Epidemiology of Visceral Leishmaniasis in Bihar, India

This project was completed in December 2016.

In India, the sand fly vector Phlebotomus argentipes is responsible for the transmission of the protozoan parasite Leishmania donovani, which causes a disease called visceral leishmaniasis (VL), from one human to another. To better understand the parasite life cycle, the Epidemiology of Visceral Leishmaniasis in Bihar, India project sought to identify those L. donovani-infected humans that are the source of infection in the sand fly.

The FNIH's effort was placed on the infrastructure and resources needed to conduct a separately funded xenodiagnostic study to specifically identify those infected populations that disproportionately contribute to the transmission of visceral leishmaniasis in the endemic region of Bihar, India. There is no animal reservoir of VL in this region and transmission is considered anthroponotic, i.e. the cycle is limited to human – sand fly –human. Significant effort is going into adapting wild-caught sandflies for the establishment of a continuous colony of “clean” uninfected sandflies that can be safely allowed to feed on humans who are clinically distinct with respect to L. donovani infection and disease, including those individuals who are infected but who remain asymptomatic. With support from U.S. sand fly experts, a number of hurdles have been overcome and the colony was established at the Kala Azar Medical Research Centre in Muzzafupur, India. Clinic facilities have been identified and a clinical research protocol has been prepared for the xenodiagnostic procedures. The FNIH will not be involved in the support of the actual xenodiagnostic clinical trial.

Goals

  • Develop infrastructure at the Kala azar Medical Research Center, train staff and establish a P. argentipes colony
  • Optimize technical approach(es) to identifying infection reservoirs in coordination with ongoing TMRC activities
  • Develop protocol(s) for human subjects and animal use approvals for larger follow-on study

Results & Accomplishments

Scientific Publications

Puja Tiwary, Shakti Kumar Singh, Anurag Kumar Kushwaha, Edgar Rowton, David Sacks, Om Prakash Singh, Shyam Sundar, Phillip Lawyer; Establishing, Expanding, and Certifying a Closed Colony of Phlebotomus argentipes (Diptera: Psychodidae) for Xenodiagnostic Studies at the Kala Azar Medical Research Center, Muzaffarpur, Bihar, India. J Med Entomol 2017 tjx099. doi: 10.1093/jme/tjx099

Selected Abstracts

ISOPS IX Meeting Abstract: Establishing, expanding and certifying a closed working colony of Phlebotomus argentipes for xenodiagnostic studies at the Kala Azar Medical Research Center, Muzaffarpur, Bihar, India.

Partners

Public-Sector Partners
National Institute of Allergy and Infectious Diseases (NIAID)

Private-Sector Partners
Banaras Hindu University, Varanasi, Uttar Pradesh, India
Bill & Melinda Gates Foundation*
Kala Azar Medical Research Center, Muzaffarpur, Bihar, India

*Provided financial or in-kind support for this program.

FNIH Contacts

Karen H. Tountas, Ph.D., Scientific Program Manager, ktountas@fnih.org