Browsing by Author "Epke A. Le Rutte"

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Dogs as Reservoirs for Leishmania donovani, Bihar, India, 2018–2022
(Centers for Disease Control and Prevention (CDC), 2024) Anurag Kumar Kushwaha; Ashish Shukla; Breanna M. Scorza; Rahul Chaubey; Dharmendra Kumar Maurya; Tulika Kumari Rai; Shyamali Yaduvanshi; Shweta Srivastava; Gaetano Oliva; Epke A. Le Rutte; Rajiv Kumar; Om Prakash Singh; Puja Tiwary; Shakti Kumar Singh; Scott A. Bernhardt; Phillip Lawyer; Edgar Rowton; Christine A. Petersen; Shyam Sundar
Visceral leishmaniasis derived from Leishmania donovani is transmitted by sand flies (Phlebotomus argentipes) throughout the Indian subcontinent. Although considered anthroponotic, L. donovani infects other mammals susceptible to sand fly bites, including dogs. Aggressive strategies to reduce sand fly populations in India have led to flies seeking nonhuman hosts, so understanding the role of dogs in L. donovani transmission has become critical. Our study investigated L. donovani infection in dogs and the potential for such infections to be transmitted back to sand flies. We performed xenodiagnosis by using P. argentipes on dogs (n = 73) with quantitative PCR–detectible parasitemia in both endemic and outbreak villages. We found that 12% (9/73) of dogs were infectious to sand flies during winter and rainy seasons. Patients with visceral leishmaniasis remain primary sources of L. donovani transmission, but our findings suggest a possible link between canine infection and human exposure. © 2024 Centers for Disease Control and Prevention (CDC). All rights reserved.
Visceral leishmaniasis: Spatiotemporal heterogeneity and drivers underlying the hotspots in Muzaffarpur, Bihar, India
(Public Library of Science, 2018) Caroline A. Bulstra; Epke A. Le Rutte; Paritosh Malaviya; Epco C. Hasker; Luc E. Coffeng; Albert Picado; Om Prakash Singh; Marleen C. Boelaert; Sake J. de Vlas; Shyam Sundar
Background: Despite the overall decrease in visceral leishmaniasis (VL) incidence on the Indian subcontinent, there remain spatiotemporal clusters or ‘hotspots’ of new cases. The characteristics of these hotspots, underlying transmission dynamics, and their importance for shaping control strategies are not yet fully understood and are investigated in this study for a VL endemic area of ~100,000 inhabitants in Bihar, India between 2007–2015. Methodology/Principal findings: VL incidence (cases/10,000/year) dropped from 12.3 in 2007 to 0.9 in 2015, which is just below the World Health Organizations’ threshold for elimination as a public health problem. Clustering of VL was assessed between subvillages (hamlets), using multiple geospatial and (spatio)temporal autocorrelation and hotspot analyses. One to three hotspots were identified each year, often persisting for 1–5 successive years with a modal radius of ~500m. The relative risk of having VL was 5–86 times higher for inhabitants of hotspots, compared to those living outside hotspots. Hotspots harbour significantly more households from the two lowest asset quintiles (as proxy for socio-economic status). Overall, children and young adelescents (5–14 years) have the highest risk for VL, but within hotspots and at the start of outbreaks, older age groups (35+ years) show a comparable high risk. Conclusions/Significance: This study demonstrates significant spatiotemporal heterogeneity in VL incidence at subdistrict level. The association between poverty and hotspots confirms that VL is a disease of ‘the poorest of the poor’ and age patterns suggest a potential role of waning immunity as underlying driver of hotspots. The recommended insecticide spraying radius of 500m around detected VL cases corresponds to the modal hotspot radius found in this study. Additional data on immunity and asymptomatic infection, and the development of spatiotemporally explicit transmission models that simulate hotspot dynamics and predict the impact of interventions at the smaller geographical scale will be crucial tools in sustaining elimination. © 2018 Bulstra et al. http://creativecommons.org/licenses/by/4.0/.