Skin parasite landscape determines host infectiousness in visceral leishmaniasis

Johannes S. P. Doehl, Zoe Bright, Shoumit Dey, Helen Davies, John Magson, Najmeeyah Brown, Audrey Romano, Jane E. Dalton, Ana I. Pinto, Jon W. Pitchford () and Paul M. Kaye ()
Additional contact information
Johannes S. P. Doehl: University of York
Zoe Bright: University of York
Shoumit Dey: University of York
Helen Davies: University of York
John Magson: Applied Innovation Campus
Najmeeyah Brown: University of York
Audrey Romano: University of York
Jane E. Dalton: University of York
Ana I. Pinto: University of York
Jon W. Pitchford: University of York
Paul M. Kaye: University of York

Nature Communications, 2017, vol. 8, issue 1, 1-11

Abstract: Abstract Increasing evidence suggests that the infectiousness of patients for the sand fly vector of visceral leishmaniasis is linked to parasites found in the skin. Using a murine model that supports extensive skin infection with Leishmania donovani, spatial analyses at macro-(quantitative PCR) and micro-(confocal microscopy) scales indicate that parasite distribution is markedly skewed. Mathematical models accounting for this heterogeneity demonstrate that while a patchy distribution reduces the expected number of sand flies acquiring parasites, it increases the infection load for sand flies feeding on a patch, increasing their potential for onward transmission. Models representing patchiness at both macro- and micro-scales provide the best fit with experimental sand fly feeding data, pointing to the importance of the skin parasite landscape as a predictor of host infectiousness. Our analysis highlights the skin as a critical site to consider when assessing treatment efficacy, transmission competence and the impact of visceral leishmaniasis elimination campaigns.

Date: 2017
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DOI: 10.1038/s41467-017-00103-8

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