Leishmaniasis

Leishmaniasis is caused by single-cell parasites of the genus Leishmania. More than 10 different Leishmania species can cause human disease. The two main clinical manifestations of leishmaniasis are:

  • Visceral leishmaniasis, caused by infections with Leishmania donovani, L. infantum or L. chagasi.
  • Cutaneous leishmaniasis, caused by infections with either L. major or L. tropica (in the Old World) or with the New World species: L. amazonensis, L. mexicana, L. braziliensis, L. colombiensis, L. guyanensis, L. panamensis and L. peruviana

Human leishmaniasis
Visceral leishmaniasis, affecting an estimated 500.000 – 1.000.000 people each year, is a deadly disease if left untreated. The parasites colonise the internal organs, in particular the spleen, liver, bone marrow and lymph nodes. Cutaneous leishmaniasis affects more than 1.500.000 people per year. In the case of cutaneous leishmaniasis, the parasite is confined to the skin where it causes one or more slow-healing sores, and in some species also lesions along the draining lymphatic vessels, so-called nodular lymphangitis. As severe type of cutaneous leishmaniasis is muco-cutaneous leishmaniasis, whereby the infection spreads to the mucosal membranes, especially those of mouth and nose, where it may cause extensive damage.

Veterinary leishmaniasis
Leishmaniasis is not only a human health problem. A large variety of animals, including dogs, opossums and rats, can also become infected with Leishmania parasites and may suffer from the disease. Leishmaniasis in dogs is important in countries around the Mediterranean Sea and in many countries in Latin America. However, the disease is also more and more frequently reported as an import disease in northern Europe.

 

Approach

KIT Biomedical Research develops diagnostic methods (serology and molecular biology) for the detection of leishmaniasis and is involved in their evaluation and application in the field. Furthermore, we participate in the evaluation of new treatment schemes and monitoring drug resistance. KIT Biomedical Research is also involved in epidemiological studies on leishmaniasis and studies towards the vertebrate reservoir of the disease. The work is conducted in collaboration with numerous partners in disease endemic countries all over the world and renowned European research institutes.

Over the years we have developed a number of serological (including the direct agglutination test [DAT] based on freeze dried L. donovani antigen) and molecular biological tools, which are used for diagnosis, epidemiology and strain identification.

KIT Biomedical Research serves as a knowledge center for leishmaniasis and gives advice and training to researchers and health workers from all over the world. KIT Biomedical Research can provide training in the use of molecular biological tools, including PCR, PCR-RFLP (Restriction Fragment Length Polymorphism) analysis and NASBA (Nucleic Acid Sequence-Based Amplification) technology, and serology (including techniques that can be used for the detection of anti-Leishmania antibodies and the analysis of the host immune response; i.e. iso-type specific ELISA, ELISPOT assay and Western blotting). Specific courses aimed at the practical use of these techniques can be offered.

 

Focal points

  • Development, evaluation and implementation of diagnostic tools for leishmaniasis
  • Epidemiology of the disease
  • Treatment of leishmaniasis, participation in clinical trials
  • Species identification via molecular techniques
  • Studies on the vertebrate reservoir
  • Transfer of developed technologies to disease endemic countries
  • Advice to researchers, policy makers and health workers

Example

KIT Biomedical Research and the Tropical Dermatology Department of the Academic Medical Centre have obtained a grant from the Netherlands Foundation for the Advancement of Tropical Research (NWO-WOTRO) to develop new tests that can be used for diagnosis of cutaneous leishmaniasis (CL) and to monitor the treatment of the disease.

The project has started 1 July 2003 and is carried out in collaboration with the Dermatology Department of the Institute of Tropical Medicine of the Amazonas (Manaus, Brazil), which sees yearly around 1000 patients with CL, and the Department of Dermatology, Academic Hospital together with the Dermatological Service Tourtonnelaan (both in Paramaribo, Suriname), which receives around 400 patients per year.

In this study three standard drug regimes that are applied to the patients in the clinics of the collaborating partners are being evaluated by the collection of skin biopsies before, during and after treatment. These samples are tested with newly developed assays at KIT-BR to monitor the parasite load reduction during and after treatment and relate the results to the clinical outcome. The project has so far yielded important information on the treatment and the epidemiology of CL in the Amazon region of Latin America.

 

Projects


Publications


Team members


Contact

For more information please contact Dr. Henk Schallig

Tags

disease control | diagnostics | infectious diseases | leishmaniasis | research |

Royal Tropical Institute