Infectivity of post-kala-azar dermal leishmaniasis patients to sand flies: Revisiting a proof of concept in the context of the kala-azar elimination program in the Indian subcontinent

by Molina R, Ghosh D, Carrillo E, Monnerat S, Bern C, Mondal D, Alvar J. Clinical Infectious Diseases 2017, doi: 10.1093/cid/cix245.

Summary: The primary importance of post-kala-azar dermal leishmaniasis (PKDL) derives from its role as an infection reservoir. With kala-azar incidence close to the elimination target, there is an increased urgency to better define PKDL infectivity and quantify its role in maintaining transmission. This study compared xenodiagnosis with quantitative PCR in skin biopsies from three patients with maculopapular or nodular post-kala-azar dermal leishmaniasis (PKDL). All patients infected sand flies. Parasite loads in skin varied from 1,428 to 63,058 parasites/µg. PKDL detection and treatment are important missing components of the kala-azar elimination program.

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