Widespread transmission in diverse ecotypes challenges visceral leishmaniasis control in East Africa
Year: 2025
Type: preprint
Abstract: East Africa is emerging as the global hot spot of visceral leishmaniasis (VL), yet efforts to eliminate it are hindered by substantial knowledge gaps in its ecoepidemiology. Here, we report on the high prevalence of Leishmania infection in Phlebotomus orientalis in Marsabit county, Kenya (3.9%), and Gedaref state, Sudan (3.6%), where this species comprised 99.8% (n = 1185) and 100% (n = 1350) of captured Phlebotomus females, respectively. In Aba Roba, Ethiopia, Ph. martini accounted for 99% of 184 collected Phlebotomus females and had a lower infection rate of 1.5%. Ph. orientalis and Ph. martini exhibited different habitat and feeding preferences. While Ph. orientalis was abundant in diverse peridomestic and sylvatic microhabitats, Ph. martini was predominantly collected from termite hills. Moreover, Ph. orientalis primarily fed on humans and less on domestic and sylvatic animals. In contrast, Ph. martini exhibited zoophagic behavior, mostly feeding on cows and Ovis. Widespread transmission of Leishmania in our study sites is supported by high rK39 seroprevalence in both Kenya (17.9%) and Sudan (6.22%). An observed greater prevalence of antibodies to rK39 in individuals living near than away from VL cases in both Kenya (19.8% versus 7.41%, P = 0.0015) and Sudan (8.4% versus 2.1%, P = 0.0105) demonstrated that proximity to a VL case carries an increased risk of infection. Our findings highlight the need for a risk-based targeted site-specific elimination strategy that accounts for the intensity, diversity, and complexity of VL transmission in today’s East Africa.
Source: medRxiv
Authors: Eva Iniguez, Mercy Tuluso, Steve Kiplagat, Araya Gebresilassie, Esayas Aklilu, Olivia Battistoni, Johnstone Ingonga, John Mark Makwatta, Mohamed Alamin, Osman Dakien, Alphine Chebet, Esther Kaunda, Patrick Huffcutt, Serena Doh, Pedro Cecilio, Galgallo Bonaya, Claudio Meneses, Tiago D. Serafim, Myrthe Pareyn, Mohamed Osman, Eltahir A. G. Khalil, Omran F. Osman, Brima M. Younis, Sithar Dorjee, Guofa Zhou, Jesus G. Valenzuela, Dan K. Masiga, Ahmed M. Musa, Asrat Hailu, Abhay Satoskar, Shaden Kamhawi, Damaris Matoke-Muhia
Institutions: National Institutes of Health, National Institute of Allergy and Infectious Diseases, Kenya Medical Research Institute, International Centre of Insect Physiology and Ecology, Addis Ababa University, The Ohio State University Wexner Medical Center, The Ohio State University, University of Khartoum, Gadarif University, Instituut voor Tropische Geneeskunde, University of York, University of California, Irvine, Khesar Gyalpo University of Medical Sciences of Bhutan
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4414786950