study demonstrated a 9.63% sero-positivity of VL and a remarkable gap in knowledge, attitude, and practices towards VL. P. orientalis was also detected, which could be a probable vector in this area. Thus, public education should be prioritized to improve the community's awareness of VL and its public health impact. In addition, detailed epidemiological and entomological studies are recommended.
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Affiliation(s)
- Ahmed Ismail
- College of Veterinary Medicine, Jigjiga University, Jigjiga, Ethiopia
| | - Solomon Yared
- Department of Biology, Jigjiga University, Jigjiga, Ethiopia
| | - Sisay Dugassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Adugna Abera
- Malaria and Neglected Tropical Diseases Research Team, Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Abebe Animut
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Berhanu Erko
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Araya Gebresilassie
- Department of Zoological Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
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Iniguez E, Saha S, Petrellis G, Menenses C, Herbert S, Gonzalez-Rangel Y, Rowland T, Aronson NE, Rose C, Rafuse Haines L, Acosta-Serrano A, Serafim TD, Oliveira F, Srikantiah S, Bern C, Valenzuela JG, Kamhawi S. A Composite Recombinant Salivary Proteins Biomarker for Phlebotomus argentipes Provides a Surveillance Tool Postelimination of Visceral Leishmaniasis in India. J Infect Dis 2022; 226:1842-1851. [PMID: 36052609 PMCID: PMC10205619 DOI: 10.1093/infdis/jiac354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Indexed: 11/13/2022] Open
Abstract
Incidence of visceral leishmaniasis (VL) in the Indian subcontinent (ISC) has declined by more than 95% since initiation of the elimination program in 2005. As the ISC transitions to the postelimination surveillance phase, an accurate measurement of human-vector contact is needed to assure long-term success. To develop this tool, we identified PagSP02 and PagSP06 from saliva of Phlebotomus argentipes, the vector of Leishmania donovani in the ISC, as immunodominant proteins in humans. We also established the absence of cross-reactivity with Phlebotomus papatasi saliva, the only other human-biting sand fly in the ISC. Importantly, by combining recombinant rPagSP02 and rPagSP06 we achieved greater antibody recognition and specificity than single salivary proteins. The receiver operating characteristics curve for rPagSP02 + rPagSP06 predicts exposure to Ph. argentipes bites with 90% specificity and 87% sensitivity compared to negative control sera (P >.0001). Overall, rPagSP02 + rPagSP06 provides an effective surveillance tool for monitoring vector control efforts after VL elimination.
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Affiliation(s)
- Eva Iniguez
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
| | - Samiran Saha
- Department of Biotechnology, Institute of Science, Visva Bharati University, Bolpur, West Bengal, India
| | - Georgios Petrellis
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
- Laboratory of Microbiology, Parasitology, and Hygiene, University of Antwerp, Antwerp, Belgium
| | - Claudio Menenses
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
| | - Samantha Herbert
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
| | - Yvonne Gonzalez-Rangel
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
| | - Tobin Rowland
- Entomology Branch, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Naomi E Aronson
- Infectious Diseases Division, Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Clair Rose
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Lee Rafuse Haines
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Alvaro Acosta-Serrano
- Department of Parasitology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Tiago D Serafim
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
| | - Fabiano Oliveira
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
| | - Sridhar Srikantiah
- Bihar Technical Support Program, CARE India Solutions for Sustainable Development, Patna, India
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Jesus G Valenzuela
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
| | - Shaden Kamhawi
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, Maryland, USA
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Livestock and rodents within an endemic focus of Visceral Leishmaniasis are not reservoir hosts for Leishmania donovani. PLoS Negl Trop Dis 2022; 16:e0010347. [PMID: 36264975 PMCID: PMC9624431 DOI: 10.1371/journal.pntd.0010347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 11/01/2022] [Accepted: 10/12/2022] [Indexed: 11/23/2022] Open
Abstract
Leishmaniasis on the Indian subcontinent is thought to have an anthroponotic transmission cycle. There is no direct evidence that a mammalian host other than humans can be infected with Leishmania donovani and transmit infection to the sand fly vector. The aim of the present study was to evaluate the impact of sand fly feeding on other domestic species and provide clinical evidence regarding possible non-human reservoirs through experimental sand fly feeding on cows, water buffalo goats and rodents. We performed xenodiagnosis using colonized Phlebotomus argentipes sand flies to feed on animals residing in villages with active Leishmania transmission based on current human cases. Xenodiagnoses on mammals within the endemic area were performed and blood-fed flies were analyzed for the presence of Leishmania via qPCR 48hrs after feeding. Blood samples were also collected from these mammals for qPCR and serology. Although we found evidence of Leishmania infection within some domestic mammals, they were not infectious to vector sand flies. Monitoring infection in sand flies and non-human blood meal sources in endemic villages leads to scientific proof of exposure and parasitemia in resident mammals. Lack of infectiousness of these domestic mammals to vector sand flies indicates that they likely play no role, or a very limited role in Leishmania donovani transmission to people in Bihar. Therefore, a surveillance system in the peri-/post-elimination phase of visceral leishmaniasis (VL) must monitor absence of transmission. Continued surveillance of domestic mammals in outbreak villages is necessary to ensure that a non-human reservoir is not established, including domestic mammals not present in this study, specifically dogs.
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Chastonay AHM, Chastonay OJ. Housing Risk Factors of Four Tropical Neglected Diseases: A Brief Review of the Recent Literature. Trop Med Infect Dis 2022; 7:tropicalmed7070143. [PMID: 35878154 PMCID: PMC9319438 DOI: 10.3390/tropicalmed7070143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/12/2022] [Accepted: 07/19/2022] [Indexed: 01/27/2023] Open
Abstract
Alongside peace, education, food, income, a stable ecosystem, sustainable resources and social justice, shelter is a prerequisite for health. According to international human rights law, everyone is entitled to an adequate standard of living, which includes adequate housing. Adequate housing, including access to water and sanitation, plays a critical role in the prevention and management of neglected tropical diseases, which affect over 1 billion people worldwide. Inadequate housing conditions represent a risk factor for many of them, e.g., Chagas disease that affects 6–8 million people worldwide, visceral leishmaniasis that kills 20,000–30,000 people/year, lymphatic filariasis which threatens 859 million people worldwide or dengue that has increased 8–10 fold over the last two decades. Vector control strategies for the above-mentioned diseases have shown their effectiveness and should include systematic and repetitive in-house spraying and individual protection (e.g., impregnated nets), as well as better-quality construction material and techniques and better sanitation infrastructures and practices. Access to adequate housing is a basic human right. The violation of the right to adequate housing may affect the enjoyment of other human rights. Access to adequate housing can strengthen (and facilitate access to) other basic human rights, such as the rights to work, health, security, and education.
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Affiliation(s)
| | - Oriane J. Chastonay
- Réseau Fribourgeois de Santé Mentale, 1700 Fribourg, Switzerland
- Correspondence:
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Kushwaha AK, Scorza BM, Singh OP, Rowton E, Lawyer P, Sundar S, Petersen CA. Domestic mammals as reservoirs for Leishmania donovani on the Indian subcontinent: Possibility and consequences on elimination. Transbound Emerg Dis 2022; 69:268-277. [PMID: 33686764 PMCID: PMC8455064 DOI: 10.1111/tbed.14061] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/05/2021] [Accepted: 03/06/2021] [Indexed: 01/19/2023]
Abstract
Leishmania donovani is the causative agent of historically anthroponotic visceral leishmaniasis (VL) on the Indian subcontinent (ISC). L. donovani is transmitted by the sand fly species Phlebotomus argentipes. Our collaborative group and others have shown that sand flies trapped outside in endemic villages have fed on cattle and dogs in addition to people. Domestic animals are reservoirs for L. donovani complex spp., particularly L. infantum, in other endemic areas. Multiple studies using quantitative PCR or serological detection methods have demonstrated that goats, cattle, rats and dogs were diagnostically positive for L. donovani infection or exposure in eastern Africa, Bangladesh, Nepal and India. There is a limited understanding of the extent to which L. donovani infection of domestic animals drives transmission to other animals or humans on the ISC. Evidence from other vector-borne disease elimination strategies indicated that emerging infections in domestic species hindered eradication. The predominant lesson learned from these other situations is that non-human reservoirs must be identified, controlled and/or prevented. Massive efforts are underway for VL elimination on the Indian subcontinent. Despite these herculean efforts, residual VL incidence persists. The spectre of an animal reservoir complicating elimination efforts haunts the final push towards full VL control. Better understanding of L. donovani transmission on the Indian subcontinent and rigorous consideration of how non-human reservoirs alter VL ecology are critical to sustain elimination goals.
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Affiliation(s)
- Anurag Kumar Kushwaha
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Breanna M. Scorza
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Om Prakash Singh
- Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Edgar Rowton
- Division of Entomology, Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Phillip Lawyer
- Laboratory of Parasitic Diseases, National Institute of Allergy and Infectious Diseases, National Institute of Health, Bethesda, MD, USA
| | - Shyam Sundar
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Christine A. Petersen
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa, USA
- Center for Emerging Infectious Diseases, University of Iowa, Coralville, Iowa, USA
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9
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Fortunato AK, Glasser CP, Watson JA, Lu Y, Rychtář J, Taylor D. Mathematical modelling of the use of insecticide-treated nets for elimination of visceral leishmaniasis in Bihar, India. ROYAL SOCIETY OPEN SCIENCE 2021; 8:201960. [PMID: 34234949 PMCID: PMC8242840 DOI: 10.1098/rsos.201960] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 05/24/2021] [Indexed: 05/27/2023]
Abstract
Visceral leishmaniasis (VL) is a deadly neglected tropical disease caused by a parasite Leishmania donovani and spread by female sand flies Phlebotomus argentipes. There is conflicting evidence regarding the role of insecticide-treated nets (ITNs) on the prevention of VL. Numerous studies demonstrated the effectiveness of ITNs. However, KalaNet, a large trial in Nepal and India did not support those findings. The purpose of this paper is to gain insight into the situation by mathematical modelling. We expand a mathematical model of VL transmission based on the KalaNet trial and incorporate the use of ITNs explicitly into the model. One of the major contributions of this work is that we calibrate the model based on the available epidemiological data, generally independent of the KalaNet trial. We validate the model on data collected during the KalaNet trial. We conclude that in order to eliminate VL, the ITN usage would have to stay above 96%. This is higher than the 91% ITNs use at the end of the trial which may explain why the trial did not show a positive effect from ITNs. At the same time, our model indicates that asymptomatic individuals play a crucial role in VL transmission.
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Affiliation(s)
- Anna K. Fortunato
- Department of Mathematics, University of Richmond, Richmond, VA 23173, USA
| | - Casey P. Glasser
- Department of Mathematics, Virginia Tech, Blacksburg, VA 24061-1026, USA
| | - Joy A. Watson
- Department of Mathematics and Economics, Virginia State University, Petersburg, VA 23806, USA
| | - Yongjin Lu
- Department of Mathematics and Economics, Virginia State University, Petersburg, VA 23806, USA
| | - Jan Rychtář
- Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA 23284-2014, USA
| | - Dewey Taylor
- Department of Mathematics and Applied Mathematics, Virginia Commonwealth University, Richmond, VA 23284-2014, USA
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10
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Garlapati R, Iniguez E, Serafim TD, Mishra PK, Rooj B, Sinha B, Valenzuela JG, Srikantiah S, Bern C, Kamhawi S. Towards a Sustainable Vector-Control Strategy in the Post Kala-Azar Elimination Era. Front Cell Infect Microbiol 2021; 11:641632. [PMID: 33768013 PMCID: PMC7985538 DOI: 10.3389/fcimb.2021.641632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/03/2021] [Indexed: 11/26/2022] Open
Abstract
Visceral leishmaniasis (VL) is a potentially deadly parasitic disease. In the Indian sub-continent, VL is caused by Leishmania donovani and transmitted via the bite of an infected Phlebotomus argentipes female sand fly, the only competent vector species in the region. The highest disease burden is in the northern part of the Indian sub-continent, especially in the state of Bihar. India, Bangladesh, and Nepal embarked on an initiative, coordinated by World Health Organization, to eliminate VL as a public health problem by the year 2020. The main goal is to reduce VL incidence below one case per 10,000 people through early case-detection, prompt diagnosis and treatment, and reduction of transmission using vector control measures. Indoor residual spraying, a major pillar of the elimination program, is the only vector control strategy used by the government of India. Though India is close to its VL elimination target, important aspects of vector bionomics and sand fly transmission dynamics are yet to be determined. To achieve sustained elimination and to prevent a resurgence of VL, knowledge gaps in vector biology and behavior, and the constraints they may pose to current vector control methods, need to be addressed. Herein, we discuss the successes and failures of previous and current vector-control strategies implemented to combat kala-azar in Bihar, India, and identify gaps in our understanding of vector transmission towards development of innovative tools to ensure sustained vector control in the post-elimination period.
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Affiliation(s)
- Rajesh Garlapati
- Bihar Technical Support Program, CARE India Solutions for Sustainable Development, Patna, India
| | - Eva Iniguez
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States
| | - Tiago D Serafim
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States
| | - Prabhas K Mishra
- Bihar Technical Support Program, CARE India Solutions for Sustainable Development, Patna, India
| | - Basab Rooj
- Bihar Technical Support Program, CARE India Solutions for Sustainable Development, Patna, India
| | - Bikas Sinha
- Bihar Technical Support Program, CARE India Solutions for Sustainable Development, Patna, India
| | - Jesus G Valenzuela
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States
| | - Sridhar Srikantiah
- Bihar Technical Support Program, CARE India Solutions for Sustainable Development, Patna, India
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States
| | - Shaden Kamhawi
- Vector Molecular Biology Section, Laboratory of Malaria and Vector Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, United States
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11
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Salih OAMM, Nail AM, Modawe GA, Swar MO, Ahmed MH, Khalil A, Satti AB, Abuzeid N. Risk Factors of Inpatients Mortality of Visceral Leishmaniasis, Khartoum State, Sudan. J Glob Infect Dis 2020; 12:135-140. [PMID: 33343164 PMCID: PMC7733432 DOI: 10.4103/jgid.jgid_25_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 04/05/2020] [Accepted: 04/14/2020] [Indexed: 11/26/2022] Open
Abstract
Background: Visceral leishmaniasis (VL) is one of the common infections in Sudan and can be associated with an increase in morbidity and mortality. The aim of this study was to assess the risk factors associated with mortality and morbidity with VL. Materials and Methods: This is a cross-sectional hospital-based study that recruited 150 patients with VL from two centers in Khartoum. Secondary data were extracted from the patient records, and data were analyzed using SPSS version 24.0. Results: The study included 2.5% of infants, 39.4% children, and 58% of adults. Male represents 77.3% of the cohort, and total mortality was 16%. Among the death reported 12.5% in infants, 16.7% were children, and 70.8% were in adults. Laboratory parameters significantly associated with mortality in univariate analysis were low white cell count, low platelets, high creatinine, and high liver enzymes. While risk factors such as infant, male, acquired infection from Eastern Sudan or White Nile, weight loss, morbid diseases, and concomitant bacterial infections were also associated with significant mortality in univariate analysis. Importantly, logistic regression analysis revealed significant association with infant (P = 0.02), concomitant bacterial infections (P = 0.003), comorbid disease (P = 0.001), low total blood cell count (P = 0.018), low platelets (P = 0.013), and high aspartate transaminase/alanine aminotransferase (P = 0.013). Conclusion: Health education and awareness are needed in terms of prevention and control, especially with high mortality seen in the infant. Treatment of underlying co-morbid diseases and bacterial infections are important to enhance survival. Patients with Leishmania are vulnerable; therefore, regular routine blood tests are an essential part of management to manage complications such as renal, hepatic failure, or severe anemia.
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Affiliation(s)
| | - Abdelsalam M Nail
- Department of Internal Medicine, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Sudan
| | - Gad Allah Modawe
- Department of Biochemistry, Faculty of Medicine and Health Sciences, Omdurman Islamic University, Sudan
| | - Mohamed Osman Swar
- Department of Pediatrics and Child Health, School of Medicine, Ahfad University for Women, Sudan
| | - Mohamed H Ahmed
- Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Milton Keynes, Buckinghamshire, UK
| | - Atif Khalil
- Department of Nephrology, Noble Hospital, Isle of Man, UK
| | - Abdelsalam Basheir Satti
- Department of Microbiology, Faculty of Medical Laboratory Sciences, Omdurman Islamic University, Omdurman, Sudan
| | - Nadir Abuzeid
- Department of Microbiology, Faculty of Medical Laboratory Sciences, Omdurman Islamic University, Omdurman, Sudan
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12
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Cytokine saga in visceral leishmaniasis. Cytokine 2020; 147:155322. [PMID: 33127259 DOI: 10.1016/j.cyto.2020.155322] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 12/12/2022]
Abstract
In humans, infection with Leishmania manifests into a spectrum of diseases. The manifestation of the diseases depend on the resultant evasion of the parasite to immune responses namely by macrophages, which is an exclusive host of Leishmania. The B cells valiantly mount antibody responses, however, to no avail as the Leishmania parasites occupy the intracellular niches of the macrophages and subvert the immune response. Extensive studies have been documented on the role of cell-mediated immunity (CMI) in protection and counter survival strategies of the parasites leading to downregulation of CMI. The present review attempts to discuss the cytokines in progression or resolution of visceral form of leishmaniasis or kala-azar, predominantly affecting the Indian subcontinent. The components/cytokine(s) responsible for the regulation of the critical balance of T helper cells and their subsets have been discussed in the perspective. Therefore, any strategy involving the treatment of visceral leishmania (VL) needs to consider the balance and regulation of T cell function.
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13
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Jaiswal P, Ghosh M, Patra G, Saha B, Mukhopadhyay S. Clinical Proteomics Profiling for Biomarker Identification Among Patients Suffering With Indian Post Kala Azar Dermal Leishmaniasis. Front Cell Infect Microbiol 2020; 10:251. [PMID: 32528904 PMCID: PMC7266879 DOI: 10.3389/fcimb.2020.00251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 04/29/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Post Kala Azar Dermal Leishmaniasis (PKDL) is a non-fatal dermal sequel of Visceral Leishmaniasis (VL), affecting individuals worldwide. Available diagnostic tools lack sensitivity and specificity toward identifying macular (MAC) PKDL patients, due to low parasite load in patients' sample. Confirmatory test like punch biopsy are invasive and painful. Considering the rural nature of this disease and the prevailing situation of diagnostic scenario, PKDL patients mostly remains unattended from receiving proper medical care. They in turn act as “mobile parasite reservoir,” responsible for VL transmission among healthy individuals (HI). This study aims to identify PKDL disease specific glycated protein biomarkers, utilizing the powerful LC-MS/MS technology, which is the tool of choice to efficiently identify and quantify disease specific protein biomarkers. These identified PKDL disease specific novel glycoproteins could be developed in future as immunochromatographic based assay for efficient case detection. Methodology: Previously our lab had identified importance of glycated (Circulating Immune Complexes) CICs, among PKDL patients. This study aims to further characterize disease specific glycated protein biomarkers, among MAC PKDL patients for both diagnostic and prognostic evaluation of the disease. LC-MS/MS based comparative spectral count analysis of MAC PKDL to polymorphic (POLY) PKDL, HI, and Cured (CR) individuals were performed. Proteins level alterations among all study groups were confirmed by Western blot and enzyme-linked immunosorbant Assay (ELISA). Results: Among MAC PKDL patients 43, 60, 90 proteins were altered compared to POLY PKDL, HI, and CR groups, respectively. Filtering for the most significant proteins, Plasminogen (PLG) and Vitronectin (VTN) were identified which promisingly identified MAC PKDL cases. Active surveillance results from endemic districts of West Bengal revealed drastic rise of MAC PKDL cases, alarming the urgency for field adaptive efficient biomarker. Conclusion: This current study aims to establish PLG and VTN as novel diagnostic and prognostic protein biomarker for MAC and POLY PKDL cases management.
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Affiliation(s)
- Priyank Jaiswal
- Department of Laboratory Medicine, School of Tropical Medicine, Kolkata, India
| | - Manab Ghosh
- Department of Tropical Medicine, School of Tropical Medicine, Department of Health & Family Welfare, Government of West Bengal, Kolkata, India
| | - Goutam Patra
- Department of Laboratory Medicine, School of Tropical Medicine, Kolkata, India
| | - Bibhuti Saha
- Department of Tropical Medicine, School of Tropical Medicine, Department of Health & Family Welfare, Government of West Bengal, Kolkata, India
| | - Sumi Mukhopadhyay
- Department of Laboratory Medicine, School of Tropical Medicine, Kolkata, India
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Adinehbeigi K, Shaddel M, Khalili S, Zakeri A. Suramin could block the activity of Arabinono-1, 4-lactone oxidase enzyme from Leishmania donovani: structure-based screening and molecular dynamics analyses. Trans R Soc Trop Med Hyg 2020; 114:162-172. [PMID: 31667504 DOI: 10.1093/trstmh/trz091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 07/07/2019] [Accepted: 08/02/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Leishmania donovani, a parasitic protozoan causing visceral leishmaniasis, can lead to a dangerous and often fatal disease in humans. Current treatment for leishmaniasis may have severe side effects, low efficacy and high cost, hence an immediate need for new efficient drugs is essential. Arabinono-1, 4-lactone oxidase enzyme from Leishmania donovani (LdALO), which catalyzes the last step of the ascorbate biosynthesis pathway, has been considered as a potential target for antileishmanial drugs design. METHODS The current study was performed with an in silico approach to predict novel inhibitory molecules against the LdALO enzyme. Various modeling and refinement processes were employed to obtain a reliable 3D structure. RESULTS The best LdALO model with the highest qualitative model energy analysis score was predicted by the Robetta server and subsequently refined by 3D refine and ModLoop servers. The high quality of the final LdALO model was confirmed using model assessment software. Based on docking analysis results, we predicted 10 inhibitory molecules of a US Food and Drug Administration-approved library, with appropriate criteria regarding energy binding and interaction with the main functionally active sites of LdALO, indicating that they could be significant targets for further drug design investigations against L. donovani. CONCLUSION Suramin is used to treat the first stage of African sleeping sickness and its mechanism of action is unknown. Our results showed that suramin was the best-predicted inhibitor compound for LdALO enzyme activity.
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Affiliation(s)
- Keivan Adinehbeigi
- Department of Parasitology and Mycology, Faculty of Medicine, AJA University of Medical Sciences, Etemad Zadeh Street, Fatemi Street, Tehran, Iran
| | - Minoo Shaddel
- Department of Parasitology and Mycology, Faculty of Medicine, AJA University of Medical Sciences, Etemad Zadeh Street, Fatemi Street, Tehran, Iran
| | - Saeed Khalili
- Department of Biology Science, Shahid Rajaee University, Tehran, Iran
| | - Alireza Zakeri
- Department of Biology Science, Shahid Rajaee University, Tehran, Iran
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15
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Poché DM, Wang HH, Grant WE. Visceral leishmaniasis on the Indian Subcontinent: Efficacy of fipronil-based cattle treatment in controlling sand fly populations is dependent on specific aspects of sand fly ecology. PLoS Negl Trop Dis 2020; 14:e0008011. [PMID: 32069283 PMCID: PMC7048295 DOI: 10.1371/journal.pntd.0008011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 02/28/2020] [Accepted: 12/22/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) is a deadly disease transmitted by the sand fly Phlebotomus argentipes on the Indian subcontinent, with a promising means of vector control being orally treating cattle with fipronil-based drugs. While prior research investigating the dynamic relationship between timing of fipronil-based control schemes and the seasonality of sand flies provides insights into potential of treatment on a large scale, ecological uncertainties remain. We investigated how uncertainties associated with sand fly ecology might affect our ability to assess efficacy of fipronil-based control schemes. To do this, we used a previously-described, individual-based, stochastic sand fly model to quantify how uncertainties associated with 1) the percentage of female sand flies taking blood meals from cattle, and 2) the percentage of female sand flies ovipositing in organic matter containing feces from treated cattle might impact the efficacy of fipronil-based sand fly control schemes. PRINCIPAL FINDINGS Assuming no prior knowledge of sand fly blood meal and oviposition sites, the probabilities of achieving effective sand fly population reduction with treatments performed 3, 6 and 12 times per year were ≈5-22%, ≈27-36%, and ≈46-54%, respectively. Assuming ≥50% of sand flies feed on cattle, probabilities of achieving efficacious control increased to ≈8-31%, ≈15-42%, and ≈52-65%. Assuming also that ≥50% of sand flies oviposit in cattle feces, the above probabilities increased further to ≈14-53%, ≈31-81%, and ≈89-97%. CONCLUSIONS Our assessments of the efficacy of fipronil-based cattle treatments in controlling sand fly populations depend on our assumptions regarding key aspects of sand fly ecology. Assessments are most sensitive to assumptions concerning the percentage of sand flies ovipositing in feces of treated cattle, thus emphasizing the importance of identifying sand fly oviposition sites. Our results place the evaluation of fipronil-based cattle treatment within a broader ecological context, which could aid in the planning and execution of a largescale field trial.
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Affiliation(s)
- David M. Poché
- Genesis Laboratories, Inc., Wellington, Colorado, United States of America
| | - Hsiao-Hsuan Wang
- Ecological Systems Laboratory, Department of Wildlife and Fisheries Sciences, Texas A&M University, College Station, Texas, United States of America
| | - William E. Grant
- Ecological Systems Laboratory, Department of Wildlife and Fisheries Sciences, Texas A&M University, College Station, Texas, United States of America
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16
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Environmental and socioeconomic risk factors associated with visceral and cutaneous leishmaniasis: a systematic review. Parasitol Res 2020; 119:365-384. [PMID: 31897789 DOI: 10.1007/s00436-019-06575-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 12/10/2019] [Indexed: 12/11/2022]
Abstract
We performed a systematic review of the literature published since 1900 about leishmaniasis a neglected vector-borne disease, focused on environmental and social risk factors for visceral (VL) and cutaneous leishmaniasis (CL) to better understand their impact on the incidence of disease. The search terms were "leishmaniasis" AND "risk factors" using Google Scholar, PudMed, and Scielo. We reviewed 177 articles, 95 studies for VL, 75 for CL, and 7 on both forms. We identified 14 categories of risk factors which were divided into three groups: socioeconomic (7), environmental (5), and climate (2) variables. Socioeconomic factors were also associated with disease incidence in vulnerable human populations of arid and tropical developing regions. Environmental and climate factors showed significant associations with the incidence of VL and CL in all the studies that considered them. Proximity to natural vegetation remnants increased disease risk in both the New and Old World while the climate conditions favorable for disease transmission differed among regions. We propose a common conceptual framework for both clinical forms that highlights networks of interaction among risk factors. In both clinical forms, the interplay of these factors played a major role in disease incidence. Although there are similarities in environmental and socioeconomic conditions that mediate the transmission cycle of tropical, arid, and Mediterranean regions, the behavior of vector and reservoirs in each region is different. Special attention should be given to the possibility of vector adaptation to urban environments in developing countries where populations with low socioeconomic status are particularly vulnerable to the disease.
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17
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Hasker E, Malaviya P, Cloots K, Picado A, Singh OP, Kansal S, Boelaert M, Sundar S. Visceral Leishmaniasis in the Muzaffapur Demographic Surveillance Site: A Spatiotemporal Analysis. Am J Trop Med Hyg 2019; 99:1555-1561. [PMID: 30298812 PMCID: PMC6283495 DOI: 10.4269/ajtmh.18-0448] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
In the Indian subcontinent, visceral leishmaniasis (VL) has a strongly clustered distribution. The “index case approach” is promoted both for active case finding and indoor residual spraying (IRS). Uncertainty exists about the optimal radius. Buffer zones of 50–75 m around incident cases have been suggested for active case finding, for IRS the recommendation is to cover a radius of 500 m. Our aim was to establish optimal target areas both for IRS and for (re)active case finding. We plotted incident VL cases on a map per 6-month period (January–June or July–December) and drew buffers of 0 (same household), 50, 75, 100, 200, 300, 400, and 500 m around these cases. We then recorded total population and numbers of VL cases diagnosed over the next 6-month period in each of these buffers and beyond. We calculated incidence rate ratios (IRRs) using the population at more than 500 m from any case as reference category. There was a very strong degree of spatial clustering of VL with IRRs ranging from 45.2 (23.8–85.6) for those living in the same households to 14.6 (10.1–21.2) for those living within 75 m of a case diagnosed, during the previous period. Up to 500 m the IRR was still five times higher than that of the reference category. Our findings corroborate the rationale of screening not just household contacts but also those living within a perimeter of 50–75 m from an index case. For IRS, covering a perimeter of 500 m, appears to be a rational choice.
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Affiliation(s)
- Epco Hasker
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Paritosh Malaviya
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Kristien Cloots
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Albert Picado
- ISGlobal, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.,Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Om Prakash Singh
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Sangeeta Kansal
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Marleen Boelaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Shyam Sundar
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
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18
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Calderon-Anyosa R, Galvez-Petzoldt C, Garcia PJ, Carcamo CP. Housing Characteristics and Leishmaniasis: A Systematic Review. Am J Trop Med Hyg 2019; 99:1547-1554. [PMID: 30382013 DOI: 10.4269/ajtmh.18-0037] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Leishmaniasis is a major neglected tropical disease associated with high rates of disability and death. This disease is associated with poverty, which can be reflected in housing quality, especially in rural areas. This systematic review found that mud walls with cracks and holes, damp, and dark houses were risk factors for transmission of leishmaniasis. These characteristics create favorable conditions for sand fly breeding and resting as sand flies prefer humidity, warmth, and protection from sunlight during the day. Housing interventions might be a promising research area with a special focus on education as individual and collective protection for the effective control of leishmaniasis.
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Affiliation(s)
- Renzo Calderon-Anyosa
- Kuskaya Program, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Camila Galvez-Petzoldt
- Kuskaya Program, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Patricia J Garcia
- Kuskaya Program, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Cesar P Carcamo
- Kuskaya Program, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
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19
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Alebie G, Worku A, Yohannes S, Urga B, Hailu A, Tadesse D. Epidemiology of visceral leishmaniasis in Shebelle Zone of Somali Region, eastern Ethiopia. Parasit Vectors 2019; 12:209. [PMID: 31060585 PMCID: PMC6503444 DOI: 10.1186/s13071-019-3452-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 04/20/2019] [Indexed: 12/15/2022] Open
Abstract
Background Visceral leishmaniasis (VL), a vector-borne disease caused by species of the L.donovani complex, has (re)-emerged in Ethiopia during the last two decades and is currently of increasing public health concern. However, very little is known about VL epidemiology in the Somali Region of Ethiopia. The aim of this study was to provide detailed epidemiological information on seroprevalence, associated factors and incriminated vectors of VL in Shebelle Zone and Ethiopian Somali Region in general. Methods A cross-sectional epidemiological study was conducted between March and May 2016 in Gode and Adadle districts of Shebelle Zone, Ethiopian Somali Region. Two-stage semi-random sampling was applied for selecting study participants for the field survey. The study included structured questionnaire interviews, serological assays (rK39-immunochromatographic test), ELISA and entomological surveys. Results From a total of 361 participants, 57 (15.8%) were seropositive for VL including 46 (12.7%) rK39 positive and 11 (3.0%) positive by both rK39 and ELISA. VL seroprevalence was higher (P < 0.001) in Adadle (31.1%) compared to Gode (12.7%) district. The VL seroprevalence rate was higher in females than in males [rK39 (17.2 vs 14.0%) and ELISA (3.4 vs 2.5%)]. Children under the 15 years of age were the most highly affected group [rK39 (20.4%) and ELISA (4.4%)]. Increased VL risk was associated with presence of termite hills, study district, outdoor sleeping, Acacia trees and domestic animals [odds ratio (95% confidence interval): 12.58 (5.911–26.763), 5.40 (2.90–10.07), 5.31 (2.283–12.364), 2.37 (1.1190–4.728) and 0.199 (0.097–0.410), respectively]. The entomological survey identified 74 Phlebotomus [P. (Larroussius) orientalis (52/74), P. (Anaphlebotomus) rodhaini (14/74), P. (Paraphlebotomus) sergenti (8/74)] and 11 Sergentomyia sand flies. The average frequency of P. orientalis (3.06 ± 0.66) collected by all traps per night was higher than that of other species. The average frequency of total and specific (P. orientalis) female sand flies was higher in Adadle (1.89 ± 0.423 vs 1.11 ± 0.309) than in Gode (0.62 ± 0.324 vs 0.38 ± 0.183) district. The highest mean numbers of total (8 ± 1.5) and P. orientalis (6 ± 0.913) sand flies were collected in termite hills. Conclusions The present findings revealed potential new VL-transmission foci in the study districts. Therefore, the need for parasitological and molecular characterization of the parasite in humans and vector sand flies is of paramount importance to confirm transmission. Electronic supplementary material The online version of this article (10.1186/s13071-019-3452-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Getachew Alebie
- Department of Biology, Jigjiga University, Jigjiga, Ethiopia.
| | - Amha Worku
- Department of Biology, Jigjiga University, Jigjiga, Ethiopia
| | - Siele Yohannes
- Department of Biology, Jigjiga University, Jigjiga, Ethiopia
| | - Befikadu Urga
- College of Veterinary Medicine, Jigjiga University, Jigjiga, Ethiopia
| | - Asrat Hailu
- Department of Microbiology, Immunology and Parasitology, Faculty of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dagimawie Tadesse
- Department of Medical Microbiology, DNDi Leishmaniasis Research and Treatment Center, Arbaminch Hospital, Arbaminch, Ethiopia
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Afrin F, Chouhan G, Islamuddin M, Want MY, Ozbak HA, Hemeg HA. Cinnamomum cassia exhibits antileishmanial activity against Leishmania donovani infection in vitro and in vivo. PLoS Negl Trop Dis 2019; 13:e0007227. [PMID: 31071090 PMCID: PMC6529017 DOI: 10.1371/journal.pntd.0007227] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 05/21/2019] [Accepted: 02/08/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND There is a pressing need for drug discovery against visceral leishmaniasis, a life-threatening protozoal infection, as the available chemotherapy is antiquated and not bereft of side effects. Plants as alternate drug resources has rewarded mankind in the past and aimed in this direction, we investigated the antileishmanial potential of Cinnamomum cassia. METHODOLOGY Dichloromethane, ethanolic and aqueous fractions of C. cassia bark, prepared by sequential extraction, were appraised for their anti-promastigote activity along with apoptosis-inducing potential. The most potent, C. cassia dichloromethane fraction (CBD) was evaluated for anti-amastigote efficacy in infected macrophages and nitric oxide (NO) production studied. The in vivo antileishmanial efficacy was assessed in L. donovani infected BALB/c mice and hamsters and various correlates of host protective immunity ascertained. Toxicity profile of CBD was investigated in vitro against peritoneal macrophages and in vivo via alterations in liver and kidney functions. The plant secondary metabolites present in CBD were identified by gas chromatography-mass spectroscopy (GC-MS). PRINCIPAL FINDINGS CBD displayed significant anti-promastigote activity with 50% inhibitory concentration (IC50) of 33.6 μg ml-1 that was mediated via apoptosis. This was evidenced by mitochondrial membrane depolarization, increased proportion of cells in sub-G0-G1 phase, ROS production, PS externalization and DNA fragmentation (TUNEL assay). CBD also inhibited intracellular amastigote proliferation (IC50 14.06 μg ml-1) independent of NO production. The in vivo protection achieved was 80.91% (liver) and 82.92% (spleen) in mice and 75.61% (liver) and 78.93% (spleen) in hamsters indicating its profound therapeutic efficacy. CBD exhibited direct antileishmanial activity, as it did not specifically induce a T helper type (Th)-1-polarized mileu in cured hosts. This was evidenced by insignificant modulation of NO production, lymphoproliferation, DTH (delayed type hypersensitivity), serum IgG2a and IgG1 levels and production of Th2 cytokines (IL-4 and IL-10) along with restoration of pro-inflammatory Th1 cytokines (INF-γ, IL-12p70) to the normal range. CBD was devoid of any toxicity in vitro as well as in vivo. The chemical constituents, cinnamaldehyde and its derivatives present in CBD may have imparted the observed antileishmanial effect. CONCLUSIONS Our study highlights the profound antileishmanial efficacy of C. cassia bark DCM fraction and merits its further exploration as a source of safe and effective antieishmanial compounds.
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Affiliation(s)
- Farhat Afrin
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Kingdom of Saudi Arabia, Saudi Arabia
| | - Garima Chouhan
- Parasite Immunology Laboratory, Department of Biotechnology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Mohammad Islamuddin
- Parasite Immunology Laboratory, Department of Biotechnology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Muzamil Y. Want
- Parasite Immunology Laboratory, Department of Biotechnology, Jamia Hamdard (Hamdard University), New Delhi, India
| | - Hani A. Ozbak
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Kingdom of Saudi Arabia, Saudi Arabia
| | - Hassan A. Hemeg
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Taibah University, Madinah, Kingdom of Saudi Arabia, Saudi Arabia
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Chapman LAC, Morgan ALK, Adams ER, Bern C, Medley GF, Hollingsworth TD. Age trends in asymptomatic and symptomatic Leishmania donovani infection in the Indian subcontinent: A review and analysis of data from diagnostic and epidemiological studies. PLoS Negl Trop Dis 2018; 12:e0006803. [PMID: 30521526 PMCID: PMC6283524 DOI: 10.1371/journal.pntd.0006803] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 08/30/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Age patterns in asymptomatic and symptomatic infection with Leishmania donovani, the causative agent of visceral leishmaniasis (VL) in the Indian subcontinent (ISC), are currently poorly understood. Age-stratified serology and infection incidence have been used to assess transmission levels of other diseases, which suggests that they may also be of use for monitoring and targeting control programmes to achieve elimination of VL and should be included in VL transmission dynamic models. We therefore analysed available age-stratified data on both disease incidence and prevalence of immune markers with the aim of collating the currently available data, estimating rates of infection, and informing modelling and future data collection. METHODOLOGY/PRINCIPAL FINDINGS A systematic literature search yielded 13 infection prevalence and 7 VL incidence studies meeting the inclusion criteria. Statistical tests were performed to identify trends by age, and according to diagnostic cut-off. Simple reversible catalytic models with age-independent and age-dependent infection rates were fitted to the prevalence data to estimate infection and reversion rates, and to test different hypotheses about the origin of variation in these rates. Most of the studies showed an increase in infection prevalence with age: from ≲10% seroprevalence (<20% Leishmanin skin test (LST) positivity) for 0-10-year-olds to >10% seroprevalence (>20% LST-positivity) for 30-40-year-olds, but overall prevalence varied considerably between studies. VL incidence was lower amongst 0-5-year-olds than older age groups in most studies; most showing a peak in incidence between ages 5 and 20. The age-independent catalytic model provided the best overall fit to the infection prevalence data, but the estimated rates for the less parsimonious age-dependent model were much closer to estimates from longitudinal studies, suggesting that infection rates may increase with age. CONCLUSIONS/SIGNIFICANCE Age patterns in asymptomatic infection prevalence and VL incidence in the ISC vary considerably with geographical location and time period. The increase in infection prevalence with age and peaked age-VL-incidence distribution may be due to lower exposure to infectious sandfly bites in young children, but also suggest that acquired immunity to the parasite increases with age. However, poor standardisation of serological tests makes it difficult to compare data from different studies and draw firm conclusions about drivers of variation in observed age patterns.
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Affiliation(s)
- Lloyd A. C. Chapman
- Zeeman Institute, University of Warwick, Coventry, United Kingdom
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Alex L. K. Morgan
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
- School of Biological Sciences, University of Edinburgh, Edinbugh, United Kingdom
| | - Emily R. Adams
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Caryn Bern
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Graham F. Medley
- Centre for Mathematical Modelling of Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - T. Déirdre Hollingsworth
- Zeeman Institute, University of Warwick, Coventry, United Kingdom
- School of Life Sciences, University of Warwick, Coventry, United Kingdom
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, United Kingdom
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Poché DM, Torres-Poché Z, Garlapati R, Clarke T, Poché RM. Short-term movement of Phlebotomus argentipes (Diptera: Psychodidae) in a visceral leishmaniasis-endemic village in Bihar, India. JOURNAL OF VECTOR ECOLOGY : JOURNAL OF THE SOCIETY FOR VECTOR ECOLOGY 2018; 43:285-292. [PMID: 30408297 DOI: 10.1111/jvec.12312] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 07/26/2018] [Indexed: 06/08/2023]
Abstract
Visceral leishmaniasis (VL), transmitted by the sand fly, Phlebotomus argentipes, is frequently reported on the Indian subcontinent where its basic ecology is largely unknown. Our objective was to evaluate the effectiveness of sugar solution (10%), containing colored food dye (0.5%) applied to peridomestic vegetation, to mark P. argentipes and subsequently estimate horizontal movement by capturing dye-marked specimens in CDC light traps in a village in Bihar, India. From September 30 to November 27, 2016, a total of 667 captured sand flies were successfully marked using sugar baits, of which 608 were P. argentipes (~91.2%). Although the majority of P. argentipes were captured <100 m from the respective marking sites, a significantly greater proportion of females (15.7%) was captured >100 m from marking sites when compared to males (3.1%). Sand flies that ingested sugar bait were only collected from areas containing >eight vegetation types and mature banana plants. The average number of marked P. argentipes captured per trap-night (±SD) <100 m from respective marking sites was greatest in peridomestic vegetation (Males: 0.9 ± 1.97; Females: 0.63 ± 1.44), followed by areas with livestock (Males: 0.66 ± 2.75; Females: 0.24 ± 0.69), and areas with humans only (Males: 0.1 ± 0.36; Females: 0.11 ± 0.31). To our knowledge, this is the only study in Bihar in which sand flies have been marked with food dyes, and the results demonstrate the potential usefulness of food dyes in estimating short-term movement of P. argentipes. Limitations of this experiment are that the number of each trap location type, vegetation composition at marking sites, and distance of all trap sites from marking sites were not homogenous, and the total number of marked sand flies collected were relatively low. In spite of the above limitations, these data should prove useful in developing a large-scale study addressing the caveats. Results of such a study could provide important information regarding the dynamics of VL transmission and inspire managers to pursue alternative means of sand fly control on the Indian subcontinent.
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Affiliation(s)
| | | | | | - Tyler Clarke
- Genesis Laboratories, Inc., Wellington, CO, U.S.A
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23
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Deb RM, Stanton MC, Foster GM, Das Gupta RK, Roy N, Das P, Dhariwal AC, Coleman M. Visceral leishmaniasis cyclical trends in Bihar, India - implications for the elimination programme. Gates Open Res 2018; 2:10. [PMID: 30234191 PMCID: PMC6139379 DOI: 10.12688/gatesopenres.12793.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2018] [Indexed: 11/20/2022] Open
Abstract
Background: Visceral leishmaniasis (VL) is a vector-borne disease of public health importance in India, with the highest burden of disease in the states of Bihar, Jharkhand, West Bengal and Uttar Pradesh. The disease is currently targeted for elimination (annual incidence to less than one per 10,000 population) using indoor residual spraying, active case detection and treatment. Historically the disease trend in India has been regarded as cyclical with case resurgence characteristically occurring every 15 years. Understanding this pattern is essential if the VL elimination gains are to be sustained. To better understand the cyclical trends, annual climatic indicators including rainfall, temperature and humidity over time were compared with annual VL case incidence data. Methods: Annual climate data (rainfall, average and maximum temperature and specific humidity) from 1956-2004 were used to identify potential factors influencing VL incidence. Months relevant to the VL life-cycle were identified and defined (Monsoon, Sand-fly Peak, Pre-Sand-fly Peak and Annual) for analysis. The Kruskall-Wallis test was used to determine significant difference between categorical rainfall and VL incidence, whilst univariate negative binomial regression models were used to determine predictors of disease incidence. Results: The negative binomial regression model showed statistically significant associations (p <0.05) for VL incidence and maximum temperature, and average temperature, when considering annual and pre-sand fly peak time periods. No other associations between humidity, rainfall or temperature and VL incidence were detected (all values p >0.05). Conclusion: The VL programme in Bihar has made significant progress in adopting best practices for improved treatment and vector control, with the aim to achieve VL elimination. However, open access granular programme data for indoor residual spray activities and case detection is required to fully understand the role of climate in disease transmission and potential resurgence.
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Affiliation(s)
- Rinki M Deb
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Michelle C Stanton
- Faculty of Health and Medicine, Lancaster University, Lancaster, Lancashire , LA1 4YW, UK
| | - Geraldine M Foster
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
| | - Rudra K Das Gupta
- National Vector Borne Disease Control Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Delhi, 110054, India
| | - Nupur Roy
- National Vector Borne Disease Control Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Delhi, 110054, India
| | - Pradeep Das
- Rajendra Memorial Research Institute of Medical Sciences, Patna, Bihar, India
| | - Akshay C Dhariwal
- National Vector Borne Disease Control Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Delhi, 110054, India
| | - Michael Coleman
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, L3 5QA, UK
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24
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Jaiswal P, Datta S, Sardar B, Chaudhuri SJ, Maji D, Ghosh M, Saha B, Mukhopadhyay S. Glycoproteins in circulating immune complexes are biomarkers of patients with Indian PKDL: A study from endemic districts of West Bengal, India. PLoS One 2018; 13:e0192302. [PMID: 29420575 PMCID: PMC5805291 DOI: 10.1371/journal.pone.0192302] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 01/22/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Post Kala Azar Dermal Leishmaniasis (PKDL) occurs as dermal consequence of previous Visceral Leishmaniasis (VL) infection and serves as an important reservoir for transmission of VL. Diagnosis of PKDL is often challenging for its symptomatic resemblance to other co-endemic diseases like Leprosy or Vitiligo. Parasitological examination by slit-skin smear and culture are the standard methods but lack high sensitivity. Thus, for efficient control of VL, reliable diagnostic and prognostic assay of PKDL are required. OBJECTIVE Previously, glycoproteins (9-OAcSA) have been reported as promising biomarkers of Indian VL patients. However, till date, the status of glycans in Indian PKDL patients remains unexplored. Accordingly, in this study, the glyco-profile of PKDL Circulating Immune Complexes (CICs) as compared to other cross diseases like Vitiligo and Leprosyhas been investigated. Further, a novel Glyco CIC assay has been developed for efficient Indian PKDL patient diagnosis. METHODS/PRINCIPAL FINDING In the present study, 90 PKDL patients were enrolled from 3 VL endemic districts of West Bengal during 2015-16. Glycosylation profile of isolated CICs from sera of PKDL patients were initially analyzed through gradient SDS gel electrophoresis followed by PAS silver double staining, which revealed the presence of several glycan rich PKDL specific proteins of varying molecular weights. To further characterize the glyco-profile of acid dissociated affinity purified immuno-reactive antigens present in the CICs, glycosylation was demonstrated in these purified CIC antigens by DIG glycan differentiation kit with or without glycosidase as well as neuraminidase treatment. Diagnostic evaluation of the newly developed colorimetric Glyco CIC assay through Receiver Operating Characteristic (ROC) curve analysis revealed excellent (0.99) AUC value as compared to other conventional serodiagnostic assays like PEG CIC, Parasite ELISA (IgG and IgM). Additionally, longitudinal monitoring of 18 PKDL patients further revealed its good prognostic utility. CONCLUSION These results highlight the glycosylation status of CICs among Indian PKDL patients present in all the studied endemic districts of West Bengal. These PKDL biomarkers were completely absent in cross diseases like Vitiligo and Leprosy. Further, the newly developed Glyco CIC assay had an improved sensitivity of 95.6%, specificity of 99.3%, NPV of 97.1% and PPV of 98.9%.
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Affiliation(s)
- Priyank Jaiswal
- Department of Laboratory Medicine, School of Tropical Medicine, West Bengal, India
| | - Souvik Datta
- Department of Laboratory Medicine, School of Tropical Medicine, West Bengal, India
| | - Bikash Sardar
- Department of Tropical Medicine, School of Tropical Medicine, Government of West Bengal, West Bengal, India
| | - Surya Jyoti Chaudhuri
- Ranaghat Sub Divisional Hospital, Government of West Bengal, Nadia, West Bengal, India
| | - Dipankar Maji
- Department of Health & Family Welfare, Government of West Bengal, West Bengal, India
| | - Manab Ghosh
- Department of Tropical Medicine, School of Tropical Medicine, Government of West Bengal, West Bengal, India
| | - Bibhuti Saha
- Department of Tropical Medicine, School of Tropical Medicine, Government of West Bengal, West Bengal, India
| | - Sumi Mukhopadhyay
- Department of Laboratory Medicine, School of Tropical Medicine, West Bengal, India
- * E-mail:
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25
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Poché DM, Garlapati RB, Mukherjee S, Torres-Poché Z, Hasker E, Rahman T, Bharti A, Tripathi VP, Prakash S, Chaubey R, Poché RM. Bionomics of Phlebotomus argentipes in villages in Bihar, India with insights into efficacy of IRS-based control measures. PLoS Negl Trop Dis 2018; 12:e0006168. [PMID: 29324760 PMCID: PMC5764230 DOI: 10.1371/journal.pntd.0006168] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 12/15/2017] [Indexed: 11/23/2022] Open
Abstract
Background Visceral leishmaniasis (VL) is a deadly vector-borne disease. Approximately 90% of Indian VL cases occur in Bihar, where the sand fly, Phlebotomus argentipes, is the principal vector. Sand fly control in Bihar consists of indoor residual spraying (IRS), the practice of spraying the inner walls of village dwellings with insecticides. Prior researchers have evaluated success of IRS-control by estimating vector abundance in village houses, but the number of sampling periods (n = 2–3) were minimal, and outdoor-resting P. argentipes were neglected. We describe a large-scale field study, performed in 24 villages within two Bihari districts, during which P. argentipes were collected biweekly over 47-weeks, in cattle enclosures, houses, and outdoors in peri-domestic vegetation. The objectives of this study were to provide updated P. argentipes ecological field data, and determine if program-initiated IRS-treatment had led to noticeable differences in vector abundance. Principal findings P. argentipes (n = 126,901) relative abundance was greatest during the summer months (June-August) when minimum temperatures were highest. P. argentipes were most frequently collected from cattle enclosures (~46% total; ~56% blood fed). Many sand flies were found to have taken blood from multiple sources, with ~81% having blood fed on humans and ~60% blood feeding on bovines. Nonparametric statistical tests were determined most appropriate for evaluating IRS-treatment. Differences in P. argentipes abundance in houses, cattle enclosures and vegetation were detected between IRS-treated and untreated villages in only ~9% of evaluation periods occurring during the peak period of human-vector exposure (June-August) and in ~8% of the total observations. No significant differences were detected between the numbers of P. argentipes collected in vegetation close to the experimental villages. Conclusion The results of this study provide updated data regarding P. argentipes seasonal abundance, spatial distribution, and host preferances, and suggest vector abundance has not significantly declined in IRS-treated villages. We suggest that IRS be supplemented with vector control strategies targeting exophagic, exophilic P. argentipes, and that disease surveillance be accompanied by rigorous vector population monitoring. Visceral leishmaniasis is a disease caused by a deadly vector-borne parasite (Leishmania donovani) transmitted to man by phlebotomine sand flies. Indoor residual spraying (IRS), performed within village dwellings, is the primary means of sand fly control performed in Bihar, India and more explicit methods of evaluating the success of control are warranted. A field-based study was conducted to collect ecological sand fly data for use in evaluating the effectiveness of IRS in reducing relative sand fly abundance. Results indicate that sand flies blood feed primarily on humans and cattle and are most frequently found within cattle enclosures. Results further suggest IRS-treatment has a limited impact on vector density. Our approach incorporates detailed evaluation of sand fly spatial distribution (cattle enclosures, houses, vegetation), seasonal fluctuations in abundance, host blood meal preferences within Bihari villages, and dates of IRS performed within treated villages. Hence, this study provides an explicit means of monitoring vector populations and evaluating control measures in Bihar.
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Affiliation(s)
- David M Poché
- Department of Vector Ecology, Genesis Laboratories, Inc., Wellington, United States of America
| | - Rajesh B Garlapati
- Department of Entomology, Genesis Laboratories India Private Limited, Patna, India
| | - Shanta Mukherjee
- Department of Entomology, Genesis Laboratories India Private Limited, Patna, India
| | - Zaria Torres-Poché
- Department of Vector Ecology, Genesis Laboratories, Inc., Wellington, United States of America
| | - Epco Hasker
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Tahfizur Rahman
- Department of Entomology, Genesis Laboratories India Private Limited, Patna, India
| | - Aakanksha Bharti
- Department of Entomology, Genesis Laboratories India Private Limited, Patna, India
| | - Vishnu P Tripathi
- Department of Entomology, Genesis Laboratories India Private Limited, Patna, India
| | - Suman Prakash
- Department of Entomology, Genesis Laboratories India Private Limited, Patna, India
| | - Rahul Chaubey
- Department of Entomology, Genesis Laboratories India Private Limited, Patna, India
| | - Richard M Poché
- Department of Vector Ecology, Genesis Laboratories, Inc., Wellington, United States of America
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26
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Jervis S, Chapman LAC, Dwivedi S, Karthick M, Das A, Le Rutte EA, Courtenay O, Medley GF, Banerjee I, Mahapatra T, Chaudhuri I, Srikantiah S, Hollingsworth TD. Variations in visceral leishmaniasis burden, mortality and the pathway to care within Bihar, India. Parasit Vectors 2017; 10:601. [PMID: 29216905 PMCID: PMC5719561 DOI: 10.1186/s13071-017-2530-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 11/12/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Visceral leishmaniasis (VL) has been targeted by the WHO for elimination as a public health problem (< 1 case/10,000 people/year) in the Indian sub-continent (ISC) by 2020. Bihar State in India, which accounts for the majority of cases in the ISC, remains a major target for this elimination effort. However, there is considerable spatial, temporal and sub-population variation in occurrence of the disease and the pathway to care, which is largely unexplored and a threat to achieving the target. METHODS Data from 6081 suspected VL patients who reported being clinically diagnosed during 2012-2013 across eight districts in Bihar were analysed. Graphical comparisons and Chi-square tests were used to determine differences in the burden of identified cases by season, district, age and sex. Log-linear regression models were fitted to onset (of symptoms)-to-diagnosis and onset-to-treatment waiting times to estimate their associations with age, sex, district and various socio-economic factors (SEFs). Logistic regression models were used to identify factors associated with mortality. RESULTS Comparisons of VL caseloads suggested an annual cycle peaking in January-March. A 17-fold variation in the burden of identified cases across districts and under-representation of young children (0-5 years) relative to age-specific populations in Bihar were observed. Women accounted for a significantly lower proportion of the reported cases than men (41 vs 59%, P < 0.0001). Age, district of residence, house wall materials, caste, treatment cost, travelling for diagnosis and the number of treatments for symptoms before diagnosis were identified as correlates of waiting times. Mortality was associated with age, district of residence, onset-to-treatment waiting time, treatment duration, cattle ownership and cost of diagnosis. CONCLUSIONS The distribution of VL in Bihar is highly heterogeneous, and reported caseloads and associated mortality vary significantly across different districts, posing different challenges to the elimination campaign. Socio-economic factors are important correlates of these differences, suggesting that elimination will require tailoring to population and sub-population circumstances.
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Affiliation(s)
- Sarah Jervis
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry, CV4 7AL, UK.
| | - Lloyd A C Chapman
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry, CV4 7AL, UK.
| | - Shweta Dwivedi
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
| | - Morchan Karthick
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
| | - Aritra Das
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
| | - Epke A Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000, CA, Rotterdam, The Netherlands
| | - Orin Courtenay
- School of Life Sciences, University of Warwick, Gibbet Hill Campus, Coventry, CV4 7AL, UK
| | - Graham F Medley
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | | | - Tanmay Mahapatra
- CARE India Solutions for Sustainable Development, Patna, Bihar, India
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POCHÉ DM, POCHÉ RM, MUKHERJEE S, FRANCKOWIAK GA, BRILEY LN, SOMERS DJ, GARLAPATI RB. Phlebotomine sandfly ecology on the Indian subcontinent: does village vegetation play a role in sandfly distribution in Bihar, India? MEDICAL AND VETERINARY ENTOMOLOGY 2017; 31:207-213. [PMID: 28106262 PMCID: PMC5412671 DOI: 10.1111/mve.12224] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 11/02/2016] [Accepted: 11/28/2016] [Indexed: 06/06/2023]
Abstract
Visceral leishmaniasis (VL) is a disease that results in approximately 50 000 human deaths annually. It is transmitted through the bites of phlebotomine sandflies and around two-thirds of cases occur on the Indian subcontinent. Indoor residual spraying (IRS), the efficacy of which depends upon sandfly adults resting indoors, is the only sandfly control method used in India. Recently, in Bihar, India, considerable sandfly numbers have been recorded outdoors in village vegetation, which suggests that IRS may control only a portion of the population. The purpose of this study was to revisit previously published results that suggested some sandflies to be arboreal and to rest on outlying plants by using Centers for Disease Control light traps to capture sandflies in vegetation, including banana plants and palmyra palm trees, in two previously sampled VL-endemic Bihari villages. Over 3500 sandflies were trapped in vegetation over 12 weeks. The results showed the mean number of sandflies collected per trap night were significantly higher in banana trees than in other vegetation (P = 0.0141) and in female rather than male palmyra palm trees (P = 0.0002). The results raise questions regarding sandfly dispersal, oviposition and feeding behaviours, and suggest a need to refine current control practices in India and to take into account an evolving understanding of sandfly ecology.
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Affiliation(s)
- D. M. POCHÉ
- Genesis Laboratories, Inc.WellingtonCOU.S.A.
| | - R. M. POCHÉ
- Genesis Laboratories, Inc.WellingtonCOU.S.A.
| | - S. MUKHERJEE
- Genesis Laboratories, India Private LtdPatnaIndia
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28
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Satam V, Pedada SR, Kamaraj P, Antao N, Singh A, Hindupur RM, Pati HN. Development of a Scalable Process for the Synthesis of DNDI-VL-2098: A Potential Preclinical Drug Candidate for the Treatment of Visceral Leishmaniasis. Org Process Res Dev 2017; 21:52-59. [PMID: 28539754 PMCID: PMC5437808 DOI: 10.1021/acs.oprd.6b00331] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Indexed: 01/30/2023]
Abstract
A process suitable for kilogram-scale synthesis of (2R)-2-methyl-6-nitro-2-{[4-(trifluoromethoxy)phenoxy]methyl}-2,3-dihydroimidazo[2,1-b][1,3]oxazole (DNDI-VL-2098, 2), a preclinical drug candidate for the treatment of visceral leishmaniasis, is described. The four-step synthesis of the target compound involves the Sharpless asymmetric epoxidation of 2-methyl-2-propen-1-ol, 8. Identification of a suitable synthetic route using retrosynthetic analysis and development of a scalable process to access several kilograms of 2 are illustrated. The process was simplified by employing in situ synthesis of some intermediates, reducing safety hazards, and eliminating the need for column chromatography. The improved reactions were carried out on the kilogram scale to produce 2 in good yield, high optical purity, and high quality.
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Affiliation(s)
- Vijay
S. Satam
- Process Chemistry Division, Advinus Therapeutics Ltd., 21 & 22, Phase II, Peenya Industrial Area, Bangalore 560058, Karnataka, India
| | - Srinivasa Rao Pedada
- Process Chemistry Division, Advinus Therapeutics Ltd., 21 & 22, Phase II, Peenya Industrial Area, Bangalore 560058, Karnataka, India
| | - Pasumpon Kamaraj
- Process Chemistry Division, Advinus Therapeutics Ltd., 21 & 22, Phase II, Peenya Industrial Area, Bangalore 560058, Karnataka, India
| | - Nakita Antao
- Process Chemistry Division, Advinus Therapeutics Ltd., 21 & 22, Phase II, Peenya Industrial Area, Bangalore 560058, Karnataka, India
| | - Apoorva Singh
- Process Chemistry Division, Advinus Therapeutics Ltd., 21 & 22, Phase II, Peenya Industrial Area, Bangalore 560058, Karnataka, India
| | - Rama Mohan Hindupur
- Process Chemistry Division, Advinus Therapeutics Ltd., 21 & 22, Phase II, Peenya Industrial Area, Bangalore 560058, Karnataka, India
| | - Hari N. Pati
- Process Chemistry Division, Advinus Therapeutics Ltd., 21 & 22, Phase II, Peenya Industrial Area, Bangalore 560058, Karnataka, India
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Welay GM, Alene KA, Dachew BA. Visceral leishmaniasis treatment outcome and its determinants in northwest Ethiopia. Epidemiol Health 2016; 39:e2017001. [PMID: 28092934 PMCID: PMC5343104 DOI: 10.4178/epih.e2017001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 12/28/2016] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES Poor treatment outcomes of visceral leishmaniasis (VL) are responsible for the high mortality rate of this condition in resource-limited settings such as Ethiopia. This study aimed to identify the proportion of poor VL treatment outcomes in northwest Ethiopia and to evaluate the determinants associated with poor outcomes. METHODS A hospital-based retrospective study was conducted among 595 VL patients who were admitted to Kahsay Abera Hospital in northwest Ethiopia from October 2010 to April 2013. Data were entered into Epi Info version 7.0 and exported to SPSS version 20 for analysis. Bivariate and multivariate logistic regression models were fitted to identify the determinants of VL treatment outcomes. Adjusted odds ratio (aORs) with 95% confidence intervals (CIs) were used, and p-values <0.05 were considered to indicate statistical significance. RESULTS The proportion of poor treatment outcomes was 23.7%. Late diagnosis (≥29 days) (aOR, 4.34; 95% CI, 2.22 to 8.46), severe illness at admission (inability to walk) (aOR, 1.63; 95% CI, 1.06 to 2.40) and coinfection with VL and human immunodeficiency virus (HIV) (aOR, 2.72; 95% CI, 1.40 to 5.20) were found to be determinants of poor VL treatment outcomes. CONCLUSIONS Poor treatment outcomes, such as death, treatment failure, and non-adherence, were found to be common. Special attention must be paid to severely ill and VL/HIV-coinfected patients. To improve VL treatment outcomes, the early diagnosis and treatment of VL patients is recommended.
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Affiliation(s)
| | - Kefyalew Addis Alene
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Berihun Assefa Dachew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.,The University of Queensland, School of Public Health, Herston Qld 4006, Australia
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Singh K, Singh KP, Equbal A, Suman SS, Zaidi A, Garg G, Pandey K, Das P, Ali V. Interaction between cysteine synthase and serine O-acetyltransferase proteins and their stage specific expression in Leishmania donovani. Biochimie 2016; 131:29-44. [PMID: 27638321 DOI: 10.1016/j.biochi.2016.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 09/05/2016] [Accepted: 09/05/2016] [Indexed: 01/14/2023]
Abstract
Leishmania possess a unique trypanothione redox metabolism with undebated roles in protection from oxidative damage and drug resistance. The biosynthesis of trypanothione depends on l-cysteine bioavailability which is regulated by cysteine biosynthesis pathway. The de novo cysteine biosynthesis pathway is comprised of serine O-acetyltransferase (SAT) and cysteine synthase (CS) enzymes which sequentially mediate two consecutive steps of cysteine biosynthesis, and is absent in mammalian host. However, despite the apparent dependency of redox metabolism on cysteine biosynthesis pathway, the role of SAT and CS in redox homeostasis has been unexplored in Leishmania parasites. Herein, we have characterized CS and SAT to investigate their interaction and relative abundance of these proteins in promastigote vs. amastigote growth stages of L. donovani. CS and SAT genes of L. donovani (LdCS and LdSAT) were cloned, expressed, and fusion proteins purified to homogeneity with affinity column chromatography. Purified LdCS contains PLP as cofactor and showed optimum enzymatic activity at pH 7.5. Enzyme kinetics showed that LdCS catalyses the synthesis of cysteine using O-acetylserine and sulfide with a Km of 15.86 mM and 0.17 mM, respectively. Digitonin fractionation and indirect immunofluorescence microscopy showed that LdCS and LdSAT are localized in the cytoplasm of promastigotes. Size exclusion chromatography, co-purification, pull down and immuno-precipitation assays demonstrated a stable complex formation between LdCS and LdSAT proteins. Furthermore, LdCS and LdSAT proteins expression/activity was upregulated in amastigote growth stage of the parasite. Thus, the stage specific differential expression of LdCS and LdSAT suggests that it may have a role in the redox homeostasis of Leishmania.
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Affiliation(s)
- Kuljit Singh
- Laboratory of Molecular Biochemistry and Cell Biology, Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, 800007, India; Department of Biotechnology, National Institute of Pharmaceutical Education and Research, EPIP Complex, Hajipur, 844102, India
| | - Krishn Pratap Singh
- Laboratory of Molecular Biochemistry and Cell Biology, Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, 800007, India
| | - Asif Equbal
- Laboratory of Molecular Biochemistry and Cell Biology, Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, 800007, India
| | - Shashi S Suman
- Laboratory of Molecular Biochemistry and Cell Biology, Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, 800007, India
| | - Amir Zaidi
- Laboratory of Molecular Biochemistry and Cell Biology, Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, 800007, India
| | - Gaurav Garg
- Laboratory of Molecular Biochemistry and Cell Biology, Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, 800007, India; Department of Biotechnology, National Institute of Pharmaceutical Education and Research, EPIP Complex, Hajipur, 844102, India
| | - Krishna Pandey
- Department of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, 800007, India
| | - Pradeep Das
- Department of Molecular Biology, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, 800007, India
| | - Vahab Ali
- Laboratory of Molecular Biochemistry and Cell Biology, Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna, 800007, India; Department of Biotechnology, National Institute of Pharmaceutical Education and Research, EPIP Complex, Hajipur, 844102, India.
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Adam GK, Ali KM, Abdella YH, Omar SM, Ahmed MAA, Abdalla TM, Ali AA. Trend in cumulative cases and mortality rate among visceral leishmaniasis patients in Eastern Sudan: a 14-year registry, 2002-2015. Int J Infect Dis 2016; 51:81-84. [PMID: 27596686 DOI: 10.1016/j.ijid.2016.08.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 08/23/2016] [Accepted: 08/24/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Leishmaniasis is one of the neglected infectious diseases of the world. This disease largely affects individuals of low socio-economic level, mainly in developing countries. METHODS The aim of this study was to investigate the cumulative number of cases, case fatality rate, and trend in incidence and mortality rate of visceral leishmaniasis (VL) in Eastern Sudan. A retrospective descriptive study was performed through analysis of the database managed by the Ministry of Health in Gadarif State, which includes all cases of VL. RESULTS Over the 14-year study period (2002-2015), a total of 51773 patients were registered in Gadarif State with clinical and laboratory evidence of proven VL. The trend in VL was considerably higher over the years 2003-2005 as compared to the last 5 years of 2011-2015. The highest fatality rate was observed in 2002 (4.8%) and it had declined in 2014 (1.1%) and 2015 (1.7%). Rural residence was statistically associated with death related to VL (p=0.021). CONCLUSIONS This study showed a high number of cumulative cases of VL in Eastern Sudan. The fatality rate was found to be highest among rural residents and has declined in the last 5 years. Thus immediate interventions are needed in terms of health education and the implementation of preventive measures, with a specific focus on people residing in rural areas.
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Affiliation(s)
- Gamal K Adam
- Faculty of Medicine, Gadarif University - Kala-azar Research Centre (KRC), Gadarif, Sudan
| | - Khalid M Ali
- Faculty of Medicine, Gadarif University - Kala-azar Research Centre (KRC), Gadarif, Sudan
| | - Yassin H Abdella
- Faculty of Medicine, Gadarif University - Kala-azar Research Centre (KRC), Gadarif, Sudan
| | - Saeed M Omar
- Faculty of Medicine, Gadarif University - Kala-azar Research Centre (KRC), Gadarif, Sudan
| | - Mohammed Ahmed A Ahmed
- Faculty of Medicine, Gadarif University - Kala-azar Research Centre (KRC), Gadarif, Sudan
| | - Tajeldin M Abdalla
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kassala University, PO Box 496, Kassala, Sudan
| | - AbdelAziem A Ali
- Department of Obstetrics and Gynecology, Faculty of Medicine, Kassala University, PO Box 496, Kassala, Sudan.
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Visceral Leishmaniasis on the Indian Subcontinent: Modelling the Dynamic Relationship between Vector Control Schemes and Vector Life Cycles. PLoS Negl Trop Dis 2016; 10:e0004868. [PMID: 27537774 PMCID: PMC4990243 DOI: 10.1371/journal.pntd.0004868] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 06/30/2016] [Indexed: 11/19/2022] Open
Abstract
Background Visceral leishmaniasis (VL) is a disease caused by two known vector-borne parasite species (Leishmania donovani, L. infantum), transmitted to man by phlebotomine sand flies (species: Phlebotomus and Lutzomyia), resulting in ≈50,000 human fatalities annually, ≈67% occurring on the Indian subcontinent. Indoor residual spraying is the current method of sand fly control in India, but alternative means of vector control, such as the treatment of livestock with systemic insecticide-based drugs, are being evaluated. We describe an individual-based, stochastic, life-stage-structured model that represents a sand fly vector population within a village in India and simulates the effects of vector control via fipronil-based drugs orally administered to cattle, which target both blood-feeding adults and larvae that feed on host feces. Principle findings Simulation results indicated efficacy of fipronil-based control schemes in reducing sand fly abundance depended on timing of drug applications relative to seasonality of the sand fly life cycle. Taking into account cost-effectiveness and logistical feasibility, two of the most efficacious treatment schemes reduced population peaks occurring from April through August by ≈90% (applications 3 times per year at 2-month intervals initiated in March) and >95% (applications 6 times per year at 2-month intervals initiated in January) relative to no control, with the cumulative number of sand fly days occurring April-August reduced by ≈83% and ≈97%, respectively, and more specifically during the summer months of peak human exposure (June-August) by ≈85% and ≈97%, respectively. Conclusions Our model should prove useful in a priori evaluation of the efficacy of fipronil-based drugs in controlling leishmaniasis on the Indian subcontinent and beyond. Visceral leishmaniasis is a disease caused by a virulent vector-borne parasite transmitted to man by phlebotomine sand flies. Fipronil-based drugs, administered to cattle orally, provide a potential means of sand fly control by permeating in cattle blood and being excreted in cattle feces, targeting adult females feeding on cattle blood and larvae feeding on cattle feces, respectively. An agent-based, stochastic simulation model was developed to represent sand fly population dynamics in a village in Bihar, India, at all developmental stages, with the goal of predicting the impact of various vector control strategies, utilizing drug treated cattle, on vector population numbers. Results indicate that success of treatment is dependent on the number of treatments applied annually and the seasonality of the sand fly lifecycle. Results further suggest that treatment schemes are most effective in reducing vector populations when high drug efficacy is maintained in cattle feces during periods of high larval density. Our approach incorporates detailed representation of the vector population and provides an explicit representation of the effects of insecticide application on adult and larval sand flies. Hence, this model predicts treatment schemes that may have the greatest potential to reduce sand fly numbers.
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Cameron MM, Acosta-Serrano A, Bern C, Boelaert M, den Boer M, Burza S, Chapman LAC, Chaskopoulou A, Coleman M, Courtenay O, Croft S, Das P, Dilger E, Foster G, Garlapati R, Haines L, Harris A, Hemingway J, Hollingsworth TD, Jervis S, Medley G, Miles M, Paine M, Picado A, Poché R, Ready P, Rogers M, Rowland M, Sundar S, de Vlas SJ, Weetman D. Understanding the transmission dynamics of Leishmania donovani to provide robust evidence for interventions to eliminate visceral leishmaniasis in Bihar, India. Parasit Vectors 2016; 9:25. [PMID: 26812963 PMCID: PMC4729074 DOI: 10.1186/s13071-016-1309-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 01/15/2016] [Indexed: 12/31/2022] Open
Abstract
Visceral Leishmaniasis (VL) is a neglected vector-borne disease. In India, it is transmitted to humans by Leishmania donovani-infected Phlebotomus argentipes sand flies. In 2005, VL was targeted for elimination by the governments of India, Nepal and Bangladesh by 2015. The elimination strategy consists of rapid case detection, treatment of VL cases and vector control using indoor residual spraying (IRS). However, to achieve sustained elimination of VL, an appropriate post elimination surveillance programme should be designed, and crucial knowledge gaps in vector bionomics, human infection and transmission need to be addressed. This review examines the outstanding knowledge gaps, specifically in the context of Bihar State, India.The knowledge gaps in vector bionomics that will be of immediate benefit to current control operations include better estimates of human biting rates and natural infection rates of P. argentipes, with L. donovani, and how these vary spatially, temporally and in response to IRS. The relative importance of indoor and outdoor transmission, and how P. argentipes disperse, are also unknown. With respect to human transmission it is important to use a range of diagnostic tools to distinguish individuals in endemic communities into those who: 1) are to going to progress to clinical VL, 2) are immune/refractory to infection and 3) have had past exposure to sand flies.It is crucial to keep in mind that close to elimination, and post-elimination, VL cases will become infrequent, so it is vital to define what the surveillance programme should target and how it should be designed to prevent resurgence. Therefore, a better understanding of the transmission dynamics of VL, in particular of how rates of infection in humans and sand flies vary as functions of each other, is required to guide VL elimination efforts and ensure sustained elimination in the Indian subcontinent. By collecting contemporary entomological and human data in the same geographical locations, more precise epidemiological models can be produced. The suite of data collected can also be used to inform the national programme if supplementary vector control tools, in addition to IRS, are required to address the issues of people sleeping outside.
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Affiliation(s)
- Mary M Cameron
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | | | - Caryn Bern
- UCSF School of Medicine, 550 16th Street, San Francisco, 94158, CA, USA.
| | | | | | - Sakib Burza
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | | | - Alexandra Chaskopoulou
- European Biological Control Laboratory, USDA-ARS, Tsimiski 43 Street, Thessaloniki, 54623, Greece.
| | - Michael Coleman
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Orin Courtenay
- University of Warwick, Gibbet Hill Campus, Coventry, CV4 7AL, UK.
| | - Simon Croft
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Pradeep Das
- Rajendra Memorial Research Institute of Medical Sciences, Patna, India.
| | - Erin Dilger
- University of Warwick, Gibbet Hill Campus, Coventry, CV4 7AL, UK.
| | - Geraldine Foster
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | | | - Lee Haines
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | | | - Janet Hemingway
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | | | - Sarah Jervis
- University of Warwick, Gibbet Hill Campus, Coventry, CV4 7AL, UK.
| | - Graham Medley
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Michael Miles
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Mark Paine
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Albert Picado
- FIND, Campus Biotech, Chemin des Mines 9, 1202, Geneva, Switzerland.
| | - Richard Poché
- Genesis Laboratories, Inc., Wellington, CO, 80549, USA.
| | - Paul Ready
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Matthew Rogers
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Mark Rowland
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
| | - Shyam Sundar
- Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
| | - Sake J de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands.
| | - David Weetman
- Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
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Bublitz DC, Poché RM, Garlapati R. Measures to Control Phlebotomus argentipes and Visceral Leishmaniasis in India. J Arthropod Borne Dis 2016; 10:113-26. [PMID: 27308270 PMCID: PMC4906751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Accepted: 10/26/2015] [Indexed: 11/29/2022] Open
Abstract
Visceral leishmaniasis is a deadly parasitic disease that is transmitted via the bite of a female sand fly, Phlebotomus argentipes. The highest burden of this disease is in northern India. In 2005, India embarked on an initiative with Nepal, Bangladesh, and the World Health Organization to eliminate visceral leishmaniasis by 2015. With the goal of 1 case in 10,000 people still unmet, it is prudent to evaluate the tools that have been used thus far to reduce vector numbers and cases of the disease. Herein, we present a review of studies conducted on vector-control strategies in India to combat visceral leishmaniasis including indoor residual spraying, insecticide-treated bed nets, environmental modification, and feed-through insecticides. This review suggests that the quality of indoor residual spraying may enhance control measures while a combination of spraying, nets, and feed-through insecticides would best confront the diverse habitats of P. argentipes.
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Affiliation(s)
- DeAnna C. Bublitz
- Genesis Laboratories, 10122 NE Frontage Road, Wellington, CO 80549, USA
| | - Richard M. Poché
- Genesis Laboratories, 10122 NE Frontage Road, Wellington, CO 80549, USA,Corresponding author: Dr Richard M. Poché, E-mail:
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Nackers F, Mueller YK, Salih N, Elhag MS, Elbadawi ME, Hammam O, Mumina A, Atia AA, Etard JF, Ritmeijer K, Chappuis F. Determinants of Visceral Leishmaniasis: A Case-Control Study in Gedaref State, Sudan. PLoS Negl Trop Dis 2015; 9:e0004187. [PMID: 26544177 PMCID: PMC4636291 DOI: 10.1371/journal.pntd.0004187] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 10/02/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Improving knowledge on local determinants of visceral leishmaniasis (VL) is crucial to guide the development of relevant control strategies. This study aimed to identify individual and household level determinants of primary VL in 24 highly endemic villages of Tabarak Allah hospital's catchment area, Gedaref State, Sudan. METHODS From September 2012 to July 2013, in an unmatched case-control design, 198 patients with primary VL were compared to 801 controls free of VL symptoms and with a negative VL rapid test. Using random spatial sampling, controls were selected with a distribution of age, sex and village of residence proportionate to the distribution of the target population. Data were collected using a structured questionnaire. RESULTS Children and men were at higher risk of VL. Reporting VL patient(s) in the household in the previous year was the strongest VL risk factor. In a multivariate analysis, VL risk increased with household size, sleep location (outside the yard, not in the farm), evening outdoor activities in the rainy season (playing, watching TV, radio listening), use of ground nut oil as animal repellent and of smoke of Acacia seyal as indoor repellent, presence of dogs in the yard at night, Acacia nilotica in the yard's immediate surroundings and of a forest at eye range. VL risk appeared to decrease with the use of drinking water sources other than the village water tank, a buffer distance from the adjacent house yard, and with the presence of animals other than dogs in the yard at night. In contrast with previous studies, housing factors, mosquito-net use, black cotton soil, ethnicity, socioeconomic index, presence of Balanites aegyptica and Azadirachta indica in the yard were not independent VL determinants. DISCUSSION AND CONCLUSION Although these results do not provide evidence of causality, they provide useful suggestions for guiding further intervention studies on VL preventive measures.
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Affiliation(s)
| | | | - Niven Salih
- Médecins Sans Frontières, Operational Centre Geneva, Khartoum, Sudan
| | - Mousab Siddig Elhag
- Federal Ministry of Health, Neglected Tropical Diseases Division, Khartoum, Sudan
| | | | - Omer Hammam
- Médecins Sans Frontières, Operational Centre Geneva, Khartoum, Sudan
| | - Ann Mumina
- Médecins Sans Frontières, Operational Centre Geneva, Khartoum, Sudan
| | - Atia Abdalla Atia
- Médecins Sans Frontières, Operational Centre Geneva, Khartoum, Sudan
| | - Jean-François Etard
- Epicentre, Paris, France
- Institut de Recherche pour le Développement, Montpellier University, Montpellier, France
| | - Koert Ritmeijer
- Médecins Sans Frontières, Operational Centre Amsterdam, Amsterdam, the Netherlands
| | - François Chappuis
- Médecins Sans Frontières, Operational Centre Geneva, Geneva, Switzerland
- Geneva University Hospital, Department of Community Medicine, Geneva, Switzerland
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Castellanos-Gonzalez A, Saldarriaga OA, Tartaglino L, Gacek R, Temple E, Sparks H, Melby PC, Travi BL. A Novel Molecular Test to Diagnose Canine Visceral Leishmaniasis at the Point of Care. Am J Trop Med Hyg 2015; 93:970-5. [PMID: 26240156 DOI: 10.4269/ajtmh.15-0145] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 06/23/2015] [Indexed: 12/17/2022] Open
Abstract
Dogs are the principal reservoir hosts of zoonotic visceral leishmaniasis (VL) but current serological methods are not sensitive enough to detect all subclinically infected animals, which is crucial to VL control programs. Polymerase chain reaction (PCR) methods have greater sensitivity but require expensive equipment and trained personnel, impairing its implementation in endemic areas. We developed a diagnostic test that uses isothermal recombinase polymerase amplification (RPA) to detect Leishmania infantum. This method was coupled with lateral flow (LF) reading with the naked eye to be adapted as a point-of-care test. The L. infantum RPA-LF had an analytical sensitivity similar to real time-PCR, detecting DNA of 0.1 parasites spiked in dog blood, which was equivalent to 40 parasites/mL. There was no cross amplification with dog or human DNA or with Leishmania braziliensis, Leishmania amazonensis, or Trypanosoma cruzi. The test also amplified Leishmania donovani strains (N = 7). In a group of clinically normal dogs (N = 30), RPA-LF detected more subclinical infections than rK39 strip test, a standard serological method (50% versus 13.3% positivity, respectively; P = 0.005). Also, RPA-LF detected L. infantum in noninvasive mucosal samples of dogs with a sensitivity comparable to blood samples. This novel molecular test may have a positive impact in leishmaniasis control programs.
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Affiliation(s)
- Alejandro Castellanos-Gonzalez
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, Texas; Department of Microbiology and Immunology, Center for Tropical Diseases (CTD), University of Texas Medical Branch (UTMB), Galveston, Texas; Secretaria de Calidad de Vida, Municipalidad de Posadas, Misiones, Argentina; Instituto Municipal de Sanidad Animal, Municipalidad de Posadas, Misiones, Argentina; Baylor University, Waco, Texas
| | - Omar A Saldarriaga
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, Texas; Department of Microbiology and Immunology, Center for Tropical Diseases (CTD), University of Texas Medical Branch (UTMB), Galveston, Texas; Secretaria de Calidad de Vida, Municipalidad de Posadas, Misiones, Argentina; Instituto Municipal de Sanidad Animal, Municipalidad de Posadas, Misiones, Argentina; Baylor University, Waco, Texas
| | - Lilian Tartaglino
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, Texas; Department of Microbiology and Immunology, Center for Tropical Diseases (CTD), University of Texas Medical Branch (UTMB), Galveston, Texas; Secretaria de Calidad de Vida, Municipalidad de Posadas, Misiones, Argentina; Instituto Municipal de Sanidad Animal, Municipalidad de Posadas, Misiones, Argentina; Baylor University, Waco, Texas
| | - Rosana Gacek
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, Texas; Department of Microbiology and Immunology, Center for Tropical Diseases (CTD), University of Texas Medical Branch (UTMB), Galveston, Texas; Secretaria de Calidad de Vida, Municipalidad de Posadas, Misiones, Argentina; Instituto Municipal de Sanidad Animal, Municipalidad de Posadas, Misiones, Argentina; Baylor University, Waco, Texas
| | - Elissa Temple
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, Texas; Department of Microbiology and Immunology, Center for Tropical Diseases (CTD), University of Texas Medical Branch (UTMB), Galveston, Texas; Secretaria de Calidad de Vida, Municipalidad de Posadas, Misiones, Argentina; Instituto Municipal de Sanidad Animal, Municipalidad de Posadas, Misiones, Argentina; Baylor University, Waco, Texas
| | - Hayley Sparks
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, Texas; Department of Microbiology and Immunology, Center for Tropical Diseases (CTD), University of Texas Medical Branch (UTMB), Galveston, Texas; Secretaria de Calidad de Vida, Municipalidad de Posadas, Misiones, Argentina; Instituto Municipal de Sanidad Animal, Municipalidad de Posadas, Misiones, Argentina; Baylor University, Waco, Texas
| | - Peter C Melby
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, Texas; Department of Microbiology and Immunology, Center for Tropical Diseases (CTD), University of Texas Medical Branch (UTMB), Galveston, Texas; Secretaria de Calidad de Vida, Municipalidad de Posadas, Misiones, Argentina; Instituto Municipal de Sanidad Animal, Municipalidad de Posadas, Misiones, Argentina; Baylor University, Waco, Texas
| | - Bruno L Travi
- Division of Infectious Diseases, Department of Internal Medicine, University of Texas Medical Branch (UTMB), Galveston, Texas; Department of Microbiology and Immunology, Center for Tropical Diseases (CTD), University of Texas Medical Branch (UTMB), Galveston, Texas; Secretaria de Calidad de Vida, Municipalidad de Posadas, Misiones, Argentina; Instituto Municipal de Sanidad Animal, Municipalidad de Posadas, Misiones, Argentina; Baylor University, Waco, Texas
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Hernández-Torres A, García-Vázquez E, Bravo-Urbieta J, Bernal Morell E, Alcaraz-Vidal B, Sánchez-Serrano A, Gómez Gómez J. La leishmaniasis visceral en la región de Murcia: estudio multicéntrico 1997-2013. INFECTIO 2015. [DOI: 10.1016/j.infect.2014.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Sundar S, Pandey K, Thakur CP, Jha TK, Das VNR, Verma N, Lal CS, Verma D, Alam S, Das P. Efficacy and safety of amphotericin B emulsion versus liposomal formulation in Indian patients with visceral leishmaniasis: a randomized, open-label study. PLoS Negl Trop Dis 2014; 8:e3169. [PMID: 25233346 PMCID: PMC4169371 DOI: 10.1371/journal.pntd.0003169] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 08/04/2014] [Indexed: 11/18/2022] Open
Abstract
Background India is home to 60% of the total global visceral leishmaniasis (VL) population. Use of long-term oral (e.g. miltefosine) and parenteral drugs, considered the mainstay for treatment of VL, is now faced with increased resistance, decreased efficacy, low compliance and safety issues. The authors evaluated the efficacy and safety of an alternate treatment option, i.e. single infusion of preformed amphotericin B (AmB) lipid emulsion (ABLE) in comparison with that of liposomal formulation (LAmB). Methods In this multicentric, open-label study, 500 patients with VL were randomly assigned in a 3∶1 ratio to receive 15 mg/kg single infusion of either ABLE (N = 376) or LAmB (N = 124). Initial cure (Day 30/45), clinical improvement (Day 30) and long term definitive cure (Day 180) were assessed. Findings A total of 326 (86.7%) patients in the ABLE group and 122 (98.4%) patients in the LAmB group completed the study. Initial cure was achieved by 95.9% of patients in the ABLE group compared to 100% in the LAmB group (p = 0.028; 95% CI: −0.0663, −0.0150). Clinical improvement was comparable between treatments (ABLE: 98.9% vs. LAmB: 98.4%). Definitive cure was achieved in 85.9% with ABLE compared to 98.4% with LAmB. Infusion-related pyrexia (37.2% vs. 32.3%) and chills (18.4% vs. 18.5%) were comparable between ABLE and LAmB, respectively. Treatment-related serious adverse events were fewer in ABLE (0.3%) compared to LAmB (1.6%). Two deaths occurred in the ABLE group, of which one was probably related to the study drug. Nephrotoxicity and hepatotoxicity was not observed in either group. Conclusions ABLE 15 mg/kg single infusion had favorable efficacy and was well tolerated. Considering the demographic profile of the population in this region, a single dose treatment offers advantages in terms of compliance, cost and applicability. Trial Registration www.clinicaltrials.govNCT00876824 Visceral leishmaniasis (VL) is highly prevalent in northeastern India, particularly the state of Bihar and its bordering areas with Bangladesh and Nepal. The current standards of treatment, namely, miltefosine (oral) and pentavalent antimonials (parenteral) have long treatment durations and are faced with increasing resistance, decreased efficacy, low compliance and safety issues. In this regard, lipid formulations of amphotericin B (AmB) have become an attractive treatment option due to their high efficacy, shorter treatment regimens and favorable safety profiles. This Phase III study evaluated the efficacy and safety of preformed AmB lipid emulsion (ABLE) versus liposomal AmB (LAmB) (both 15 mg/kg single dose infusions) in the treatment of VL. ABLE showed favorable efficacy measured in terms of initial cure at Day 30/45, and overall clinical improvement. ABLE was well tolerated and its adverse event profile was consistent with previously documented findings. Based on the favorable efficacy and safety profile of ABLE, and considering the demographic profile of the population in the endemic region, a single dose treatment may offer advantages in terms of compliance, cost and applicability.
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Affiliation(s)
- Shyam Sundar
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
| | - Krishna Pandey
- Department of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India
- * E-mail:
| | | | - Tara Kant Jha
- Kalazar Research Centre, Brahmpura, Muzaffarpur, Bihar, India
| | - Vidya Nand Ravi Das
- Department of Clinical Medicine, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India
| | - Neena Verma
- Department of Pathology, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India
| | - Chandra Shekhar Lal
- Department of Biochemistry, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India
| | - Deepak Verma
- Kala-azar Medical Research Center, Muzaffarpur, Bihar, India
| | - Shahnawaz Alam
- Kala-azar Medical Research Center, Muzaffarpur, Bihar, India
| | - Pradeep Das
- Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Agamkuan, Patna, Bihar, India
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