Singh Om Prakash, Hasker Epco, Boelaert Marleen, Sacks David, Sundar Shyam
Department of Biochemistry, Institute of Science, Banaras Hindu University, Varanasi, India.
Infectious Diseases Research Laboratory, Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
PLoS Negl Trop Dis. 2020 Aug 13;14(8):e0008363. doi: 10.1371/journal.pntd.0008363. eCollection 2020 Aug.
Visceral leishmaniasis (VL) remains an important public health issue worldwide causing substantial morbidity and mortality. The Indian subcontinent accounted for up to 90% of the global VL burden in the past but made significant progress during recent years and is now moving towards elimination. However, to achieve and sustain elimination of VL, knowledge gaps on infection reservoirs and transmission need to be addressed urgently. Xenodiagnosis is the most direct way for testing the infectiousness of hosts to the vectors and can be used to investigate the dynamics and epidemiology of Leishmania donovani transmission. There are, however, several logistic and ethical issues with xenodiagnosis that need to be addressed before its application on human subjects. In the current Review, we discuss the critical knowledge gaps in VL transmission and the role of xenodiagnosis in disease transmission dynamics along with its technical challenges. Establishment of state of the art xenodiagnosis facilities is essential for the generation of much needed evidence in the VL elimination initiative.
内脏利什曼病（VL）仍然是一个重要的全球公共卫生问题，会导致大量发病和死亡。印度次大陆过去占全球VL负担的90%，但近年来取得了重大进展，目前正朝着消除该疾病迈进。然而，为了实现并维持VL的消除，感染源和传播方面的知识差距亟待解决。异种诊断是检测宿主对媒介传染性的最直接方法，可用于研究杜氏利什曼原虫传播的动态和流行病学。然而，在将异种诊断应用于人类受试者之前，有几个后勤和伦理问题需要解决。在本综述中，我们讨论了VL传播中的关键知识差距、异种诊断在疾病传播动态中的作用及其技术挑战。建立先进的异种诊断设施对于在VL消除倡议中产生急需的证据至关重要。
