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Dorji T, Dorjee S, Wangdi T, Tshokey T, Pradhan AR, Penjor K, Namgay R, Togbye T, Karunaweera N. Efforts toward the Elimination of Visceral Leishmaniasis in South Asia: A Review of Progress in Bhutan. Am J Trop Med Hyg 2024; 110:633-638. [PMID: 38471147 PMCID: PMC10993832 DOI: 10.4269/ajtmh.23-0642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/11/2023] [Indexed: 03/14/2024] Open
Abstract
Leishmaniases are a group of diseases under the category of neglected tropical diseases targeted for global elimination. However, they continue to pose major clinical and public health problems, especially among those living in poor socioeconomic conditions. Here, we summarize leishmaniasis elimination efforts in Bhutan. Between 1994 and 2022, Bhutan recorded 54 cases of leishmaniasis across 14 of its 20 districts. There are seven species of Phlebotomus and three species of Sergentomyia sand flies documented in the country. At a subnational level, all endemic districts recorded a visceral leishmaniasis annual incidence <1 per 10,000 population, meeting the regional elimination targets. Serological testing with ELISA and molecular testing with polymerase chain reaction were established at the Royal Center for Disease Control in 2022. A leishmaniasis prevention and management guideline was adopted in 2023 to aid clinicians in diagnosis and management. Active and passive case surveillance was integrated with the national infectious disease early warning and response system. Risk-based entomological surveillance and control have also been prioritized. Climate change may play a major role in rendering districts in the temperate zone favorable for vector proliferation. The country's medical university introduced a diploma course in medical entomology in 2023 to augment the human resources needed for vector surveillance efforts. However, leishmaniasis elimination lacks dedicated programmatic management amid competing priorities for resources against other infectious diseases. Leishmaniasis elimination requires a targeted and programmatic approach in Bhutan, including cross-border collaborative efforts with neighboring Indian states. Bhutan remains highly committed to achieving leishmaniasis elimination targets.
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Affiliation(s)
- Thinley Dorji
- Department of Internal Medicine, Central Regional Referral Hospital, Gelephu, Bhutan
| | - Sithar Dorjee
- Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Tenzin Wangdi
- Vector-Borne Disease Control Programme, Ministry of Health, Gelephu, Bhutan
| | - Tshokey Tshokey
- Department of Pathology and Laboratory Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Ambika Rani Pradhan
- Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
- Department of Dermatology, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan
| | - Kinley Penjor
- Faculty of Nursing and Public Health, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Rinzin Namgay
- Vector-Borne Disease Control Programme, Ministry of Health, Gelephu, Bhutan
| | - Togbye Togbye
- Vector-Borne Disease Control Programme, Ministry of Health, Gelephu, Bhutan
| | - Nadira Karunaweera
- Department of Parasitology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
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Awoke TD, Kassa SM, Morupisi KS, Tsidu GM. Sex-structured disease transmission model and control mechanisms for visceral leishmaniasis (VL). PLoS One 2024; 19:e0301217. [PMID: 38564571 PMCID: PMC10986940 DOI: 10.1371/journal.pone.0301217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Leishmaniasis are a group of diseases caused by more than 20 species of the protozoan that are transmitted through the bite of female sand fly. The disease is endemic to 98 countries of the world. It affects most commonly the poorest of the poor and mainly males. Several research has been conducted to propose disease control strategies. Effective medical care, vector control, environmental hygiene, and personal protection are the mainstays of the current preventative and control methods. The mathematical models for the transmission dynamics of the disease studied so far did not consider the sex-biased burden of the disease into consideration. METHODOLOGY Unlike the previous VL works, this study introduces a new deterministic sex-structured model for understanding the transmission dynamics of visceral leishmaniasis. Basic properties of the model including basic reproduction number ([Formula: see text]), and conditions for the existence of backward bifurcation of the model are explored. Baseline parameter values were estimated after the model was fitted to Ethiopia's VL data. Sensitivity analysis of the model was performed to identify the parameters that significantly impact the disease threshold. Numerical simulations were performed using baseline parameter values, and scenario analysis is performed by changing some of these parameters as appropriate. CONCLUSION The analysis of the model shows that there is a possibility for a backward bifurcation for [Formula: see text], which means bringing [Formula: see text] to less than unity may not be enough to eradicate the disease. Our numerical result shows that the implementation of disease-preventive strategies, as well as effectively treating the affected ones can significantly reduce the disease prevalence if applied for more proportion of the male population. Furthermore, the implementation of vector management strategies also can considerably reduce the total prevalence of the disease. However, it is demonstrated that putting more effort in treating affected reservoir animals may not have any significant effect on the overall prevalence of the disease as compared to other possible mechanisms. The numerical simulation infers that a maximum of 60% of extra preventative measures targeted to only male population considerably reduces the total prevalence of VL by 80%. It is also possible to decrease the total prevalence of VL by 69.51% when up to 50% additional infected males receive treatment with full efficacy. Moreover, applying a maximum of 15% additional effort to reduce the number of vectors, decreases the total VL prevalence by 57.71%. Therefore, in order to reduce the disease burden of visceral leishmaniasis, public health officials and concerned stakeholders need to give more emphasis to the proportion of male humans in their intervention strategies.
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Affiliation(s)
- Temesgen Debas Awoke
- Department of Mathematical and Statistical Sciences, Botswana International University of Science and Technology, Palapye, Botswana
| | - Semu Mitiku Kassa
- Department of Mathematical and Statistical Sciences, Botswana International University of Science and Technology, Palapye, Botswana
| | - Kgomotso Suzan Morupisi
- Department of Mathematical and Statistical Sciences, Botswana International University of Science and Technology, Palapye, Botswana
| | - Gizaw Mengistu Tsidu
- Department of Earth and Environmental Sciences, Botswana International University of Science and Technology, Palapye, Botswana
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Salgado CL, Corea AFM, Covre LP, Fonseca-Martins AMD, Falqueto A, Guedes HLDM, Rossi-Bergmann B, Gomes DCO. Intranasal delivery of LaAg vaccine improves immunity of aged mice against visceral Leishmaniasis. Acta Trop 2024; 252:107125. [PMID: 38280636 DOI: 10.1016/j.actatropica.2024.107125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/29/2024]
Abstract
There are no approved vaccines yet for human visceral leishmaniasis (VL), the most severe form of the leishmaniasis clinical manifestations that is fatal in over 95 % of untreated cases. It is well-accepted that immunological changes during aging have deleterious impact on the efficacy of vaccines and response to infections. In this work, we compared the response of young and aged mice to intranasal vaccination with killed Leishmania amazonensis promastigote antigens (LaAg) that were then challenged with L. infantum infection, a species that causes visceral leishmaniasis. Intranasal vaccination with LaAg induced a similar reduction in parasitism and hepatosplenomegaly in both young and aged mice compared to their unvaccinated counterparts. Following infection, there was also a less prominent inflammatory profile particularly in the vaccinated aged group, with lower production of TNF-α and nitrite compared to the respective unvaccinated group. Interestingly, the LaAg intranasal vaccination promoted increased production of IFN-γ that was observed in both young- and aged vaccinated groups. Additionally, CD4+ and CD8+T cells from both vaccinated groups presented decreased expression of the inhibitory receptors PD-1 and KLRG1 compared to their unvaccinated controls. Interestingly, a strong positive correlation was observed between the expression of both inhibitory receptors PD-1 and KLRG1 and parasitism, which was more conspicuous in the unvaccinated-aged mice than in the others. Overall, this study helps define new strategies to improve vaccine effectiveness and provides a perspective for prophylactic alternatives against leishmaniasis.
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Affiliation(s)
- Caio Loureiro Salgado
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | | | - Luciana Polaco Covre
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitoria, Brazil; Division of Medicine, University College London, London, United Kingdom
| | | | - Aloisio Falqueto
- Departamento de Medicina Social, Universidade Federal do Espírito Santo, Vitoria, Brazil
| | - Herbert Leonel de Matos Guedes
- Instituto de Microbiologia Professor Paulo de Goes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil; Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Bartira Rossi-Bergmann
- Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Daniel Cláudio Oliviera Gomes
- Núcleo de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitoria, Brazil; Núcleo de Biotecnologia, Universidade Federal do Espírito Santo, Vitoria, Brazil.
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Guha SK, Sardar AA, Saha P, Chatterjee M, Jana K, Samanta A, Maji D, Biswas P, Bhattacharya R, Maji AK. Challenges for maintaining post elimination phase of visceral leishmaniasis control programme in India: A field-based study. PLoS Negl Trop Dis 2024; 18:e0012028. [PMID: 38452055 PMCID: PMC10950250 DOI: 10.1371/journal.pntd.0012028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 03/19/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND India is going through the maintenance phase of VL elimination programme which may be threatened by the persistence of hidden parasite pools among asymptomatic leishmanial infection (ALI) and PKDL. The present work was designed to determine the burden of VL, PKDL, and ALI and to assess the role of treatment of ALI in maintaining post-elimination phase. METHODS AND FINDING The study was undertaken in Malda district, West Bengal, India during October 2016 to September 2021. Study areas were divided into 'Study' and 'Control' arms. VL and PKDL cases of both the arms were diagnosed by three active mass surveys with an interval of one year and treated as per National guideline. ALI of 'Study' arm was treated like VL. ALI of 'Control' arm was followed up to determine their fate. Fed sand-fly pools were analysed for parasitic DNA. No significant difference was noted between the incidence of VL and PKDL in both the arms. Incidence of ALI declined sharply in 'Study' arm but an increasing trend was observed in 'Control' arm. Significantly higher rate of sero-conversion was noted in 'Control' arm and was found to be associated with untreated ALI burden. Parasitic DNA was detected in 22.8% ALI cases and 2.2% sand-fly pools. CONCLUSION Persistence of a significant number of PKDL and ALI and ongoing transmission, as evidenced by new infection and detection of leishmanial DNA in vector sand-flies, may threaten the maintenance of post-elimination phase. Emphasis should be given for elimination of pathogen to prevent resurgence of VL epidemics.
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Affiliation(s)
| | - Ashif Ali Sardar
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Pabitra Saha
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
- Department of Zoology, P. R. Thakur Govt. College, Thakurnagar, West Bengal, India
| | - Moytrey Chatterjee
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Kingsuk Jana
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Anwesha Samanta
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
| | - Dipankar Maji
- Department of Health and Family Welfare, Government of West Bengal, Swasthya Bhavan, Kolkata, West Bengal, India
| | - Prasanta Biswas
- Department of Health and Family Welfare, Government of West Bengal, Swasthya Bhavan, Kolkata, West Bengal, India
| | - Rahul Bhattacharya
- Department of Statistics, University of Calcutta, Kolkata, West Bengal, India
| | - Ardhendu Kumar Maji
- Department of Microbiology, School of Tropical Medicine, Kolkata, West Bengal, India
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Liu J, Zhou Z, Zhang X, Huang L, Luo Z, Chen S, Zhang Y, Li S. [Construction of an evaluation index system for the capability of comprehensive control of mountain - type zoonotic visceral leishmaniasis based on the One Health concept]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2024; 35:545-556. [PMID: 38413015 DOI: 10.16250/j.32.1374.2023176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
OBJECTIVE To construct an evaluation index system for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept, so as to provide insights into the control and elimination of mountain-type zoonotic visceral leishmaniasis using the One Health approach. METHODS A preliminary evaluation index system was constructed based on literature review, panel discussions and field surveys. Thirty-three experts were selected from 7 provincial disease control and prevention centers in Beijing Municipality, Hebei Province, Shanxi Province, Henan Province, Sichuan Province, Shaanxi Province and Gansu Province where mountain-type zoonotic visceral leishmaniasis was endemic, and two rounds of expert consultations were conducted to screen the indicators. The positive coefficient, degree of concentration, degree of coordination, and authority of the experts were calculated, and the normalized weights of each index were calculated with the analytic hierarchy process. RESULTS The response rates of questionnaires during two rounds of expert consultation were both 100.00% (33/33), and the authority coefficients of the experts were 0.86 and 0.88, respectively. The coefficients of coordination among experts on the rationality, importance, and operability of the indicators were 0.392, 0.437, 0.258, and 0.364, 0.335, 0.263, respectively (all P values < 0.05). Following screening, the final evaluation index system included 3 primary indicators, 17 secondary indicators, and 50 tertiary indicators. The normalized weights of primary indicators "external environment", "internal support" and "comprehensive control" were 16.98%, 38.73% and 44.29%, respectively. Among the secondary indicators of the primary indicator "external environment", the highest weight was seen for natural environment (66.67%), and among the secondary indicators of the primary indicator "internal support", the lowest weight was seen for the scientific research for visceral leishmaniasis control (8.26%), while other indicators had weights of 12.42% to 13.38%. Among the secondary indicators of the primary indicator "comprehensive control", the weight was 16.67% for each indicator. CONCLUSIONS An evaluation index system has been constructed for the capability of comprehensive control of mountain-type zoonotic visceral leishmaniasis based on the One Health concept. In addition to assessment of the effect of conventional mountain-type zoonotic visceral leishmaniasis control measures, this index system integrates the importance of top-level design, organizational management, and implementation of control measures, and includes indicators related to multi-sectoral cooperation.
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Affiliation(s)
- J Liu
- School of Global Health, Chinese Center for Tropical Diseases Research and Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- One Health Center, Shanghai Jiao Tong University and The University of Edinburgh, Shanghai 200025, China
- Co-first authors
| | - Z Zhou
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
- Co-first authors
| | - X Zhang
- School of Global Health, Chinese Center for Tropical Diseases Research and Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- One Health Center, Shanghai Jiao Tong University and The University of Edinburgh, Shanghai 200025, China
| | - L Huang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Z Luo
- Beijing Center for Disease Control and Prevention, China
| | - S Chen
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - Y Zhang
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
| | - S Li
- School of Global Health, Chinese Center for Tropical Diseases Research and Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- One Health Center, Shanghai Jiao Tong University and The University of Edinburgh, Shanghai 200025, China
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), National Health Commission Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, National Center for International Research on Tropical Diseases, Shanghai 200025, China
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Kumar S, Bodhale N, Patra SK, Sarode A, Zhao L, Sarkar A, Saha B. Interleukin-7 potentiates MAPK10-elicited host-protective vaccine against Leishmania donovani. Cytokine 2024; 174:156475. [PMID: 38134556 DOI: 10.1016/j.cyto.2023.156475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/29/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023]
Abstract
Leishmania donovani causes the potentially fatal disease visceral leishmaniasis for which neither a vaccine nor an adjuvant for human use exists. Although interleukin-7 (IL-7) is implicated in CD4+ T-cell response stabilization, its anti-leishmanial function is uncertain. Therefore, we examined whether IL-7 would potentiate the efficacy of Leishmania major-expressed MAPK10 (LmjMAPK10; M10)-elicited anti-leishmanial host-protective response. We observed that aligning with IL-7R expression, IL-7 increased IFN-γ-secreting TH1 cell but reduced IL-4-producing TH2 cells and production of IL-10 and TGF-β effectuating anti-leishmanial functions in susceptible BALB/c mouse-derived macrophages. Co-culturing IL-7-pre-treated L. donovani-infected macrophages with L. donovani-infected BALB/c-derived T cells induced IFN-γ-dominated TH1 type anti-leishmanial function. IL-7 treatment of L. donovani-infected BALB/c mice significantly reduced splenic and hepatic parasite loads. Co-culturing CD4+ T cells from IL to 7-treated mice with L. donovani-infected macrophages reduced amastigote numbers suggesting IL-7-elicited host-protective effector T cells. Priming BALB/c with M10 + IL-7 reduced the splenic parasite burden more effectively than that was observed in M10-primed mice. An enhanced protection against L. donovani infection was accompanied by enhanced IL-12 and IFN-γ, but suppressed IL-10 and IL-4, response and host-protective TH1 and memory T cells. These results indicate IL-7-induced leishmanial antigen-specific memory T cell response that protects a susceptible host against L. donovani infection.
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Affiliation(s)
- Sunil Kumar
- National Centre for Cell Science, Ganeshkhind, Pune 411007. India
| | - Neelam Bodhale
- National Centre for Cell Science, Ganeshkhind, Pune 411007. India
| | | | - Aditya Sarode
- National Centre for Cell Science, Ganeshkhind, Pune 411007. India
| | - Ling Zhao
- Ling Zhao, Huazhong Agricultural University, Wuhan 430070, China
| | - Arup Sarkar
- Trident Academy of Creative Technology, Bhubaneswar 751024. India
| | - Bhaskar Saha
- National Centre for Cell Science, Ganeshkhind, Pune 411007. India; Trident Academy of Creative Technology, Bhubaneswar 751024. India.
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Clasta RB, Rivas AV, Souza AB, Dos Santos AGV, Le Quesne AHM, Gonçalves AAM, Cangussu ASR, Giunchetti RC, Viana KF. LaSap vaccine: Immunotherapy and immunochemotherapy associated with allopurinol in dogs naturally infected with Leishmania infantum. Parasite Immunol 2024; 46:e13028. [PMID: 38389494 DOI: 10.1111/pim.13028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/22/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024]
Abstract
Canine visceral leishmaniasis is a parasitic zoonosis that has a profound impact on public health in countries where it is endemic. Chemotherapeutic treatments cannot keep dogs stable for long periods, and the risk of generating parasitic resistance must be considered. Forty-four symptomatic and naturally infected dogs with Leishmania infantum were tested with two treatment protocols (i) immunotherapy with LaSap vaccine and (ii) immunochemotherapy with LaSap vaccine plus allopurinol. At 90 days after the end of the treatment, it was verified that, although both protocols had generated significant clinical improvements with a greater production of IFN-γ/IL-10, in relation to the parasite load, mainly in the skin, the dogs treated only with immunotherapy maintained the same profile. These results indicate that LaSap is a good strategy to control dog parasitism.
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Affiliation(s)
- Ricardo B Clasta
- Vaccine Development Technology Laboratory, Latin American Institute of Life and Nature Sciences, Federal University of Latin American Integration, Foz do Iguaçu, Brazil
| | - Açucena Veleh Rivas
- Vaccine Development Technology Laboratory, Latin American Institute of Life and Nature Sciences, Federal University of Latin American Integration, Foz do Iguaçu, Brazil
- Department of Clinical Analysis, Center for Tropical Medicine, Foz do Iguaçu, Brazil
| | - Adrieli Barboza Souza
- Vaccine Development Technology Laboratory, Latin American Institute of Life and Nature Sciences, Federal University of Latin American Integration, Foz do Iguaçu, Brazil
| | - Angelo G V Dos Santos
- Vaccine Development Technology Laboratory, Latin American Institute of Life and Nature Sciences, Federal University of Latin American Integration, Foz do Iguaçu, Brazil
| | - Andrés Hernán Mojoli Le Quesne
- Vaccine Development Technology Laboratory, Latin American Institute of Life and Nature Sciences, Federal University of Latin American Integration, Foz do Iguaçu, Brazil
- Department of Medicine, Catholic University of Alto Paraná, Ciudad del Este, Paraguay
| | - Ana Alice Maia Gonçalves
- Laboratory of Biology of Cellular Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Alex Sander R Cangussu
- Department of Bioprocess Engineering and Biotechnology, Federal University of Tocantins, Gurupi, Brazil
| | - Rodolfo C Giunchetti
- Laboratory of Biology of Cellular Interactions, Department of Morphology, Institute of Biological Sciences, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Kelvinson F Viana
- Vaccine Development Technology Laboratory, Latin American Institute of Life and Nature Sciences, Federal University of Latin American Integration, Foz do Iguaçu, Brazil
- Department of Research, Development and Innovation, Devax Biotechnology for Health, Foz do Iguaçu, Brazil
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Subramanian S, Maheswari RU, Prabavathy G, Khan MA, Brindha B, Srividya A, Kumar A, Rahi M, Nightingale ES, Medley GF, Cameron MM, Roy N, Jambulingam P. Modelling spatiotemporal patterns of visceral leishmaniasis incidence in two endemic states in India using environment, bioclimatic and demographic data, 2013-2022. PLoS Negl Trop Dis 2024; 18:e0011946. [PMID: 38315725 PMCID: PMC10868833 DOI: 10.1371/journal.pntd.0011946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 02/15/2024] [Accepted: 01/26/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND As of 2021, the National Kala-azar Elimination Programme (NKAEP) in India has achieved visceral leishmaniasis (VL) elimination (<1 case / 10,000 population/year per block) in 625 of the 633 endemic blocks (subdistricts) in four states. The programme needs to sustain this achievement and target interventions in the remaining blocks to achieve the WHO 2030 target of VL elimination as a public health problem. An effective tool to analyse programme data and predict/ forecast the spatial and temporal trends of VL incidence, elimination threshold, and risk of resurgence will be of use to the programme management at this juncture. METHODOLOGY/PRINCIPAL FINDINGS We employed spatiotemporal models incorporating environment, climatic and demographic factors as covariates to describe monthly VL cases for 8-years (2013-2020) in 491 and 27 endemic and non-endemic blocks of Bihar and Jharkhand states. We fitted 37 models of spatial, temporal, and spatiotemporal interaction random effects with covariates to monthly VL cases for 6-years (2013-2018, training data) using Bayesian inference via Integrated Nested Laplace Approximation (INLA) approach. The best-fitting model was selected based on deviance information criterion (DIC) and Watanabe-Akaike Information Criterion (WAIC) and was validated with monthly cases for 2019-2020 (test data). The model could describe observed spatial and temporal patterns of VL incidence in the two states having widely differing incidence trajectories, with >93% and 99% coverage probability (proportion of observations falling inside 95% Bayesian credible interval for the predicted number of VL cases per month) during the training and testing periods. PIT (probability integral transform) histograms confirmed consistency between prediction and observation for the test period. Forecasting for 2021-2023 showed that the annual VL incidence is likely to exceed elimination threshold in 16-18 blocks in 4 districts of Jharkhand and 33-38 blocks in 10 districts of Bihar. The risk of VL in non-endemic neighbouring blocks of both Bihar and Jharkhand are less than 0.5 during the training and test periods, and for 2021-2023, the probability that the risk greater than 1 is negligible (P<0.1). Fitted model showed that VL occurrence was positively associated with mean temperature, minimum temperature, enhanced vegetation index, precipitation, and isothermality, and negatively with maximum temperature, land surface temperature, soil moisture and population density. CONCLUSIONS/SIGNIFICANCE The spatiotemporal model incorporating environmental, bioclimatic, and demographic factors demonstrated that the KAMIS database of the national programmme can be used for block level predictions of long-term spatial and temporal trends in VL incidence and risk of outbreak / resurgence in endemic and non-endemic settings. The database integrated with the modelling framework and a dashboard facility can facilitate such analysis and predictions. This could aid the programme to monitor progress of VL elimination at least one-year ahead, assess risk of resurgence or outbreak in post-elimination settings, and implement timely and targeted interventions or preventive measures so that the NKAEP meet the target of achieving elimination by 2030.
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Affiliation(s)
| | | | | | | | - Balan Brindha
- ICMR-Vector Control Research Centre, Indira Nagar, Puducherry, India
| | | | - Ashwani Kumar
- ICMR-Vector Control Research Centre, Indira Nagar, Puducherry, India
| | - Manju Rahi
- ICMR-Vector Control Research Centre, Indira Nagar, Puducherry, India
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research, New Delhi, India
| | - Emily S Nightingale
- Centre for Mathematical Modelling of Infectious Disease and Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Graham F Medley
- Centre for Mathematical Modelling of Infectious Disease and Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Mary M Cameron
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Nupur Roy
- National Centre for Vector-Borne Diseases Control, Ministry of Health and Family Welfare, Government of India, New Delhi
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Joshi AB, Banjara MR, Das ML, Ghale P, Pant KR, Pyakurel UR, Dahal G, Paudel KP, Das CL, Kroeger A, Aseffa A. Epidemiological, Serological, and Entomological Investigation of New Visceral Leishmaniasis Foci in Nepal. Am J Trop Med Hyg 2024; 110:44-51. [PMID: 38011729 DOI: 10.4269/ajtmh.23-0373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 09/15/2023] [Indexed: 11/29/2023] Open
Abstract
The aim of this study was to explore epidemiological, serological, entomological, and social aspects of visceral leishmaniasis (VL) in new foci in Nepal. The study was conducted in 11 villages of five districts that had been previously free of VL but that reported new cases between 2019 and 2021. We screened 1,288 inhabitants using rK39 tests and investigated the epidemiological and clinical characteristics of 12 recent VL cases. A total of 182 community members were interviewed about knowledge, attitude, and practices regarding VL. They then underwent an awareness training; 40 of them had a second interview at 6 months to assess the training impact. Vector surveys were conducted in six houses per village to assess sandfly density and infection rates. The prevalence of VL infection was 0.5% and 3.2% among screened populations in Dolpa and Kavre districts, respectively, while the other districts had no rK39-positive cases. No association between travel history and VL infection was found. Phlebotomus argentipes sandflies were collected in three districts at high altitudes (from 1,084 to 4,450 m). None of the sandflies captured had Leishmania donovani DNA. People in new foci were not aware of VL symptoms, vectors, or preventive measures. The training significantly improved their knowledge and practice in seeking medical care in case of illness. The epidemiological, serological, and entomological investigations suggest indigenous focal transmission of VL. An integrated package of strategic interventions should be implemented by the national VL elimination program in districts with new VL foci.
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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, 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
| | - Pragyan Ghale
- 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, 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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10
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Zheng L, Wu X, Liu Y. [Current prevalence and control strategies of visceral leishmaniasis in Sichuan Province: A review]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2024; 35:646-650. [PMID: 38413028 DOI: 10.16250/j.32.1374.2023150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Visceral leishmaniasis is a parasitic disease transmitted by Phlebotomus chinensis that poses a great threat to human health. Historically, visceral leishmaniasis was predominantly prevalent in northwestern regions of Sichuan Province. Following the founding of the People's Republic of China, large-scale integrated interventions had been implemented in visceral leishmaniasis-endemic areas of Sichuan Province, including identification and treatment of visceral leishmaniasis patients, elimination of infected dogs, Ph. chinensis control and health education. This review summarizes the prevalence of visceral leishmaniasis, discusses the control strategy of visceral leishmaniasis and analyzes the challenges of elimination of visceral leishmaniasis based on the One Health concept in Sichuan Province, so as to provide insights into elimination of visceral leishmaniasis in the province.
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Affiliation(s)
- L Zheng
- School of Public Health, Chengdu Medical College, Chengdu, Sichuan 610500, China
| | - X Wu
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China
| | - Y Liu
- Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China
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11
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Sádlová J, Yeo M, Mateus DS, Phelan J, Hai LA, Bhattacharyya T, Kurtev S, Sebesta O, Myskova J, Seblova V, Andersson B, Florez de Sessions P, Volf P, Miles MA. Comparative genomics of Leishmania donovani progeny from genetic crosses in two sand fly species and impact on the diversity of diagnostic and vaccine candidates. PLoS Negl Trop Dis 2024; 18:e0011920. [PMID: 38295092 PMCID: PMC10830044 DOI: 10.1371/journal.pntd.0011920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 01/15/2024] [Indexed: 02/02/2024] Open
Abstract
Sand fly transmitted Leishmania species are responsible for severe, wide ranging, visceral and cutaneous leishmaniases. Genetic exchange can occur among natural Leishmania populations and hybrids can now be produced experimentally, with limitations. Feeding Phlebotomus orientalis or Phlebotomus argentipes on two strains of Leishmania donovani yielded hybrid progeny, selected using double drug resistance and fluorescence markers. Fluorescence activated cell sorting of cultured clones derived from these hybrids indicated diploid progeny. Multilocus sequence typing of the clones showed hybridisation and nuclear heterozygosity, although with inheritance of single haplotypes in a kinetoplastid target. Comparative genomics showed diversity of clonal progeny between single chromosomes, and extraordinary heterozygosity across all 36 chromosomes. Diversity between progeny was seen for the HASPB antigen, which has been noted previously as having implications for design of a therapeutic vaccine. Genomic diversity seen among Leishmania strains and hybrid progeny is of great importance in understanding the epidemiology and control of leishmaniasis. As an outcome of this study we strongly recommend that wider biological archives of different Leishmania species from endemic regions should be established and made available for comparative genomics. However, in parallel, performance of genetic crosses and genomic comparisons should give fundamental insight into the specificity, diversity and limitations of candidate diagnostics, vaccines and drugs, for targeted control of leishmaniasis.
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Affiliation(s)
- Jovana Sádlová
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Matthew Yeo
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London United Kingdom
| | - David S. Mateus
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London United Kingdom
| | - Jody Phelan
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London United Kingdom
| | - Le Anh Hai
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London United Kingdom
| | - Tapan Bhattacharyya
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London United Kingdom
| | - Stefan Kurtev
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London United Kingdom
| | - Ondrej Sebesta
- Laboratory of Confocal and Fluorescence Microscopy, Faculty of Science, Charles University, Prague, Czech Republic
| | - Jitka Myskova
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Veronika Seblova
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Björn Andersson
- Department of Cell and Molecular Biology, Karolinska Institute, Stockholm, Sweden
| | - Paola Florez de Sessions
- Genome Institute of Singapore, Biomedical Sciences Institutes, Agency for Science, Technology and Research, Singapore
| | - Petr Volf
- Department of Parasitology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Michael A. Miles
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London United Kingdom
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12
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Kumar P, Kumar P, Shrivastava A, Dar MA, Lokhande KB, Singh N, Singh A, Velayutham R, Mandal D. Immunoinformatics-based multi-epitope containing fused polypeptide vaccine design against visceral leishmaniasis with high immunogenicity and TLR binding. Int J Biol Macromol 2023; 253:127567. [PMID: 37866569 DOI: 10.1016/j.ijbiomac.2023.127567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 10/24/2023]
Abstract
Visceral leishmaniasis (VL) is the most lethal among all leishmaniasis diseases and remains categorized as a neglected tropical disease (NTD). This study aimed to develop a peptide-based multi-epitope vaccine construct against VL using immunoinformatics methodologies. To achieve this, four distinct proteins were screened to identify peptides consisting of 9-15 amino acids with high binding affinity to toll-like receptors (TLRs), strong antigenicity, low allergenicity, and minimal toxicity. The resulting multi-epitope vaccine construct was fused in a tandem arrangement with appropriate linker peptides and exhibited superior properties related to cytotoxic T lymphocytes (CTLs), helper T lymphocytes (HTLs), and B-cell epitopes. Subsequently, a three-dimensional (3D) model of the vaccine construct was generated, refined, and validated for structural stability and immune response capabilities. Molecular docking and simulations confirmed the vaccine construct's stability and binding affinities with TLRs, with TLR4 displaying the highest binding affinity, followed by TLR2 and TLR3. Additionally, simulations predicted robust cellular and humoral antibody-mediated immune responses elicited by the designed vaccine construct. Notably, this vaccine construct includes proteins from various pathways of Leishmania donovani (LD), which have not been previously utilized in VL vaccine design. Thus, this study opens new avenues for the development of vaccines against diverse protozoan diseases.
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Affiliation(s)
- Pawan Kumar
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur-Vaishali, Bihar 844102, India
| | - Prakash Kumar
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur-Vaishali, Bihar 844102, India
| | - Ashish Shrivastava
- Translational Bioinformatics and Computational Genomics Research Lab, Department of Life Sciences, Shiv Nadar Institution of Eminence, Gautam Buddha Nagar, UP, India
| | - Mukhtar Ahmad Dar
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur-Vaishali, Bihar 844102, India
| | - Kiran Bharat Lokhande
- Translational Bioinformatics and Computational Genomics Research Lab, Department of Life Sciences, Shiv Nadar Institution of Eminence, Gautam Buddha Nagar, UP, India
| | - Nidhi Singh
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER) Ahmedabad, India
| | - Ashutosh Singh
- Translational Bioinformatics and Computational Genomics Research Lab, Department of Life Sciences, Shiv Nadar Institution of Eminence, Gautam Buddha Nagar, UP, India
| | - Ravichandiran Velayutham
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur-Vaishali, Bihar 844102, India; National Institute of Pharmaceutical Education and Research (NIPER) Kolkata, India
| | - Debabrata Mandal
- Department of Biotechnology, National Institute of Pharmaceutical Education and Research (NIPER) Hajipur-Vaishali, Bihar 844102, India.
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13
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Siewe N, Friedman A. Treatment of leishmaniasis with chemotherapy and vaccine: a mathematical model. J Biol Dyn 2023; 17:2257746. [PMID: 37733407 DOI: 10.1080/17513758.2023.2257746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 09/05/2023] [Indexed: 09/22/2023]
Abstract
Leishmaniasis, an infectious disease, manifests itself mostly in two forms, cutaneous leishmaniasis (CL) and, a more severe and potentially deadly form, visceral leishmaniasis (VL). The current control strategy for leishmaniasis relies on chemotherapy drugs such as sodium antimony gluconate (SAG) and meglumine antimoniate (MA). However, all these chemotherapy compounds have poor efficacy, and they are associated with toxicity and other adverse effects, as well as drug resistance. While research in vaccine development for leishmaniasis is continuously progressing, no vaccine is currently available. However, some experimental vaccines such as LEISH-F1+MPL-SE (V) have demonstrated some efficacy when used as drugs for CL patients. In this paper we use a mathematical model to address the following question: To what extent vaccine shots can enhance the efficacy of standard chemotherapy treatment of leishmaniasis? Starting with standard MA treatment of leishmaniasis and combining it with three injections of V , we find, by Day 84, that efficacy increased from 29% to 65-91% depending on the amount of the vaccine. With two or just one injection of V , efficacy is still very high, but there is a definite resurgence of the disease by end-time.
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Affiliation(s)
- Nourridine Siewe
- School of Mathematical Sciences, College of Science, Rochester Institute of Technology, Rochester, NY, USA
| | - Avner Friedman
- Department of Mathematics, The Ohio State University, Columbus, OH, USA
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14
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Vlassoff C, Giron N, Vera Soto MJ, Maia-Elkhoury ANS, Lal A, Castellanos LG, Almeida G, Lim C. Ensuring access to essential health products: Lessons from Colombia's leishmaniasis control and elimination initiative. PLoS Negl Trop Dis 2023; 17:e0011752. [PMID: 38039275 PMCID: PMC10691678 DOI: 10.1371/journal.pntd.0011752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/27/2023] [Indexed: 12/03/2023] Open
Abstract
BACKGROUND This paper identifies opportunities and challenges for leishmaniasis control and elimination in Colombia, emphasizing the role of pooled procurement of essential medicines and supplies. Colombia is among the countries most affected by leishmaniasis globally, and also faces the dual challenge of procuring critically needed medicines in the context of limited national resources. It recently renewed its commitment to the control and elimination of leishmaniasis under its 2022-2031 Public Health Plan (PDSP) through a comprehensive public health approach. METHODOLOGY/PRINCIPAL FINDINGS The methodology comprises a comprehensive literature review and key informant interviews with leishmaniasis experts from the Colombian national control program and PAHO/WHO, focusing on cutaneous, mucocutaneous, and visceral leishmaniasis. Leishmaniasis is endemic throughout Colombia, with over 11 million people at risk, many of whom live in poverty-stricken, remote and isolated rural areas with limited access to health services. Leishmaniasis care, including medicines, is provided free of charge, but many barriers were nonetheless identified at environmental, population, and health system levels, including the supply of quality-assured medicines. Opportunities to alleviate these barriers were identified, including the support of the PAHO Strategic Fund. Within the context of the sustainable development goals and international leishmaniasis control and elimination targets, Colombian officials have established their own priorities, the highest of which is the reduction of deaths from visceral leishmaniasis. CONCLUSIONS/SIGNIFICANCE The elimination of leishmaniasis as a public health problem presents significant challenges, given its biological complexity and diversity, physical and clinical manifestations, social and economic impacts, frequently burdensome treatment regimens, and insufficient supply of necessary medicines. However, rigorous prevention and control efforts through strong political commitment and a highly motivated workforce can dramatically reduce its burden. Colombia's new PDSP, which highlights leishmaniasis control, is an opportunity for a revitalized health system response through committed leadership, intersectoral actions, and partnerships with international organizations that share a common vision.
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Affiliation(s)
- Carol Vlassoff
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Nora Giron
- Strategic Fund, Pan American Health Organization, Washington, DC, United States of America
| | - Mauricio Javier Vera Soto
- Subdireccion de enfermedades transmisibles, Ministerio de Salud y Protección Social, Bogotá, Colombia
| | | | - Arush Lal
- Strategic Fund, Pan American Health Organization, Washington, DC, United States of America
| | - Luis Gerardo Castellanos
- Neglected, Tropical and Vector-Borne Diseases Unit, Pan American Health Organization, Washington, DC, United States of America
| | - Gisele Almeida
- Department of Health Systems and Services, Pan American Health Organization, Washington, DC, United States of America
| | - Christopher Lim
- Strategic Fund, Pan American Health Organization, Washington, DC, United States of America
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15
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Diriba WW, Gebremedhin EZ. Assessment of knowledge, attitude, and practices towards canine visceral leishmaniasis based on the one health concept in Weliso and Ejaji Towns, Oromia, Ethiopia. Sci Rep 2023; 13:20765. [PMID: 38007526 PMCID: PMC10676349 DOI: 10.1038/s41598-023-47340-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/12/2023] [Indexed: 11/27/2023] Open
Abstract
Canine visceral leishmaniasis (CVL) is a significant vector-borne Meta zoonotic disease caused by agents of the L. donovani complex. The disease is transmitted by the bite of phlebotomine female sandflies of the genera Phlebotomus and Lutzomyia in the old and new worlds, respectively. This study was conducted to assess the knowledge, attitude, and practices of the residents about CVL based on the One Health concept in two towns of the Oromia Region, Ethiopia. A community-based cross-sectional study was conducted between October 2019 and September 2020, using an interview questionnaire as the study instrument. The study participants were selected through a simple random sampling method. Pearson's Chi-square and logistic regression tests were used to evaluate the association between the study participants' knowledge, attitude, and practices toward CVL and possible risk factors. The study included a total of 400 participants, and the results indicated that 77.25% had good knowledge, 60.5% had a favorable attitude, and 59.25% had good practices toward CVL. The town of Ejaji and dog ownership were significantly associated with good knowledge (p = 0.001), and attitude (p = 0.001) towards CVL, while having a dog (p = 0.001), having a diploma (p = 0.019) or degree and above (0.018), being divorced or widowed (0.012), and being Oromo (p = 0.013) were all significantly associated with good CVL practice. Most participants in both study areas had good knowledge but moderate attitudes and practices toward CVL. Therefore, it is crucial to undertake comprehensive community health education and awareness programs of zoonotic visceral leishmaniasis and its vectors based on the One Health concept through various means.
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Affiliation(s)
- Weraka Weya Diriba
- Department of Resource Development and Income Generation Directorate, Ambo University, Main Campus, P. O. Box 19, Ambo, Ethiopia.
| | - Endrias Zewdu Gebremedhin
- School of Veterinary Medicine, Department of Veterinary Sciences, Ambo University, Mamo Mezemir Campus, P. O. Box 19, Ambo, Ethiopia
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16
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Kaye PM, Matlashewski G, Mohan S, Le Rutte E, Mondal D, Khamesipour A, Malvolti S. Vaccine value profile for leishmaniasis. Vaccine 2023; 41 Suppl 2:S153-S175. [PMID: 37951693 DOI: 10.1016/j.vaccine.2023.01.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 12/22/2022] [Accepted: 01/24/2023] [Indexed: 11/14/2023]
Abstract
Leishmania infections are global, occurring in 98 countries and all World Health Organization (WHO) regions with 600 million to 1 billion people at risk of infection. Visceral leishmaniasis is associated with almost 20,000 reported deaths annually, with children under 5 years of age being at the greatest risk of mortality. Amongst WHO-recognised Neglected Tropical Diseases (NTDs), leishmaniasis is one of the most important in terms of mortality and morbidity. With an increasing global burden of disease and a growing threat from climate change, urbanisation and drug resistance, there remains an imperative to develop leishmaniasis vaccines. New tools to understand correlates of protection and to assess vaccine efficacy are being developed to ease the transition into larger scale efficacy trials or provide alternate routes to licensure. Early indications suggest a diverse portfolio of manufacturers exists in endemic countries with an appetite to develop leishmaniasis vaccines. This Vaccine Value Profile (VVP) provides a high-level, comprehensive assessment of the currently available data to inform the potential public health, economic, and societal value of leishmaniasis vaccines. The leishmaniasis VVP was developed by a working group of subject matter experts from academia, public health groups, policy organizations, and non-profit organizations. All contributors have extensive expertise on various elements of the leishmaniasis VVP and have collectively described the state of knowledge and identified the current gaps. The VVP was developed using only existing and publicly available information.
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Affiliation(s)
- Paul M Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, York, UK.
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada.
| | - Sakshi Mohan
- Center for Health Economics (CHE), University of York, York, UK.
| | - Epke Le Rutte
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Dinesh Mondal
- Laboratory Sciences and Services Division, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh.
| | - Ali Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran.
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17
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Joshi AB, Banjara MR, Chuke S, Kroeger A, Jain S, Aseffa A, Reeder JC. Assessment of the impact of implementation research on the Visceral Leishmaniasis (VL) elimination efforts in Nepal. PLoS Negl Trop Dis 2023; 17:e0011714. [PMID: 37943733 PMCID: PMC10635428 DOI: 10.1371/journal.pntd.0011714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023] Open
Abstract
Nepal, Bangladesh, and India signed a Memorandum of Understanding (MoU) in 2005 to eliminate visceral leishmaniasis (VL) as a public health problem from the Indian subcontinent by 2015. By 2021, the number of reported VL cases in these countries had declined by over 95% compared to 2007. This dramatic success was achieved through an elimination programme that implemented early case detection and effective treatment, vector control, disease surveillance, community participation, and operational research that underpinned these strategies. The experience offered an opportunity to assess the contribution of implementation research (IR) to VL elimination in Nepal. Desk review and a stakeholder workshop was conducted to analyse the relationship between key research outputs, major strategic decisions in the national VL elimination programme, and annual number of reported new cases over time between 2005 and 2023. The results indicated that the key decisions across the strategic elements, throughout the course of the elimination programme (such as on the most appropriate tools for diganostics and treatment, and on best strategies for case finding and vector management), were IR informed. IR itself responded dynamically to changes that resulted from interventions, addressing new questions that emerged from the field. Close collaboration between researchers, programme managers, and implementers in priority setting, design, conduct, and review of studies facilitated uptake of evidence into policy and programmatic activities. VL case numbers in Nepal are now reduced by 90% compared to 2005. Although direct attribution of disease decline to research outputs is difficult to establish, the Nepal experience demonstrates that IR can be a critical enabler for disease elimination. The lessons can potentially inform IR strategies in other countries with diseases targeted for elimination.
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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, Nepal
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland
| | - Sachi Chuke
- Public Health and Infectious Disease Research Center (PHIDReC), Kathmandu, Nepal
| | - Axel Kroeger
- Freiburg University, Centre for Medicine and Society, Freiburg, Germany
| | - Saurabh Jain
- Department of Control of Neglected Tropical Diseases, WHO, Geneva, Switzerland
| | - Abraham Aseffa
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland
| | - John C. Reeder
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland
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18
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Reid E, Deb RM, Ali A, Singh RP, Mishra PK, Shepherd J, Singh AM, Bharti A, Singh C, Sharma S, Coleman M, Weetman D. Molecular surveillance of insecticide resistance in Phlebotomus argentipes targeted by indoor residual spraying for visceral leishmaniasis elimination in India. PLoS Negl Trop Dis 2023; 17:e0011734. [PMID: 37939123 PMCID: PMC10659200 DOI: 10.1371/journal.pntd.0011734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 11/20/2023] [Accepted: 10/17/2023] [Indexed: 11/10/2023] Open
Abstract
Molecular surveillance of resistance is an increasingly important part of vector borne disease control programmes that utilise insecticides. The visceral leishmaniasis (VL) elimination programme in India uses indoor residual spraying (IRS) with the pyrethroid, alpha-cypermethrin to control Phlebotomus argentipes the vector of Leishmania donovani, the causative agent of VL. Prior long-term use of DDT may have selected for knockdown resistance (kdr) mutants (1014F and S) at the shared DDT and pyrethroid target site, which are common in India and can also cause pyrethroid cross-resistance. We monitored the frequency of these marker mutations over five years from 2017-2021 in sentinel sites in eight districts of north-eastern India covered by IRS. Frequencies varied markedly among the districts, though finer scale variation, among villages within districts, was limited. A pronounced and highly significant increase in resistance-associated genotypes occurred between 2017 and 2018, but with relative stability thereafter, and some reversion toward more susceptible genotypes in 2021. Analyses linked IRS with mutant frequencies suggesting an advantage to more resistant genotypes, especially when pyrethroid was under-sprayed in IRS. However, this advantage did not translate into sustained allele frequency changes over the study period, potentially because of a relatively greater net advantage under field conditions for a wild-type/mutant genotype than projected from laboratory studies and/or high costs of the most resistant genotype. Further work is required to improve calibration of each 1014 genotype with resistance, preferably using operationally relevant measures. The lack of change in resistance mechanism over the span of the study period, coupled with available bioassay data suggesting susceptibility, suggests that resistance has yet to emerge despite intensive IRS. Nevertheless, the advantage of resistance-associated genotypes with IRS and under spraying, suggest that measures to continue monitoring and improvement of spray quality are vital, and consideration of future alternatives to pyrethroids for IRS would be advisable.
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Affiliation(s)
- Emma Reid
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | | | | | | | | | | | | | | | | | - Michael Coleman
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - David Weetman
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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19
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Saha D, Nath Jha A. Computational multi-target approach to target essential enzymes of Leishmania donovani using comparative molecular dynamic simulations and MMPBSA analysis. Phytochem Anal 2023; 34:842-854. [PMID: 36760044 DOI: 10.1002/pca.3213] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/13/2023] [Accepted: 01/26/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Visceral leishmaniasis (VL) is caused by Leishmania donovani. The purine and pyrimidine pathways are essential for L. donovani. Simultaneously inhibiting multiple targets could be an effective strategy to eliminate the pathogen and treat VL. OBJECTIVE We aimed to target the essential enzymes of L. donovani and inhibit them using a multi-target approach. MATERIALS AND METHODS A systematic analytical method was followed, in which first reported inhibitors of two essential enzymes (adenine phosphoribosyl-transferase [APRT] and dihydroorotate dehydrogenase [DHODH]) were collected and then ADMET and PASS analyses were conducted using the Lipinski rule and Veber's rule. Additionally, molecular docking between screened ligands and proteins were performed. The stability of complexes was analyzed using molecular dynamics (MD) simulations and MMPBSA analysis. RESULTS Initially, 6,220 unique molecules were collected from the PubChem database, and then the Lipinski rule and Veber's rule were used for screening. In total, 203 compounds passed the ADMET test; their antileishmanial properties were tested by PASS analysis. As a result, 15 ligands were identified. Molecular docking simulations between APRT or DHODH and these 15 ligands were performed. Four molecules were found to be plant-derived compounds. Lig_2 and Lig_3 had good docking scores with both proteins. MD simulations were performed to determine the dynamic behavior and binding patterns of complexes. Both MD simulations and MMPBSA analysis showed Lig_3 is a promising antileishmanial inhibitor of both targets. CONCLUSION Promising plant-derived compounds that might be used to combat VL were obtained through a multi-target approach.
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Affiliation(s)
- Debanjan Saha
- Computational Biophysics Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam, India
| | - Anupam Nath Jha
- Computational Biophysics Laboratory, Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam, India
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Martschew E, Al-Aghbari AA, Joshi AB, Kroeger A, Paudel KP, Dahal G, Pyakurel UR, Diaz-Monsalve S, Banjara MR. Visceral leishmaniasis in new foci areas of Nepal: Sources and extent of infection. J Vector Borne Dis 2023; 60:414-420. [PMID: 38174519 DOI: 10.4103/0972-9062.383637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
Background & objectives The successful elimination program of visceral leishmaniasis (VL) in Nepal decreased the incidence to less than 1 per 10,000 population leading to the consolidation phase. However, new VL cases have been recorded from new districts, threatening the elimination goal. This study monitors the geographical spread of VL and identifies potential risk factors. Methods VL data of 2017-2020 were obtained from the Epidemiology and Disease Control Division (EDCD) of Nepal and mapped. Telephonic interviews with 13 VL patients were conducted. Results The incidence maps indicate that VL is spreading to new areas. The target incidence exceeded four times in hilly and twice in mountainous districts. VL cases occurred in 64 of 77 districts in all three regions (mountainous, hilly and Terai). Interviews showed a correlation between travel history (private, commercial and for studies) and the spread of VL cases to new foci. Interpretation & conclusion One major challenge of VL elimination in the maintenance phase is the spread of infection through travelers to new foci areas, which needs to be under continuous surveillance accompanied by vector control activities. This should be confirmed by a large-scale analytical study.
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Affiliation(s)
| | | | - Anand Ballabh Joshi
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Axel Kroeger
- Centre for Medicine and Society, Albert-Ludwigs-University, Freiburg, Germany
| | | | - Gokarna Dahal
- Epidemiology and Disease Control Division, Teku, Kathmandu, Nepal
| | | | - Sonia Diaz-Monsalve
- Centre for Medicine and Society, Albert-Ludwigs-University, Freiburg, Germany
| | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
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21
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Alonso A, Alcolea PJ, Larraga J, Peris MP, Esteban A, Cortés A, Ruiz-García S, Castillo JA, Larraga V. A non-replicative antibiotic resistance-free DNA vaccine delivered by the intranasal route protects against canine leishmaniasis. Front Immunol 2023; 14:1213193. [PMID: 37790927 PMCID: PMC10543895 DOI: 10.3389/fimmu.2023.1213193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/11/2023] [Indexed: 10/05/2023] Open
Abstract
Leishmania infantum is the etiological agent of zoonotic visceral leishmaniasis (ZVL). The disease is endemic in Central and South America, Central and South East Asia, and the Mediterranean basin. Dogs are the main reservoir, with an estimated prevalence of approximately 2.5 million dogs in Southern Europe. Current treatments cause side effects, disease recurrence, and drug resistance. Therefore, the development of vaccines against canine leishmaniasis is necessary. We have generated a DNA vaccine based on the non-replicative antibiotic resistance marker-free plasmid vector pPAL that contains the encoding gene for the L. infantum activated protein kinase C receptor analog (LACK). Homologous pPAL-LACK prime-boost intranasal administration confers efficacious protection in Beagle dogs with a reduction of clinical signs and a statistically significant reduction of the parasite burden in the bone marrow of more than 90% of dogs after experimental infection with highly infective promastigotes. This DNA vaccine elicits a robust cellular immune response skewed towards the Th1 profile.
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Affiliation(s)
- Ana Alonso
- Laboratory of Molecular Parasitology and Vaccines, Department of Cellular and Molecular Biology, Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CIBMS-CSIC), Madrid, Spain
| | - Pedro José Alcolea
- Laboratory of Molecular Parasitology and Vaccines, Department of Cellular and Molecular Biology, Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CIBMS-CSIC), Madrid, Spain
| | - Jaime Larraga
- Laboratory of Molecular Parasitology and Vaccines, Department of Cellular and Molecular Biology, Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CIBMS-CSIC), Madrid, Spain
| | - María Paz Peris
- Laboratory of Parasitology, Department of Animal Pathology, Faculty of Veterinary Science, University of Zaragoza, Zaragoza, Spain
| | - Adriana Esteban
- Laboratory of Parasitology, Department of Animal Pathology, Faculty of Veterinary Science, University of Zaragoza, Zaragoza, Spain
| | - Alberto Cortés
- Laboratory of Parasitology, Department of Animal Pathology, Faculty of Veterinary Science, University of Zaragoza, Zaragoza, Spain
| | - Silvia Ruiz-García
- Laboratory of Molecular Parasitology and Vaccines, Department of Cellular and Molecular Biology, Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CIBMS-CSIC), Madrid, Spain
| | - Juan Antonio Castillo
- Laboratory of Parasitology, Department of Animal Pathology, Faculty of Veterinary Science, University of Zaragoza, Zaragoza, Spain
| | - Vicente Larraga
- Laboratory of Molecular Parasitology and Vaccines, Department of Cellular and Molecular Biology, Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CIBMS-CSIC), Madrid, Spain
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22
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Shahid SK. Recent patents in the treatment and prevention of leishmaniasis. Pharm Pat Anal 2023; 12:237-248. [PMID: 38063376 DOI: 10.4155/ppa-2023-0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Leishmaniasis, a neglected tropical disease, is caused by protozoal parasites of the genus Leishmania. Clinical manifestations vary from asymptomatic to lethal grade depending on the type of the disease. The currently available antileishmanial drugs suffer from considerable limitations. There is a dire need for better and safer drugs and/or vaccines to eradicate this disease. There are enormous developments ongoing in this field. Newer combinations of existing drugs and newer drugs targeting these intracellular parasites as well as their vectors are being tried to control the disease. Attempts to develop vaccines to enhance the immunity of the patient have shown some promise. This article is a peep into the recent patent developments in this field.
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Affiliation(s)
- Sukhbir K Shahid
- Consultant Paediatrician & Paediatric Pulmonologist, Mumbai, 400077, India
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23
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de Freitas Milagres T, López-de-Felipe M, da Silva WJ, Martín-Martín I, Gálvez R, da Silva OS. Same parasite, different outcomes: unraveling the epidemiology of Leishmania infantum infection in Brazil and Spain. Trends Parasitol 2023; 39:774-785. [PMID: 37442747 DOI: 10.1016/j.pt.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023]
Abstract
Human leishmaniosis caused by Leishmania infantum is an important health problem worldwide. One of the main aspects arousing interest is the epidemiological scenario surrounding Le. infantum infection in the New World (NW) and Old World (OW). This parasite was introduced to the Americas during European colonization leading to different epidemiology outcomes, even more enigmatic in the face of global changes. Thus, this review aims to highlight the differences and similarities between Le. infantum epidemiology between Brazil (NW) and Spain (OW), as both countries are leading the total number of leishmaniosis cases in their respective continents. Grounded on a systemic view, this article also draws attention to possible common innovative strategies to rethink ways of controlling infections caused by Le. infantum.
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Affiliation(s)
- Tarcísio de Freitas Milagres
- Flebocollect Medical Entomology Citizen Science Group, Madrid, Spain; Department of Microbiology, Immunology and Parasitology, Universidade Federal Do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Wellington Junior da Silva
- Department of Microbiology, Immunology and Parasitology, Universidade Federal Do Rio Grande do Sul, Porto Alegre, Brazil
| | - Inés Martín-Martín
- Laboratory of Medical Entomology, National Center for Microbiology, Instituto de Salud Carlos III, Madrid, Spain
| | - Rosa Gálvez
- Flebocollect Medical Entomology Citizen Science Group, Madrid, Spain; Department of Specific Didactics, School of Education and Teacher Training, Universidad Autónoma de Madrid, Madrid, Spain.
| | - Onilda Santos da Silva
- Department of Microbiology, Immunology and Parasitology, Universidade Federal Do Rio Grande do Sul, Porto Alegre, Brazil
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24
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Alvar J, Beca-Martínez MT, Argaw D, Jain S, Aagaard-Hansen J. Social determinants of visceral leishmaniasis elimination in Eastern Africa. BMJ Glob Health 2023; 8:e012638. [PMID: 37380365 PMCID: PMC10410987 DOI: 10.1136/bmjgh-2023-012638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/05/2023] [Indexed: 06/30/2023] Open
Abstract
Visceral leishmaniasis is a vector-borne, protozoan disease with severe public health implications. Following the successful implementation of an elimination programme in South Asia, there is now a concerted endeavour to replicate these efforts in Eastern Africa based on the five essential elimination pillars of case management, integrated vector management, effective surveillance, social mobilisation and operational research. This article highlights how key social determinants (SD) of health (poverty, sociocultural factors and gender, housing and clustering, migration and the healthcare system) operate at five different levels (socioeconomic context and position, differential exposure, differential vulnerability, differential outcomes and differential consequences). These SD should be considered within the context of increasing the success of the five-pillar elimination programme and reducing inequity in health.
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Affiliation(s)
- Jorge Alvar
- Social Medicine, Royal Academy of Medicine, Madrid, Spain
| | | | - Daniel Argaw
- Neglected Tropical Diseases, World Health Organization, Geneva, GE, Switzerland
| | - Saurabh Jain
- Neglected Tropical Diseases, World Health Organization, Geneva, GE, Switzerland
| | - Jens Aagaard-Hansen
- Health Promotion, Steno Diabetes Center Copenhagen, Herlev, Capital Region, Denmark
- Health Research, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, Gauteng, South Africa
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25
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Marcolino Silva D, Passarella Teixeira AI, Sierra Romero GA. Socioeconomic Status of Guardians as a Risk Factor for Canine Visceral Leishmaniasis: A Cohort Study in an Endemic Area of the Federal District, Brazil. Am J Trop Med Hyg 2023; 108:328-334. [PMID: 36535251 PMCID: PMC9896338 DOI: 10.4269/ajtmh.21-1170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 07/17/2022] [Indexed: 12/23/2022] Open
Abstract
Current control measures of canine visceral leishmaniasis (CVL), a chronic and fatal zoonosis with potential transmission to humans, are not efficient enough to reduce its spread. The search for improved control measures should include studies of risk factors for infection and illness. This study aimed to identify the risk factors for CVL in an endemic locality of the Federal District, Brazil, from June 2016 to December 2018. Biologic samples and data on dog characteristics, owner household characteristics, and dog care were collected. A combination of serological and molecular tests was used to identify infected animals. The 248 dogs screened for inclusion were predominantly asymptomatic/oligosymptomatic. The baseline prevalence of infection was 27.5%. One hundred six of 162 susceptible dogs were monitored for an average period of 10.7 months. The estimated CVL incidence was 1.91 cases/100 dog-months. The multivariate analysis using a proportional Cox model included the potential risk factors, with P ≤ 0.25 in the univariate analyses. Greater purchasing power (hazard ratio [HR], 1.04; 95% CI, 1.01-1.06; P = 0.03) and paved yard (HR, 0.19; 95% CI, 0.13-1.01; P = 0.05) remained in the final model as risk and protection factors, respectively. The use of repellent collars in dogs was associated moderately (P = 0.08) with protection against CVL. Our findings reflect the challenge of identifying strong interventions for reducing CVL incidence. Increased owner wealth had a counterintuitive effect on CVL, making the intervention scenario more complex for a zoonosis traditionally associated with poverty.
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Affiliation(s)
- Debora Marcolino Silva
- Center for Tropical Medicine, University of Brasília, Brasília, Federal District, Brazil
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26
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Lai C, Heinemann J, Schleicher U, Schett G, Bogdan C, Bozec A, Soulat D. Chronic Systemic Infection of Mice with Leishmania infantum Leads to Increased Bone Mass. J Bone Miner Res 2023; 38:86-102. [PMID: 36332102 DOI: 10.1002/jbmr.4733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 10/20/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022]
Abstract
Vector-borne infections of humans with the protozoan parasite Leishmania (L.) infantum can cause a systemic and potentially lethal disease termed visceral leishmaniasis. In the corresponding mouse model, an intravenous infection with L. infantum leads to the persistence of parasites in various organs, including bone marrow (BM). Considering the anatomical proximity between the BM and the cortical bone, we investigated whether a chronic infection with L. infantum affected bone homeostasis. Unexpectedly, chronic infection with L. infantum caused an increase in bone mass in mice. In vivo, an increased number of osteoblasts and osteocytes and a decreased maturation of osteoclasts characterized the phenotype. Confocal laser scanning fluorescence microscopy confirmed the infection of BM macrophages but also revealed the presence of parasites in osteoclasts. In vitro, mature osteoclasts took up L. infantum parasites. However, infection of osteoclast progenitors abolished their differentiation and function. In addition, secretory products of infected BM-derived macrophages inhibited the maturation of osteoclasts. Both in vitro and in vivo, infected macrophages and osteoclasts showed an enhanced expression of the anti-osteoclastogenic chemokine CCL5 (RANTES). Neutralization of CCL5 prevented the inhibition of osteoclast generation seen in the presence of culture supernatants from L. infantum-infected macrophages. Altogether, our study shows that chronic infection with Leishmania increases bone mass by inducing bone formation and impairing osteoclast differentiation and function. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Chaobo Lai
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Jennifer Heinemann
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
| | - Ulrike Schleicher
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Christian Bogdan
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Aline Bozec
- Department of Internal Medicine 3, Rheumatology and Immunology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
| | - Didier Soulat
- Mikrobiologisches Institut-Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Erlangen, Germany
- Medical Immunology Campus Erlangen, FAU Erlangen-Nürnberg, Erlangen, Germany
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Kumari P, Mamud A, Jha AN. Review on the Drug Intolerance and Vaccine Development for the Leishmaniasis. Curr Drug Targets 2023; 24:1023-1031. [PMID: 37823567 DOI: 10.2174/0113894501254585230927100440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 07/07/2023] [Accepted: 09/01/2023] [Indexed: 10/13/2023]
Abstract
Leishmaniasis is one of the Neglected Tropical Diseases (NTDs), a zoonotic disease of vector-borne nature that is caused by a protozoan parasite Leishmania. This parasite is transmitted by the vector sandfly into the human via a bite. Visceral leishmaniasis (VL), also called kala-azar, is the most fatal among the types of leishmaniasis, with high mortality mostly spread in the East Africa and South Asia regions. WHO report stated that approximately 3.3 million disabilities occur every year due to the disease along with approximately 50,000 annual deaths. The real matter of concern is that there is no particular effective medicine/vaccine available against leishmaniasis to date except a few approved drugs and chemotherapy for the infected patient. The current selection of small compounds was constrained, and their growing drug resistance had been a major worry. Additionally, the serious side effects on humans of the available therapy or drugs have made it essential to discover efficient and low-cost methods to speed up the development of new drugs against leishmaniasis. Ideally, the vaccine could be a low risk and effective alternative for both CL and VL and elicit long-lasting immunity against the disease. There are a number of vaccine candidates at various stages of clinical development and preclinical stage. However, none has successfully passed all clinical trials. But, the successful development and approval of commercially available vaccines for dogs against canine leishmaniasis (CanL) provides evidence that it can be possible for humans in distant future. In the present article, the approaches used for the development of vaccines for leishmaniasis are discussed and the progress being made is briefly reviewed.
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Affiliation(s)
- Priya Kumari
- Centre of Sustainable Polymers, Indian Institute of Technology, Guwahati, Assam, India
| | - Afrin Mamud
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam, India
| | - Anupam Nath Jha
- Department of Molecular Biology and Biotechnology, Tezpur University, Tezpur, Assam, India
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Kanaan MHG, Salim ID, Tarek AM, Abdullah SS. Assessment of the knowledge, attitude, and practice related to visceral leishmaniasis among residents of Al-Suwaira city, Wasit Governorate, Middle East of Iraq. J Prev Med Hyg 2022; 63:E429-E434. [PMID: 36415302 PMCID: PMC9648553 DOI: 10.15167/2421-4248/jpmh2022.63.3.2573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION It is important to assess the knowledge, attitudes, and practice (KAP) related to visceral leishmaniasis (VL) to implement an effective control program. Hence, this study aimed to highlight KAP among residents of Al-Suwaira city in Wasit Governorate, Middle East of Iraq. METHODS During March to May 2021, a cross-sectional study was done on 121 randomly selected residents. A normal self-administered questionnaire was used to measure KAP. Descriptive analysis was used to present the results. RESULTS Overall, participants indicated average knowledge towards VL. However, the incubation period of VL (23.9%), the symptoms of VL (57.9%), and the diseases' transmission ways (54.5%) were recognized as knowledge gaps. Participants had a positive attitude towards VL, as the majority of them (more than 70.0%) agreed that VL causes health problems in local populations and local communities should be actively involved in the fight against VL. Also, the majority of participants agreed that VL is a treatable disease. Regarding the practice towards VL, 110 (90.9%) participants had taken preventive measures against sand fly bites. The majority of respondents (44.6%) chose cleanliness as a preventive measure. The main sources of information that participants used to learn about the disease were the Internet (57.0%) and television (19.8%). CONCLUSION Overall, participants had good knowledge, positive attitudes, and good practice when it came to VL prevention. However, there were also some gaps. Hence, it is recommended that knowledge-based strategies be strengthened and implemented consistently to raise awareness among residents in the region.
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Affiliation(s)
| | - Israa Dawood Salim
- Middle Technical University, Baghdad, Iraq, Institute of Medical Technology/Al-Mansour, Department of Crime Evidence
| | - Ahmad M. Tarek
- Middle Technical University, Baghdad, Iraq, Institute of Medical Technology/Al-Mansour, Department of Crime Evidence
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Banjara MR, Joshi AB, Singh VK, Das ML, Gurung CK, Olliaro P, Halleux C, Matlashewski G, Kroeger A. Response to Visceral Leishmaniasis Cases through Active Case Detection and Vector Control in Low-Endemic Hilly Districts of Nepal. Am J Trop Med Hyg 2022; 107:349-354. [PMID: 35895401 PMCID: PMC9393440 DOI: 10.4269/ajtmh.21-0766] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 03/22/2022] [Indexed: 11/24/2022] Open
Abstract
The visceral leishmaniasis (VL) elimination program in Nepal has largely completed the attack phase and is moving toward consolidation and maintenance phases. New VL foci are, however, appearing in Nepal, and therefore new innovative community-centered strategies need to be developed and tested. We conducted early case detection by an index case-based approach and assessed the feasibility, efficacy, and cost of an intervention for sandfly control through indoor residual spraying (IRS) or insecticidal wall painting (IWP) in new and low-endemic districts Palpa and Surkhet. IRS was performed in 236 households and IWP in 178 households. We screened 1,239 and 596 persons in Palpa and Surkhet, respectively, resulting in the detection of one VL case in Palpa. Both IWP and IRS were well accepted, and the percentage reductions in sandfly density after 1, 9, and 12 months of intervention were 90%, 81%, and 75%, respectively, for IWP and 81%, 59%, and 63% respectively for IRS. The cost per household protected per year was USD 10.3 for IRS and 32.8 for IWP, although over a 2-year period, IWP was more cost-effective than IRS. Active case detection combined with sandfly control through IWP or IRS can support to VL elimination in the consolidation and maintenance phase.
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Affiliation(s)
- Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Anand Ballabh Joshi
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Vivek Kumar Singh
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Murari Lal Das
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Chitra Kumar Gurung
- Public Health and Infectious Disease Research Center, New Baneshwor, Kathmandu, Nepal
| | - Piero Olliaro
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - Christine Halleux
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland
| | - Greg Matlashewski
- Department of Microbiology and Immunology, McGill University, Canada
| | - Axel Kroeger
- Freiburg University, Centre for Medicine and Society, Freiburg, Germany
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30
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Zhang J, Li J, Hu K, Zhou Q, Chen X, He J, Yin S, Chi Y, Liao X, Xiao Y, Qin H, Zheng Z, Chen J. Screening Novel Vaccine Candidates for Leishmania Donovani by Combining Differential Proteomics and Immunoinformatics Analysis. Front Immunol 2022; 13:902066. [PMID: 35812381 PMCID: PMC9260594 DOI: 10.3389/fimmu.2022.902066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/25/2022] [Indexed: 11/18/2022] Open
Abstract
Visceral leishmaniasis (VL), also known as kala-azar, is the most dangerous form of leishmaniasis. Currently no effective vaccine is available for clinical use. Since the pathogenicity of different Leishmania strains is inconsistent, the differentially expressed proteins in Leishmania strains may play an important role as virulence factors in pathogenesis. Therefore, effective vaccine candidate targets may exist in the differentially expressed proteins. In this study, we used differential proteomics analysis to find the differentially expressed proteins in two Leishmania donovani strains, and combined with immunoinformatics analysis to find new vaccine candidates. The differentially expressed proteins from L. DD8 (low virulent) and L. 9044 (virulent) strains were analyzed by LC-MS/MS, and preliminarily screened by antigenicity, allergenicity and homology evaluation. The binding peptides of MHC II, IFN-γ and MHC I from differentially expressed proteins were then predicted and calculated for the second screening. IFN-γ/IL-10 ratios and conserved domain prediction were performed to choose more desirable differentially expressed proteins. Finally, the 3D structures of three vaccine candidate proteins were produced and submitted for molecular dynamics simulation and molecular docking interaction with TLR4/MD2. The results showed that 396 differentially expressed proteins were identified by LC-MS/MS, and 155 differentially expressed proteins were selected through antigenicity, allergenicity and homology evaluation. Finally, 16 proteins whose percentages of MHC II, IFN-γ and MHC I binding peptides were greater than those of control groups (TSA, LmSTI1, LeIF, Leish-111f) were considered to be suitable vaccine candidates. Among the 16 candidates, amino acid permease, amastin-like protein and the hypothetical protein (XP_003865405.1) simultaneously had the large ratios of IFN-γ/IL-10 and high percentages of MHC II, IFN-γ and MHC I, which should be focused on. In conclusion, our comprehensive work provided a methodological basis to screen new vaccine candidates for a better intervention against VL and associated diseases.
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Affiliation(s)
- Jianhui Zhang
- Department of Pathogenic Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jiao Li
- Department of Pathogenic Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Kaifeng Hu
- Department of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qi Zhou
- Department of Pathogenic Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Xiaoxiao Chen
- Department of Pathogenic Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Jinlei He
- Department of Pathogenic Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Shuangshuang Yin
- Department of Pathogenic Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yangjian Chi
- Department of Urinary Surgery, Jianou Municipal Hospital of Fujian Province, Jianou, China
| | - Xuechun Liao
- Department of Pathogenic Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yuying Xiao
- Department of Pathogenic Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Hanxiao Qin
- Department of Pathogenic Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Zhiwan Zheng
- Department of Pathogenic Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
- *Correspondence: Zhiwan Zheng, ; Jianping Chen,
| | - Jianping Chen
- Department of Pathogenic Biology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
- Animal Disease Prevention and Food Safety Key Laboratory of Sichuan Province, Sichuan University, Chengdu, China
- *Correspondence: Zhiwan Zheng, ; Jianping Chen,
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Mazire PH, Saha B, Roy A. Immunotherapy for visceral leishmaniasis: A trapeze of balancing counteractive forces. Int Immunopharmacol 2022; 110:108969. [PMID: 35738089 DOI: 10.1016/j.intimp.2022.108969] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 06/01/2022] [Accepted: 06/13/2022] [Indexed: 11/19/2022]
Abstract
The protozoan parasite Leishmania donovani, residing and replicating within the cells of the monocyte-macrophage (mono-mac) lineage, causes visceral leishmaniasis (VL) in humans. While, Leishmania infantum, is the main causative agent for zoonotic VL, where dogs are the main reservoirs of the disease. The chemotherapy is a serious problem because of restricted repertoire of drugs, drug-resistant parasites, drug-toxicity and the requirement for parenteral administration, which is a problem in resource-starved countries. Moreover, immunocompromised individuals, particularly HIV-1 infected are at higher risk of VL due to impairment in T-helper cell and regulatory cell responses. Furthermore, HIV-VL co-infected patients report poor response to conventional chemotherapy. Recent efforts are therefore directed towards devising both prophylactic and therapeutic immunomodulation. As far as prophylaxis is concerned, although canine vaccines for the disease caused by Leishmania infantum or Leishmania chagasi are available, no vaccine is available for use in humans till date. Therefore, anti-leishmanial immunotherapy triggering or manipulating the host's immune response is gaining momentum during the last two decades. Immunomodulators comprised of small molecules, anti-leishmanial peptides, complex ligands for host receptors, cytokines or their agonists and antibodies have been given trials both in experimental models and in humans. However, the success of immunotherapy in humans remains a far-off target. We, therefore, propose that devising a successful immunotherapy is an act of balancing enhanced beneficial Leishmania-specific responses and deleterious immune activation/hyperinflammation just as the swings in a trapeze.
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Affiliation(s)
- Priyanka H Mazire
- Department of Biotechnology, Savitribai Phule Pune University, Ganeshkhind Road, Pune 411007, India
| | - Bhaskar Saha
- National Centre for Cell Science, Ganeshkhind Road, Pune 411007, India
| | - Amit Roy
- Department of Biotechnology, Savitribai Phule Pune University, Ganeshkhind Road, Pune 411007, India.
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Faber C, Montenegro Quiñonez C, Horstick O, Rahman KM, Runge-Ranzinger S. Indoor residual spraying for the control of visceral leishmaniasis: A systematic review. PLoS Negl Trop Dis 2022; 16:e0010391. [PMID: 35587498 PMCID: PMC9159594 DOI: 10.1371/journal.pntd.0010391] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 06/01/2022] [Accepted: 04/03/2022] [Indexed: 11/19/2022] Open
Abstract
Indoor Residual Spraying (IRS) is one of the interventions to control the vectors of Visceral Leishmaniasis (VL). Different insecticides are used in affected countries, also in the Regional Initiative for the Elimination of VL in South-East Asia. This systematic review assesses all available studies analysing the effectiveness of IRS on the key vectors of VL. The systematic review followed PRISMA guidelines, with a broad search strategy, applied to seven key databases. Inclusion criteria were studies focusing on 1) Visceral leishmaniasis 2) Indoor Residual Spraying (IRS) or synonyms, and 3) all primary research methods. 21 studies were included, five cluster randomised controlled trials (cRCTs), one randomised controlled trial (RCT), 11 intervention studies, also included were three modelling studies and one survey. 19 out of 21 included studies were published between 2009 and 2020. 18 of the studies were conducted in the context of the Regional Initiative. Effects of IRS on vector populations are positive, confirmed in terms of effectiveness and by the availability of studies. Deltamethrin and alpha-Cypermethrin reduce total sandfly counts, and/or Phlebotomus argentipes counts by up to 95% with an effect of a minimum of one month. Prolonged effects are not regularly seen. DDT has been used in India only: whereas in the 1990s a good effect could be measured, this effect waned over time. Two intervention studies, embedded in larger programmes in 2019 and 2020, replaced DDT with alpha-Cypermethrin throughout the study. Combinations of different interventions are not systematically researched, however showing some promising results, for example for the combination of IRS and Temephos. Constant monitoring of insecticide resistancies and quality delivery of IRS are confirmed as key issues for programmes. No human transmission data are available to directly relate an effect of IRS-although modelling studies confirm the effect of IRS on human transmission. Concluding, IRS continues to be an effective intervention for Phlebotomus argentipes control. Delivery requires constant monitoring and quality assurance. Further studies need to assess IRS in different geographical areas affected by VL and combinations of interventions.
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Affiliation(s)
- Claudia Faber
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Carlos Montenegro Quiñonez
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- Instituto de Investigaciones, Centro Universitario de Zacapa, Universidad de San Carlos de Guatemala, Zacapa, Guatemala
| | - Olaf Horstick
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
| | - Kazi Mizanur Rahman
- The University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
| | - Silvia Runge-Ranzinger
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany
- * E-mail:
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Carvalho LM, Gusmão MR, Costa AFP, de Brito RCF, Aguiar-Soares RDDO, Cardoso JMDO, Reis AB, Carneiro CM, Roatt BM. Immunochemotherapy for visceral leishmaniasis: combinatorial action of Miltefosine plus LBSapMPL vaccine improves adaptative Th1 immune response with control of splenic parasitism in experimental hamster model. Parasitology 2022; 149:371-379. [PMID: 35264268 PMCID: PMC11010489 DOI: 10.1017/s0031182021001906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/08/2021] [Accepted: 10/20/2021] [Indexed: 11/07/2022]
Abstract
The control of human visceral leishmaniasis (VL) is hard since there are no vaccines available as well as the treatment is hampered by toxicity and resistant parasites. Furthermore, as human, and canine VL causes immunosuppression, the combination of drugs with immunostimulatory agents is interesting to upregulate the immunity, reducing side-effects, improving treatment approaches against disease. Herein, we assessed the immunochemotherapy using miltefosine along with a vaccine formulated by Leishmania braziliensis antigens + saponin + monophosphoryl lipid-A (LBSapMPL) in L. infantum-infected hamsters. Two months after infection, the animals received treatments, and after 15 days they were evaluated for the treatment effect. The potential anti-Leishmania effect of miltefosine + LBSapMPL-vaccine was revealed by a specific immune response activation reflecting in control of spleen parasitism using half the miltefosine treatment time. The treated animals also showed an increase of total and T-CD4 splenocytes producing IFN-γ and TNF-α and a decrease of interleukin-10 and anti-Leishmania circulating IgG. In addition, it was demonstrated that the control of spleen parasitism is related to the generation of a protective Th1 immune response. Hence, due to the combinatorial action of miltefosine with LBSapMPL-vaccine in immunostimulating and controlling parasitism, this immunochemotherapy protocol can be an important alternative option against canine and human VL.
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Affiliation(s)
- Lívia Mendes Carvalho
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brasil
| | - Miriã Rodrigues Gusmão
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brasil
| | - Ana Flávia Pereira Costa
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brasil
| | - Rory Cristiane Fortes de Brito
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brasil
| | | | - Jamille Mirelle de Oliveira Cardoso
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brasil
| | - Alexandre Barbosa Reis
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brasil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Salvador, Bahia, Brazil
| | - Cláudia Martins Carneiro
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brasil
| | - Bruno Mendes Roatt
- Laboratório de Imunopatologia, Núcleo de Pesquisas em Ciências Biológicas/NUPEB, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brasil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais, Salvador, Bahia, Brazil
- Departamento de Ciências Biológicas, Instituto de Ciências Exatas e Biológicas, Universidade Federal de Ouro Preto, Ouro Preto, Minas Gerais, Brazil
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Montenegro-Quiñonez CA, Buhler C, Horstick O, Runge-Ranzinger S, Rahman KM. Efficacy and community-effectiveness of insecticide treated nets for the control of visceral leishmaniasis: A systematic review. PLoS Negl Trop Dis 2022; 16:e0010196. [PMID: 35235556 PMCID: PMC8890655 DOI: 10.1371/journal.pntd.0010196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 01/24/2022] [Indexed: 12/28/2022] Open
Abstract
Visceral leishmaniasis (VL) has been targeted for elimination from Southeast Asia (SEA). The disease has been endemic in SEA, and in other parts of the world involving both humans and animals. One of the key strategies for combating VL is controlling for the vector sandfly. There are a few vector control strategies that are currently in practice. We sought to assess the efficacy and community effectiveness of insecticide treated nets (ITNs) in controlling the burden of sandfly and the occurrence of VL among humans. We conducted a systematic review following a study protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) criteria. 6331 initial hits were retrieved from Google Scholar, Lilacs, PubMed, Science Direct, WHOlis, WHOiris and PAHOiris. 25 met the full inclusion criteria. Findings show that the insecticide impregnated bednets and the commercially treated long lasting insecticidal nets (LLINs) are effective in controlling sandflies, with mortalities as high as 75% lasting over a year; although their role in controlling VL in the community was not extensively studied, since effectiveness was usually measured with sandflies densities. Findings also show that insecticide impregnated bednets are low cost and well accepted in the community, however, early erosion of insecticides from nets could occur. Some studies also showed that killing of sandflies may not translate into reduction of VL, therefore sandfly knock down and killing data needs to be interpreted with caution. Conclusions of this review are (1) combining insecticide impregnated bednets, as targeted interventions, with another vector control measure, particularly indoor residual spraying, and in conjunction with case detection, could be the way forward to controlling VL in resource limited settings. (2) Given the current low incidence of VL in SEA, it can be difficult to further research the community effectiveness of those control measures in reducing VL. Visceral leishmaniasis (VL) is a vector borne disease endemic in Southeast Asia (SEA) and present in other regions of the world. In SEA the disease has been targeted for elimination. VL is transmitted by different species of sandflies and key strategies against VL rely on the control of the vectors. This systematic review assesses the efficacy and community effectiveness of insecticide treated nets (ITNs) in controlling sandflies and VL occurrence among humans. After a revision of 6331 initial hits, 25 studies were included in this systematic review. Main findings indicated that insecticide impregnated bednets and long-lasting insecticidal nets (LLINs) can effectively control sandflies, however, it was not possible to fully assess the role of ITNs in controlling VL transmission. Additional results showed that insecticide impregnated bednets are low cost and well accepted in the community, however early erosion of insecticides from the nets could occur. If insecticide impregnated bednets are combined with other vector control measures, such as indoor residual spraying, and together with case detection, it could be an important strategy to control VL in resource limited settings.
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Affiliation(s)
- Carlos Alberto Montenegro-Quiñonez
- Heidelberg Institute of Global Health, Research to Practice Group, Heidelberg University, Heidelberg, Germany
- Instituto de Investigaciones, Centro Universitario de Zacapa, Universidad de San Carlos de Guatemala, Zacapa, Guatemala
- * E-mail:
| | - Claudia Buhler
- Heidelberg Institute of Global Health, Research to Practice Group, Heidelberg University, Heidelberg, Germany
| | - Olaf Horstick
- Heidelberg Institute of Global Health, Research to Practice Group, Heidelberg University, Heidelberg, Germany
| | - Silvia Runge-Ranzinger
- Heidelberg Institute of Global Health, Research to Practice Group, Heidelberg University, Heidelberg, Germany
| | - Kazi Mizanur Rahman
- The University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
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Maity S, Chakraborty A, Mahata SK, Roy S, Das AK, Sen M. Wnt5A Signaling Blocks Progression of Experimental Visceral Leishmaniasis. Front Immunol 2022; 13:818266. [PMID: 35197983 PMCID: PMC8859155 DOI: 10.3389/fimmu.2022.818266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
Visceral leishmaniasis, caused by L. donovani infection is fatal if left untreated. The intrinsic complexity of visceral leishmaniasis complicated further by the increasing emergence of drug resistant L. donovani strains warrants fresh investigations into host defense schemes that counter infections. Accordingly, in a mouse model of experimental visceral leishmaniasis we explored the utility of host Wnt5A in restraining L. donovani infection, using both antimony sensitive and antimony resistant L. donovani strains. We found that Wnt5A heterozygous (Wnt5A +/-) mice are more susceptible to L. donovani infection than their wild type (Wnt5A +/+) counterparts as depicted by the respective Leishman Donovan Units (LDU) enumerated from the liver and spleen harvested from infected mice. Higher LDU in Wnt5A +/- mice correlated with increased plasma gammaglobulin level, incidence of liver granuloma, and disorganization of splenic white pulp. Progression of infection in mice by both antimony sensitive and antimony resistant strains of L. donovani could be prevented by activation of Wnt5A signaling through intravenous administration of rWnt5A prior to L. donovani infection. Wnt5A mediated blockade of L. donovani infection correlated with the preservation of splenic macrophages and activated T cells, and a proinflammatory cytokine bias. Taken together our results indicate that while depletion of Wnt5A promotes susceptibility to visceral leishmaniasis, revamping Wnt5A signaling in the host is able to curb L. donovani infection irrespective of antimony sensitivity or resistance and mitigate the progression of disease.
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Affiliation(s)
- Shreyasi Maity
- Cancer Biology & Inflammatory Disorder, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Arijit Chakraborty
- Department of General Surgery, Massachusetts General Hospital, Boston, MA, United States
| | - Sushil Kumar Mahata
- Medicine, VA San Diego Healthcare System, University of California, San Diego, La Jolla, CA, United States
| | - Syamal Roy
- Cancer Biology & Inflammatory Disorder, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Anjan Kumar Das
- Department of Pathology Calcutta National Medical College & Hospital, Kolkata, India
| | - Malini Sen
- Cancer Biology & Inflammatory Disorder, CSIR-Indian Institute of Chemical Biology, Kolkata, India
- *Correspondence: Malini Sen, ;
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Machado AS, Martins VT, Humbert MV, Christodoulides M, Coelho EAF. In Silico Design of Recombinant Chimera T Cell Peptide Epitope Vaccines for Visceral Leishmaniasis. Methods Mol Biol 2022; 2410:463-480. [PMID: 34914063 DOI: 10.1007/978-1-0716-1884-4_24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Visceral leishmaniasis (VL) is a neglected tropical disease caused by protozoan parasites of the genus Leishmania. Systemic VL is fatal if untreated and there are no prophylactic human vaccines available. Several studies suggest that Th1 cell-mediated immunity plays a major role in protecting against VL. In this chapter we describe a method for designing recombinant chimera vaccines in silico based on the prediction of T cell epitopes within protein antigens identified as potential protective immunogens. Development of a recombinant chimera protein (RCP) vaccine using T cell epitope peptides identified from four Leishmania proteins is used as an exemplar of this method.
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Affiliation(s)
- Amanda Sanchez Machado
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Vivian Tamietti Martins
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Maria Victoria Humbert
- Neisseria Research Group, Molecular Microbiology, School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, England, UK
| | - Myron Christodoulides
- Neisseria Research Group, Molecular Microbiology, School of Clinical and Experimental Sciences, University of Southampton Faculty of Medicine, Southampton General Hospital, Southampton, England, UK.
| | - Eduardo Antonio Ferraz Coelho
- Programa de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Elikaee S, Zarei Z, Khamesipour A, Akhoundi B, Borjian AR, Afshar MJA, Allely QK, Heidari S, Mohebali M. Live attenuated Leishmania major p27 gene knockout as a novel vaccine candidate: A study on safety, protective immunity and efficacy against canine leishmaniasis caused by Leishmania infantum. Acta Trop 2022; 225:106153. [PMID: 34634264 DOI: 10.1016/j.actatropica.2021.106153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 08/28/2021] [Accepted: 09/21/2021] [Indexed: 11/28/2022]
Abstract
Canine leishmaniasis (CanL) is an important parasitic e disease caused by Leishmania infantum and is transmitted by female phlebotomine sand flies primarily between canines and secondarily to humans. Recently, we showed that immunization with Leishmania major p27 gene knockout (Lmp27-/-) as a live attenuated vaccine was safe, induced immunogenicity, and protected against the development cutaneous and visceral leishmaniasis in mice. The p27 protein is a component of the COX protein complex which is responsible for ATP production. In this study, we analyzed the Lmp27-/- candidate vaccine potential with this regard to the safety and induction of immunogenicity and protection against CanL. Variables such a clinical manifestation, anti-Leishmania antibodies using direct agglutination test (DAT), lymphocyte proliferation, delayed-type hypersensitivity (DTH), bone marrow aspiration (BMA) and parasite burden using parasitological and molecular examinations were measured. The results demonstrated that the Lmp27-/- vaccinated group showed no clinical signs after inoculation with Lmp27-/- mutant during a 12-month follow-up, and had significantly higher T-cell responses (Lymphocyte proliferation and DTH), lower seroconversion and parasite burdens following a challenge inoculation with L. infantum after 6-mounth. In conclusion, vaccination with Lmp27-/- parasites would be safe and provide significant immunoprotectivity and efficacy against infection with wild type (WT) L. infantum.
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Affiliation(s)
- S Elikaee
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Pacific University School of Pharmacy, Hillsboro, Oregon, USA
| | - Z Zarei
- Meshkin Shahr Station, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Pathobiology, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran
| | - A Khamesipour
- Center for Research and Training in Skin Diseases and Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - B Akhoundi
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - A R Borjian
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M J Abbaszadeh Afshar
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Q K Allely
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - S Heidari
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - M Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Research Center for Endemic Parasites of Iran, Tehran University of Medical Sciences, Tehran, Iran.
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Matsumoto PSS, Hiramoto RM, Pereira VBR, Camprigher VM, Taniguchi HH, de Raeffray Barbosa JE, Cortez LRPDB, Fonseca EDS, Guimarães RB, Tolezano JE. Impact of the dog population and household environment for the maintenance of natural foci of Leishmania infantum transmission to human and animal hosts in endemic areas for visceral leishmaniasis in Sao Paulo state, Brazil. PLoS One 2021; 16:e0256534. [PMID: 34464421 PMCID: PMC8407543 DOI: 10.1371/journal.pone.0256534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/09/2021] [Indexed: 11/20/2022] Open
Abstract
When it comes to visceral leishmaniasis (VL) in Brazil, one of the main targets of public health policies of surveillance is the control of domestic canine reservoirs of Leishmania infantum. This paper aims to evaluate the effect of the dog population and household environment for the maintenance of natural foci in the transmission to human and animal hosts in an endemic city for VL, Bauru, in Brazil. We collected 6,578 blood samples of dogs living in 3,916 households from Nov.2019 to Mar.2020 and applied geospatial models to predict the disease risk based on the canine population. We used Kernel density estimation, cluster analysis, geostatistics, and Generalized Additive Models (GAM). To validate our models, we used cross-validation and created a receiver operating characteristic (ROC) curve. We found an overall canine VL (CVL) seroprevalence of 5.6% for the sampled dogs, while for the households, the positivity rate was 8.7%. Odds ratios (OR) for CVL increased progressively according to the number of canines for >2 dogs (OR 2.70); households that already had CVL in the past increased the chances for CVL currently (OR 2.73); and the cases of CVL increase the chances for human VL cases (OR 1.16). Our models were statistically significant and demonstrated a spatial association between canine and human disease cases, mainly in VL foci that remain endemic. Although the Kernel density ratio map had the best performance (AUC = 82), all the models showed high risk in the city's northwest area. Canine population dynamics must be considered in public policies, and geospatial methods may help target priority areas and planning VL surveillance in low and middle-income countries.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Raul Borges Guimarães
- Department of Geography, Sao Paulo State University/Faculty of Sciences and Technology (FCT/UNESP), Presidente Prudente, Sao Paulo, Brazil
| | - José Eduardo Tolezano
- Parasitology and Mycology Center, Adolfo Lutz Institute (IAL), Sao Paulo, Sao Paulo, Brazil
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Helou DG, Mauras A, Fasquelle F, Lanza JS, Loiseau PM, Betbeder D, Cojean S. Intranasal vaccine from whole Leishmania donovani antigens provides protection and induces specific immune response against visceral leishmaniasis. PLoS Negl Trop Dis 2021; 15:e0009627. [PMID: 34403413 PMCID: PMC8370633 DOI: 10.1371/journal.pntd.0009627] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 07/05/2021] [Indexed: 12/27/2022] Open
Abstract
Visceral leishmaniasis is a protozoan disease associated with high fatality rate in developing countries. Although the drug pipeline is constantly improving, available treatments are costly and live-threatening side effects are not uncommon. Moreover, an approved vaccine against human leishmaniasis does not exist yet. Using whole antigens from Leishmania donovani promastigotes (LdAg), we investigated the protective potential of a novel adjuvant-free vaccine strategy. Immunization of mice with LdAg via the intradermal or the intranasal route prior to infection decreases the parasitic burden in primary affected internal organs, including the liver, spleen, and bone marrow. Interestingly, the intranasal route is more efficient than the intradermal route, leading to better parasite clearance and remarkable induction of adaptive immune cells, notably the helper and cytotoxic T cells. In vitro restimulation experiments with Leishmania antigens led to significant IFN-γ secretion by splenocytes; therefore, exemplifying specificity of the adaptive immune response. To improve mucosal delivery and the immunogenic aspects of our vaccine strategy, we used polysaccharide-based nanoparticles (NP) that carry the antigens. The NP-LdAg formulation is remarkably taken up by dendritic cells and induces their maturation in vitro, as revealed by the increased expression of CD80, CD86 and MHC II. Intranasal immunization with NP-LdAg does not improve the parasite clearance in our experimental timeline; however, it does increase the percentage of effector and memory T helper cells in the spleen, suggesting a potential induction of long-term memory. Altogether, this study provides a simple and cost-effective vaccine strategy against visceral leishmaniasis based on LdAg administration via the intranasal route, which could be applicable to other parasitic diseases. Visceral leishmaniasis is a neglected tropical disease caused by specific species of Leishmania parasites that affect internal organs including spleen, liver, and bone marrow. The infective stage called promastigote, is transmitted into the host skin via sandfly bites. Visceral leishmaniasis is usually associated with high mortality rate in poor and developing countries, lacking proper health assistance. Moreover, treatments are expensive while no approved vaccines exist to prevent infection and avoid disease outbreaks. This study suggests an affordable and adjuvant-free vaccine formulation made from the total lysate of promastigotes. Vaccine administration via the intranasal route, ensures a remarkable clearance of Leishmania parasites from the internal organs of infected experimental mice. In particular, intranasal route known to be not invasive, is efficient in inducing adequate immune response against the infective form of the parasite. Further studies are now required to improve this prophylactic vaccine and provide therefore the basis for a promising translational approach.
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MESH Headings
- Adaptive Immunity
- Adjuvants, Immunologic/administration & dosage
- Administration, Intranasal
- Animals
- Antibodies, Protozoan/blood
- Antigens, Protozoan/administration & dosage
- Antigens, Protozoan/blood
- Antigens, Protozoan/immunology
- Bone Marrow/metabolism
- Bone Marrow/parasitology
- Female
- Immunization
- Interferon-gamma/metabolism
- Leishmania donovani/immunology
- Leishmaniasis Vaccines/administration & dosage
- Leishmaniasis Vaccines/immunology
- Leishmaniasis, Visceral/immunology
- Leishmaniasis, Visceral/parasitology
- Leishmaniasis, Visceral/prevention & control
- Liver/metabolism
- Liver/parasitology
- Mice
- Mice, Inbred BALB C
- Spleen/metabolism
- Spleen/parasitology
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Affiliation(s)
- Doumet Georges Helou
- Université Paris-Saclay, CNRS, BioCis-UMR 8076, Châtenay-Malabry, France
- * E-mail: (DGH); (SC)
| | - Aurélie Mauras
- Université Paris-Saclay, CNRS, BioCis-UMR 8076, Châtenay-Malabry, France
| | | | | | | | | | - Sandrine Cojean
- Université Paris-Saclay, CNRS, BioCis-UMR 8076, Châtenay-Malabry, France
- * E-mail: (DGH); (SC)
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40
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Deb R, Singh RP, Mishra PK, Hitchins L, Reid E, Barwa AM, Patra D, Das C, Sukla I, Srivastava AK, Raj S, Mishra S, Swain M, Mondal S, Mandal U, Foster GM, Trett A, Garrod G, McKenzie L, Ali A, Morchan K, Chaudhuri I, Roy N, Gill NK, Singh C, Agarwal N, Sharma S, Stanton MC, Hemingway J, Srikantiah S, Coleman M. Impact of IRS: Four-years of entomological surveillance of the Indian Visceral Leishmaniases elimination programme. PLoS Negl Trop Dis 2021; 15:e0009101. [PMID: 34370731 PMCID: PMC8376195 DOI: 10.1371/journal.pntd.0009101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 08/19/2021] [Accepted: 07/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background In 2005, Bangladesh, India and Nepal agreed to eliminate visceral leishmaniasis (VL) as a public health problem. The approach to this was through improved case detection and treatment, and controlling transmission by the sand fly vector Phlebotomus argentipes, with indoor residual spraying (IRS) of insecticide. Initially, India applied DDT with stirrup pumps for IRS, however, this did not reduce transmission. After 2015 onwards, the pyrethroid alpha-cypermethrin was applied with compression pumps, and entomological surveillance was initiated in 2016. Methods Eight sentinel sites were established in the Indian states of Bihar, Jharkhand and West Bengal. IRS coverage was monitored by household survey, quality of insecticide application was measured by HPLC, presence and abundance of the VL vector was monitored by CDC light traps, insecticide resistance was measured with WHO diagnostic assays and case incidence was determined from the VL case register KAMIS. Results Complete treatment of houses with IRS increased across all sites from 57% in 2016 to 70% of houses in 2019, rising to >80% if partial house IRS coverage is included (except West Bengal). The quality of insecticide application has improved compared to previous studies, average doses of insecticide on filters papers ranged from 1.52 times the target dose of 25mg/m2 alpha-cypermethrin in 2019 to 1.67 times in 2018. Resistance to DDT has continued to increase, but the vector was not resistant to carbamates, organophosphates or pyrethroids. The annual and seasonal abundance of P. argentipes declined between 2016 to 2019 with an overall infection rate of 0.03%. This was associated with a decline in VL incidence for the blocks represented by the sentinel sites from 1.16 per 10,000 population in 2016 to 0.51 per 10,000 in 2019. Conclusion Through effective case detection and management reducing the infection reservoirs for P. argentipes in the human population combined with IRS keeping P. argentipes abundance and infectivity low has reduced VL transmission. This combination of effective case management and vector control has now brought India within reach of the VL elimination targets. Visceral Leishmaniasis (VL), also known as kala-azar, is a major parasitic disease in South Asia (Indian subcontinent), with 85% of the disease incidence in India. Historically VL had been controlled and almost eliminated with Indoor Residual Spraying (IRS) using dichlorodiphenyltrichloroethane (DDT). However, reinitiating this approach in 2015 failed due to high insecticide resistance in the sand fly vector and poor IRS quality, meaning that VL elimination targets were not met. To improve this the National Vector Borne Disease Control Programme changed to an effective insecticide, alpha-cypermethrin and altered the mode of application to compression pumps. Sentinel sites were established to monitor the entomological indicators, these showed the positive impact of these changes from 2016 to 2019. During this period the overall incidence of disease has decreased, and India is now on track to reach it’s target incidence for VL of less than 1/1000 people at the sub-district (block) level.
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Affiliation(s)
- Rinki Deb
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | | | - Lisa Hitchins
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Emma Reid
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | | - Anna Trett
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Gala Garrod
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Laura McKenzie
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | | | | | - Nupur Roy
- National Vector Borne Disease Control Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Delhi, India
| | - Naresh K. Gill
- National Vector Borne Disease Control Programme, Directorate General of Health Services, Ministry of Health and Family Welfare, Delhi, India
| | | | | | | | | | - Janet Hemingway
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - Michael Coleman
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- * E-mail:
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de Carvalho AG, Alves I, Borges LM, Spessatto LB, Castro LS, Luz JGG. Basic knowledge about visceral leishmaniasis before and after educational intervention among primary health care professionals in Midwestern Brazil. Rev Inst Med Trop Sao Paulo 2021; 63:e56. [PMID: 34231821 PMCID: PMC8266306 DOI: 10.1590/s1678-9946202163056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/18/2021] [Indexed: 11/21/2022] Open
Abstract
Health education and training of primary health care (PHC) professionals are highly recommended to reduce the occurrence and lethality of visceral leishmaniasis (VL). This study assessed the impact of an educational intervention on the basic knowledge about visceral leishmaniasis (VL) among PHC professionals from the Brazilian municipality of Rondonopolis, an important endemic area for VL. Responses provided by physicians, nurses, nursing technicians and community health agents from 12 PHC facilities were recorded through the application of self-completed and semi-structured questionnaires before (n=92) and after (n=64) an in-person health training course covering various aspects of VL. Closed- and open-ended responses were compared by the chi-square test and analyses of word clouds, respectively. The proportion of professionals aware of the correct etiological agent (p<0.001) and transmission route (p<0.001) of VL increased post-intervention. In addition, they increased their ability to recognize fever (p<0.001), weakness (p<0.001), weight loss (p<0.001), pallor (p<0.001) and abdominal distention (p=0.013) as clinical manifestations of human VL, and weakness (p<0.001), alopecia (p<0.001) and weight loss (p=0.019) as signs of canine VL. Analyses of word clouds suggested that the participants became more aware of the role of dogs in VL transmission and the role of environmental management in the prevention of VL. In conclusion, the intervention positively impacted the baseline knowledge concerning VL among the professionals. This can support the planning of educational activities for the PHC team regarding early case detection, prevention and control of VL in endemic areas.
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Affiliation(s)
- Amanda Gabriela de Carvalho
- Universidade Federal de Rondonópolis, Instituto de Ciências Exatas e
Naturais, Curso de Medicina, Rondonópolis, Mato Grosso, Brazil
| | - Isaac Alves
- Universidade Federal de Rondonópolis, Instituto de Ciências Exatas e
Naturais, Curso de Medicina, Rondonópolis, Mato Grosso, Brazil
| | - Larissa Marquiori Borges
- Universidade Federal de Rondonópolis, Instituto de Ciências Exatas e
Naturais, Curso de Medicina, Rondonópolis, Mato Grosso, Brazil
| | - Laura Bordignon Spessatto
- Universidade Federal de Rondonópolis, Instituto de Ciências Exatas e
Naturais, Programa de Residência Multiprofissional em Saúde da Família,
Rondonópolis, Mato Grosso, Brazil
| | - Ludiele Souza Castro
- Universidade Federal de Rondonópolis, Instituto de Ciências Exatas e
Naturais, Curso de Medicina, Rondonópolis, Mato Grosso, Brazil
- Universidade Federal de Rondonópolis, Instituto de Ciências Exatas e
Naturais, Programa de Residência Multiprofissional em Saúde da Família,
Rondonópolis, Mato Grosso, Brazil
| | - João Gabriel Guimarães Luz
- Universidade Federal de Rondonópolis, Instituto de Ciências Exatas e
Naturais, Curso de Medicina, Rondonópolis, Mato Grosso, Brazil
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42
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Kushwaha V, Kaur S. Cross-protective efficacy of immuno-stimulatory recombinant Brugia malayi protein HSP60 against the Leishmania donovani in BALB/c mice. Biologicals 2021; 72:18-26. [PMID: 34229924 DOI: 10.1016/j.biologicals.2021.06.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 11/18/2022] Open
Abstract
Coinfection of Leishmania with bacteria, viruses, protozoans, and nematodes alter the immune system of the host, thereby influencing the disease outcomes. Here, we have determined the immunogenic property and protective efficacy of the cross-reactive molecule HSP60 of filarial parasite B. malayi against the L. donovani in BALB/c mice. Parasitological parameters results showed a significant decrease in the parasite burden (~59%; P < 0.001) and also a substantial increase in the delayed-type hypersensitivity (DTH) response (P < 0.001) in mice immunized with 10 μg of rBmHSP60. Protection against L. donovani in mice immunized with rBmHSP60 resulted from activation of the T cells, which is characterized by higher levels of nitric oxide (NO) production, enhanced cell proliferation, higher levels (expression and release) of IFN- γ, TNF- α, and IL-12, also, higher production of IgG and IgG2a antibodies. This strong Th1 immune response creates an inflammatory domain for L. donovani and protects the host from VL.
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Affiliation(s)
- Vikas Kushwaha
- Leishmania Research Laboratory, Department of Zoology, Panjab University, Sector-14, Chandigarh, 160014, India.
| | - Sukhbir Kaur
- Leishmania Research Laboratory, Department of Zoology, Panjab University, Sector-14, Chandigarh, 160014, India
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Goyal DK, Keshav P, Kaur S. Adjuvant effects of TLR agonist gardiquimod admixed with Leishmania vaccine in mice model of visceral leishmaniasis. Infect Genet Evol 2021; 93:104947. [PMID: 34052416 DOI: 10.1016/j.meegid.2021.104947] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/20/2021] [Accepted: 05/26/2021] [Indexed: 01/10/2023]
Abstract
Tropical and subtropical areas of the world are affected by leishmaniasis, which is caused by Leishmania spp. It has been categorized as an NTD (neglected tropical disease) because of its negligence. The sand fly of genus Phlebotomus acts as the vector for the transmission of the promastigote form of this protozoan parasite to the mammalian host where it converts to amastigote form in the macrophages. Visceral form of leishmaniasis (VL) is a deadly infection in the endothelial system of the human and other mammals. Only a few chemotherapeutic agents are available for the treatment of this infectious disease whereas no vaccine is available for the control of leishmanial infection. Therefore in the current study, we have tested the effects of gardiquimod (a TLR agonist) as an adjuvant in combination with the formalin-killed antigen of L. donovani as a vaccine. The mice were vaccinated thrice at an interval of 2 weeks and challenged with L. donovani promastigotes after 2 weeks of the last vaccination. We assessed the parasite load, delayed-type hypersensitivity (DTH) responses, humoral and cell-mediated immune response in BALB/c mice before and after challenge infection with L. donovani. Immunized mice were found to have the least parasite load, high DTH response, elevated levels of Th1 cytokines, IgG2a, and nitric oxide than non-immunized and infected control mice. The efficacy of the vaccine was boosted with the use of adjuvant gardiquimod that depicts its potential as an adjuvant in this study. Our study is reporting the adjuvant effects of gardiquimod for the first time. Further studies using other Leishmania species can be performed to signify its role.
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Affiliation(s)
- Deepak Kumar Goyal
- Parasitology Laboratory, Department of Zoology (UGC-CAS), Panjab University, Chandigarh 160014, India
| | - Poonam Keshav
- Parasitology Laboratory, Department of Zoology (UGC-CAS), Panjab University, Chandigarh 160014, India
| | - Sukhbir Kaur
- Parasitology Laboratory, Department of Zoology (UGC-CAS), Panjab University, Chandigarh 160014, India.
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González E, Molina R, Iriso A, Ruiz S, Aldea I, Tello A, Fernández D, Jiménez M. Opportunistic feeding behaviour and Leishmania infantum detection in Phlebotomus perniciosus females collected in the human leishmaniasis focus of Madrid, Spain (2012-2018). PLoS Negl Trop Dis 2021; 15:e0009240. [PMID: 33720936 PMCID: PMC7993803 DOI: 10.1371/journal.pntd.0009240] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 03/25/2021] [Accepted: 02/15/2021] [Indexed: 11/19/2022] Open
Abstract
Background An outbreak of human leishmaniasis due to Leishmania infantum has been registered in an urban area of southwestern Madrid, Spain, since 2010. Entomological surveys carried out in the municipalities of Fuenlabrada, Leganés, Getafe and Humanes de Madrid showed that Phlebotomus perniciosus is the only potential vector. In this work, an intensive molecular surveillance was performed in P. perniciosus females captured in the region between 2012 and 2018. Methodology/Principal findings A total of 1805 P. perniciosus females were analyzed for Leishmania infection, and 1189 of them also for bloodmeal identification. Eleven different species of vertebrate were detected by amplification and subsequent sequencing of the 359 bp cytb fragment. The most prevalent blood source identified was hare (n = 553, 46.51%), followed by rabbit (n = 262, 21.95%). Less frequent were cat (n = 45, 3.80%), human (n = 34, 2.90%), pig (n = 14, 1.20%), horse (n = 11, 0.93%), sheep (n = 3, 0.25%), rhea (n = 3, 0.25%), partridge (n = 1, 0.09%) and chicken (n = 1, 0.09%). The distribution of the blood meal sources varied between the different locations. Regarding L. infantum detection, PCR amplification of a fragment of kDNA, cpb gene and ITS1 region showed 162 positive specimens (8.97%). The highest infection rate was found in the municipality of Leganés (15.17%). Conclusions The results of this molecular survey in P. perniciosus, the only leishmaniasis vector in the outbreak occurred in southwestern Madrid region, showed its opportunistic blood-feeding behaviour, high infection rates and the differences between the different points. This study was an essential part of the intensive surveillance plan in the area and the results obtained have supported the implementation of control measures in the outbreak. Vector-borne diseases (VBD) comprise a pathogen-vector-reservoir relation, and control programs should take into account different factors involving this relationship. This study is focused on a leishmaniasis outbreak that has occurred in the southwestern Madrid region since 2010. An intensive molecular surveillance of the sand fly vector Phlebotomus perniciosus was carried out from 2012 to 2018 in 4 municipalities from the affected region: Fuenlabrada, Leganés, Getafe and Humanes de Madrid. The aim of this investigation was to discern how much the vector was infected and find out its blood-feeding habits in the different surveyed points. The results showed an important rate of infected sand flies and also that P. perniciosus presents an opportunistic blood-feeding behaviour, taking blood from many different hosts, depending on their availability and density. The results obtained in this surveillance helped the authorities to plan and implement more accurate and effective control measures in the area, reflecting the importance of applying molecular surveillance in VBD outbreaks.
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Affiliation(s)
- Estela González
- Laboratorio de Entomología Médica, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid
| | - Ricardo Molina
- Laboratorio de Entomología Médica, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid
| | - Andrés Iriso
- Área de Vigilancia de Riesgos Ambientales en Salud, Dirección General de Salud Pública, Consejería de Sanidad, Comunidad de Madrid
| | - Sonia Ruiz
- Laboratorio de Entomología Médica, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid
| | - Irene Aldea
- Laboratorio de Entomología Médica, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid
| | - Ana Tello
- Departamento de Zoología y Antropología Física, Facultad de Ciencias Biológicas, Universidad Complutense de Madrid
| | - Daniel Fernández
- Laboratorio de Entomología Médica, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid
| | - Maribel Jiménez
- Laboratorio de Entomología Médica, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid
- * E-mail:
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Galvis-Ovallos F, Ueta AE, Marques GDO, Sarmento AMC, Araujo G, Sandoval C, Tomokane TY, da Matta VLR, Laurenti MD, Galati EAB. Detection of Pintomyia fischeri (Diptera: Psychodidae) With Leishmania infantum (Trypanosomatida: Trypanosomatidae) Promastigotes in a Focus of Visceral Leishmaniasis in Brazil. J Med Entomol 2021; 58:830-836. [PMID: 33047129 DOI: 10.1093/jme/tjaa199] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Indexed: 06/11/2023]
Abstract
Visceral leishmaniasis is spreading in Brazil where the main vector of its agent, Leishmania infantum Nicolle, 1908, is the Lutzomyia longipalpis (Lutz & Neiva, 1912) species complex (Diptera: Psychodidae: Phlebotominae), on which many of the activities of the visceral leishmaniasis surveillance program are based. However, there are areas where canine, and/or human cases have been occurring without the presence of this species complex as in the western part of the Greater São Paulo Metropolitan region, where Embu das Artes municipality is situated. In this area, Pintomyia fischeri (Pinto, 1926) has been implicated as potential vector of Le. infantum but so far its natural infection with this parasite has not yet been ascertained. Therefore, the present study sought to investigate the natural infection in sand flies of a CVL focus in Embu das Artes. The sand fly collections were undertaken with Shannon and CDC traps, monthly, between 1800 and 2100 hours from November 2018 to October 2019, inclusive. A total of 951 sand flies (457 males and 494 females), belonging to 10 species, were captured. Pintomyia fischeri was the predominant species (89.5%); of which 426 females were dissected and one of them (0.23%) was found to be harboring flagellates in its midgut. A sample of these flagellates was isolated in culture and characterized by a 234 base pair fragment of Leishmania heat-shock protein 70 gene (hsp70) and restriction fragment length polymorphism with Hae III restriction enzyme as Le. infantum. This finding reinforces previous evidence of Pi. fischeri as a vector of Le. infantum in foci of visceral leishmaniasis and highlights the importance of vector surveillance in areas where this species occurs.
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Affiliation(s)
- Fredy Galvis-Ovallos
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, CEP, Cerqueira Cesar, São Paulo, São Paulo, Brazil
| | - Adriele Eiko Ueta
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, CEP, Cerqueira Cesar, São Paulo, São Paulo, Brazil
| | - Gabriella de Oliveira Marques
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, CEP, Cerqueira Cesar, São Paulo, São Paulo, Brazil
| | - Ana Maria Casagrande Sarmento
- Centro de Controle de Zoonoses, Av. Ecologista de João de Oliveira Ramos de Sá 336, CEP, Chácaras Bartira, Embu das Artes, São Paulo, Brazil
| | - Gabriela Araujo
- Laboratório de Patologia de Moléstias Infecciosas, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, CEP, Cerqueira Cesar, São Paulo, São Paulo, Brazil
| | - Carmen Sandoval
- Laboratório de Patologia de Moléstias Infecciosas, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, CEP, Cerqueira Cesar, São Paulo, São Paulo, Brazil
| | - Thaíse Yumie Tomokane
- Laboratório de Patologia de Moléstias Infecciosas, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, CEP, Cerqueira Cesar, São Paulo, São Paulo, Brazil
| | - Vânia Lúcia Ribeiro da Matta
- Laboratório de Patologia de Moléstias Infecciosas, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, CEP, Cerqueira Cesar, São Paulo, São Paulo, Brazil
| | - Márcia Dalastra Laurenti
- Laboratório de Patologia de Moléstias Infecciosas, Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, CEP, Cerqueira Cesar, São Paulo, São Paulo, Brazil
| | - Eunice Aparecida Bianchi Galati
- Departamento de Epidemiologia, Faculdade de Saúde Pública, Universidade de São Paulo, CEP, Cerqueira Cesar, São Paulo, São Paulo, Brazil
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Goyal DK, Keshav P, Kaur S. Immune induction by adjuvanted Leishmania donovani vaccines against the visceral leishmaniasis in BALB/c mice. Immunobiology 2021; 226:152057. [PMID: 33545508 DOI: 10.1016/j.imbio.2021.152057] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/09/2020] [Accepted: 01/11/2021] [Indexed: 01/06/2023]
Abstract
Visceral leishmaniasis (VL) is a neglected tropical disease caused by Leishmania donovani or Leishmania infantum. Currently, the patients are treated with chemotherapeutic drugs; however, their toxicity limits their use. It would be desirable to develop a vaccine against this infection. In this study, we assessed the efficacy of different vaccine formulations at variable time points. Heat-killed (HK) antigen of Leishmania donovani was adjuvanted with two adjuvants (AddaVax and Montanide ISA 201) and three immunizations at a gap of 2 weeks (wk) were given to BALB/c mice. After 2 weeks of the last booster, mice were given challenge infection and sacrificed before challenge and after 4wk, 8wk, and 12 wk post-challenge. Significant protective immunity was observed in all the immunized animals and it was indicated by the notable rise in delayed-type hypersensitivity (DTH) response, remarkably declined parasite burden, a significant increase in the levels of interferon-gamma (IFN-γ), interleukin-12, interleukin-17 (Th1 cytokines), and IgG2a in contrast to infected control mice. Montanide ISA 201 with HK antigen provided maximum protection followed by AddaVax with HK and then HK alone. These findings elaborate on the importance of the tested adjuvants in the vaccine formulations against murine visceral leishmaniasis.
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Affiliation(s)
- Deepak Kumar Goyal
- Parasitology Laboratory, Department of Zoology, Panjab University, Chandigarh 160014, India
| | - Poonam Keshav
- Parasitology Laboratory, Department of Zoology, Panjab University, Chandigarh 160014, India
| | - Sukhbir Kaur
- Parasitology Laboratory, Department of Zoology, Panjab University, Chandigarh 160014, India.
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Queiroga TBD, Ferreira HRP, Dos Santos WV, de Assis ABL, de Araújo Neto VT, da Câmara ACJ, Fagundes Neto JC, Dos Reis RK, Nascimento MSL, Gama RA, Guedes PMM. Fluralaner (Bravecto®) induces long-term mortality of Lutzomyia longipalpis after a blood meal in treated dogs. Parasit Vectors 2020; 13:609. [PMID: 33276818 PMCID: PMC7716428 DOI: 10.1186/s13071-020-04489-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/19/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Leishmania infantum is the etiological agent of visceral leishmaniasis (VL) in the New World, where the sand fly Lutzomyia longipalpis and domestic dogs are considered the main vector and host reservoirs, respectively. Systemic insecticides have been studied as an alternative to control vector-borne diseases, including VL. Fluralaner, an isoxazoline class compound, is a systemic insecticide used in dogs, with proven efficiency against different species of phlebotomine sand flies. However, to date no studies have demonstrated the efficacy of fluralaner on Lu. longipalpis. The aim of this study was to evaluate the insecticidal effect of fluralaner (Bravecto®) on the sand fly Lu. longipalpis after blood meal in treated dogs. METHODS Healthy mongrel dogs (n = 8) were recruited from the Zoonoses Control Center in the city of Natal, Rio Grande do Norte, Brazil, and randomized into two groups: fluralaner treated (n = 4) and non-treated control (n = 4). Colony-reared female specimens of Lu. longipalpis (n = 20) were allowed to feed on all dogs for 40 min before treatment (for fluralaner-treated dogs), at day 1 after treatment and then monthly until 1 year post-treatment. RESULTS In the treatment group, there was 100% mortality of Lu. longipalpis for up to 5 months after treatment initiation, decreasing to 72.5% at 6 months post-treatment initiation. The efficacy of fluralaner ranged from 100% at day 1 (P = 0.0002) to 68% ( P = 0.0015) at 6 months, decreasing to 1.4% at 1 year post-treatment. Sand fly mortality carried out blood meal in non-treated control dogs remained constant at ≤ 15%. CONCLUSIONS Taken together, our results suggest that fluralaner may be used as a control strategy for VL in dogs in VL endemic areas.
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Affiliation(s)
| | | | - Wilo Victor Dos Santos
- Graduate Program in Parasitary Biology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Ana Beatriz Lourenço de Assis
- Graduate Program in Parasitary Biology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Vicente Toscano de Araújo Neto
- Graduate Program in Pharmaceutical Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Antônia Cláudia Jácome da Câmara
- Department of Clinical and Toxicological Analyses, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | | | | | - Manuela Sales Lima Nascimento
- Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Renata Antonaci Gama
- Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Paulo Marcos Matta Guedes
- Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
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48
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Yimam Y, Mohebali M. Effectiveness of insecticide-impregnated dog collars in reducing incidence rate of canine visceral leishmaniasis: A systematic review and meta-analysis. PLoS One 2020; 15:e0238601. [PMID: 32881961 PMCID: PMC7470253 DOI: 10.1371/journal.pone.0238601] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 08/19/2020] [Indexed: 02/07/2023] Open
Abstract
Canines are proven reservoir hosts of Leishmania infantum, the causative agent of human zoonotic visceral leishmaniasis, and therefore domestic dogs play a central role in transmitting the disease to humans. Studies on the effect of insecticide-impregnated dog collars for controlling canine visceral leishmaniasis (CanL) have been increasing; however, meta-analysis has not been conducted. This study assessed the effectiveness of insecticide-impregnated dog collars for preventing CanL. We searched (PubMed, Web of Science, Scopus, Embase, Ovid Medline(R), and Cochrane library), from inception until 2 May 2020. Two authors independently performed articles screening and data extraction. We applied the RoB 2.0 tool to evaluate the risk of bias in randomized trials, while the ROBINS-I tool was used for non-randomized trials. I-squared statistics(I2) and funnel plot and Egger’s test, respectively, were used to assesses heterogeneity between studies and publication bias. Relative Risk (RR) and 95% Confidence Interval (CI) were calculated using the random-effects model in Stata 14 software. Out of 242 citations identified, 14 studies comprising 3786 collared dogs and 3428 uncollared dogs were eligible for meta-analysis. The use of deltamethrin-impregnated dog collars(DMC) showed an overall effectiveness of 54% (95%CI: 35–65%, I2 = 63.2%, P = 0.002) in decreasing incidence of CanL, while 10% imidacloprid and 4.5% flumethrin collars provided an overall effectiveness of 90% (95%CI: 80–96%, I2 = 0.0%, P = 0.376). DMC efficacy stratified by follow-up duration was estimated to be 58% (RR = 0.42, 95%CI: 0.20–0.87), 54% (RR = 0.46, 95%CI: 0.31–0.68), 53% (RR = 0.47, 95%CI: 0.29–0.82) for follow-up periods of 5 to 6 months, 1 year and 2 years, respectively. The current evidence indicates that using insecticide-impregnated dog collars can reduce the risk of CanL caused by L. infantum. Therefore, insecticide-impregnated dog collars could be a viable alternative for inclusion as a public health measure for controlling CanL.
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Affiliation(s)
- Yonas Yimam
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biology, Faculty of Natural and Computational Sciences, Woldia University, Woldia, Ethiopia
- * E-mail:
| | - Mehdi Mohebali
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Centers for Research of Endemic Parasites of Iran (CREPI), Tehran University of Medical Sciences, Tehran, Iran
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49
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Sevá ADP, Ferreira F, Amaku M. How much does it cost to prevent and control visceral leishmaniasis in Brazil? Comparing different measures in dogs. PLoS One 2020; 15:e0236127. [PMID: 32692783 PMCID: PMC7373293 DOI: 10.1371/journal.pone.0236127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 06/29/2020] [Indexed: 11/19/2022] Open
Abstract
Visceral leishmaniasis (VL) is an important zoonosis in Brazil. Dogs are considered the main domestic reservoirs of the disease in the country; hence, control measures are focused on these reservoirs. Despite efforts to prevent and control VL, important reductions in disease prevalence and incidence have not been identified, stimulating the development and application of new strategies. The choice and implementation of new control strategies can benefit from the application of mathematical models that allow the simulation of different strategies in different scenarios. Selecting the best strategy to be implemented is also supported by cost-effectiveness studies. Here we used the results of a mathematical model in which scenarios, including isolated use of the vaccine and insecticide-impregnated collar (IIC), both at different coverage rates, were simulated to conduct a cost-effectiveness study. The costs were calculated for each scenario considering a simulation period of four years. Collar application in both infected and non-infected animals was the most cost-effective strategy. For example, to reduce the prevalence in humans and dogs by approximately 70%, the costs ranged from $250,000 and $550,000 for the IICs and vaccination, respectively. Even in the scenario with 40% loss/replacement of IICs, this measure was more advantageous in terms of cost-effectiveness than vaccination. If the vaccine were applied with culling of seropositive tested dogs, then the measure became more effective with a reduced cost compared with the vaccine alone. The use of the three first consecutive vaccine doses had the greatest impact on the cost of the vaccination strategy. The advantage of using IICs is that there is no need for a prior diagnosis, unlike vaccination, reducing costs and facilitating implementation. The present study aims to contribute to strategies to reduce hosts infected with VL by reducing public expenditure.
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Affiliation(s)
- Anaiá da Paixão Sevá
- Department of Animal Health and Preventive Veterinary, University of São Paulo, São Paulo, São Paulo, Brazil
- Department of Exact and Technological Sciences, State University of Santa Cruz, Ilhéus, Brazil
- * E-mail: ,
| | - Fernando Ferreira
- Department of Animal Health and Preventive Veterinary, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Marcos Amaku
- Department of Animal Health and Preventive Veterinary, University of São Paulo, São Paulo, São Paulo, Brazil
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50
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Le Rutte EA, Coffeng LE, Malvolti S, Kaye PM, de Vlas SJ. The potential impact of human visceral leishmaniasis vaccines on population incidence. PLoS Negl Trop Dis 2020; 14:e0008468. [PMID: 32614857 PMCID: PMC7363103 DOI: 10.1371/journal.pntd.0008468] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/15/2020] [Accepted: 06/10/2020] [Indexed: 11/18/2022] Open
Abstract
Human visceral leishmaniasis (VL) vaccines are currently under development and there is a need to understand their potential impact on population wide VL incidence. We implement four characteristics from different human VL vaccine candidates into two published VL transmission model variants to estimate the potential impact of these vaccine characteristics on population-wide anthroponotic VL incidence on the Indian subcontinent (ISC). The vaccines that are simulated in this study 1) reduce the infectiousness of infected individuals towards sand flies, 2) reduce risk of developing symptoms after infection, 3) reduce the risk of developing post-kala-azar dermal leishmaniasis (PKDL), or 4) lead to the development of transient immunity. We also compare and combine a vaccine strategy with current interventions to identify their potential role in elimination of VL as a public health problem. We show that the first two simulated vaccine characteristics can greatly reduce VL incidence. For these vaccines, an approximate 60% vaccine efficacy would lead to achieving the ISC elimination target (<1 VL case per 10,000 population per year) within 10 years’ time in a moderately endemic setting when vaccinating 100% of the population. Vaccinating VL cases to prevent the development of PKDL is a promising tool to sustain the low incidence elimination target after regular interventions are halted. Vaccines triggering the development of transient immunity protecting against infection lead to the biggest reduction in VL incidence, but booster doses are required to achieve perduring impact. Even though vaccines are not yet available for implementation, their development should be pursued as their potential impact on transmission can be substantial, both in decreasing incidence at the population level as well as in sustaining the ISC elimination target when other interventions are halted. Vaccines for human visceral leishmaniasis (VL) are currently under development. In this study, we simulate VL transmission dynamics using mathematical models to explore the potential impact of vaccines on population-wide incidence. We show that some vaccines have high potential to reduce VL incidence, namely those that reduce the infectiousness of infected individuals to sand flies and those that reduce the chance of developing symptoms once infected. The effect of vaccines that lead to protection from infection is potentially the greatest, but depending on the duration of immunity, individuals would require booster doses to guarantee lifelong impact. Vaccines that prevent the development of post-kala-azar dermal leishmaniasis are a promising tool to sustain low VL incidence and prevent recrudescence of infection when regular interventions are halted. Our results strongly support the continued development of VL vaccines, as their potential impact on population incidence can be substantial.
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Affiliation(s)
- Epke A. Le Rutte
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- * E-mail:
| | - Luc E. Coffeng
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Paul M. Kaye
- York Biomedical Research Institute, Hull York Medical School, University of York, York, United Kingdom
| | - Sake J. de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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