Infectiousness in asymptomatic carriers of L. Donovani (SKIN-Leish)

Background: Visceral leishmaniasis (VL) is a fatal infectious disease if not treated timely. India, Bangladesh and Nepal aim to eliminate VL as a problem of public health concern. However, the role of the many asymptomatically infected individuals in transmission is not yet clear. Our hypothesis is that they can transmit L.donovani and hence pose a threat to the elimination target. The current reference method to assess infectiousness, xenodiagnosis, is very cumbersome. Recently, a microbiopsy device was developed to detect parasite DNA in the skin, which is considered a proxy of infectiousness. We aim to perform a proof of concept study of this new tool.
Research questions: 1. Whether/to what extent the skin parasite load obtained with the new microbiopsy device correlates with parasitemia in the same subject and 2. Whether skin parasite load correlates with disease status.
Methods: We will assess the presence of parasite DNA in the skin of confirmed VL patients, infected persons without symptoms, Post-Kala-Azar Dermal Leishmaniasis patients, and non-endemic controls. We will compare this with parasitemia on blood samples as assessed by molecular tools.
Discussion: If conclusive, this proof of concept study will jumpstart a larger research project on infectiousness of asymptomatically infected to elucidate L.donovani transmission dynamics.

Project type:PhD project