ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Quantifying the Infectiousness of Post-Kala-Azar Dermal Leishmaniasis Toward Sand Flies.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
98 citing papers in PubMed, 1 synthesis or guideline pooled it, 137 citations in OpenAlex.
- From visceral to visible: A systematic review and meta-analysis of post-kala-azar dermal leishmaniasis incidence, risk factors, and treatment outcomes in Eastern Africa.PLoS neglected tropical diseases · 2026Pooled it
- A phase II, non-comparative randomised trial of two treatments involving liposomal amphotericin B and miltefosine for post-kala-azar dermal leishmaniasis in India and Bangladesh.PLoS neglected tropical diseases · 2024Trial
- Safety and efficacy of paromomycin/miltefosine/liposomal amphotericin B combinations for the treatment of post-kala-azar dermal leishmaniasis in Sudan: A phase II, open label, randomized, parallel arm study.PLoS neglected tropical diseases · 2023Trial
- IgG3 and IL10 are effective biomarkers for monitoring therapeutic effectiveness in Post Kala-Azar Dermal Leishmaniasis.PLoS neglected tropical diseases · 2021Trial
- Safety and immunogenicity of ChAd63-KH vaccine in post-kala-azar dermal leishmaniasis patients in Sudan.Molecular therapy : the journal of the American Society of Gene Therapy · 2021Trial
- Long-term incidence of relapse and post-kala-azar dermal leishmaniasis after three different visceral leishmaniasis treatment regimens in Bihar, India.PLoS neglected tropical diseases · 2020Trial
- Widespread transmission in diverse ecotypes challenges visceral leishmaniasis control in East Africa.One health (Amsterdam, Netherlands) · 2026Article
- Article
- High Seropositivity to rK39 and Capture of Leishmania-Infected Sand Flies in Bihar and Jharkhand Emphasize the Need for Post-Elimination Surveillance of Visceral Leishmaniasis in India.The Journal of infectious diseases · 2026Article
- Risk factors for post-kala-azar dermal leishmaniasis (PKDL): Challenges in understanding pathophysiology.PLoS neglected tropical diseases · 2026Review
- Elimination of visceral leishmaniasis as a public health problem in Bangladesh: Lessons learned and questions remaining.PLoS neglected tropical diseases · 2026Review
- Post-kala-azar dermal leishmaniasis: insights into underlying pathogenic mechanisms and genetic landscape.Frontiers in microbiology · 2026Review
- The development of a global research agenda and individual participant data platform for visceral leishmaniasis: challenges and future opportunities.Parasites & vectors · 2025Article
- Leishmaniasis.Nature reviews. Disease primers · 2025Review
- Genetic Manipulation Tools in Leishmania: From CRISPR/Cas9 to Vaccine Strategies for Disease Control.Acta parasitologica · 2025Review
- Article
- The story of elimination of visceral leishmaniasis (kala-azar) in India-Challenges towards sustainment.PLoS neglected tropical diseases · 2025Review
- Kala-azar elimination in India: reflections on success and sustainability.International health · 2025Article
- Trends in Post-Kala-Azar Dermal Leishmaniasis in Sudan: Cases, Ethnic Distribution, and Recovery.The American journal of tropical medicine and hygiene · 2025Article
- The Lifecycle of Phlebotomus argentipes (Diptera: Psychodidae) Sand Fly in a Newly Developed Colony in Bangladesh.The American journal of tropical medicine and hygiene · 2025Article
38 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOn the Indian subcontinent, visceral leishmaniasis (VL) incidence is on track to reach elimination goals by 2020 in nearly all endemic districts. Although not included in official targets, previous data suggest post-kala-azar dermal leishmaniasis (PKDL) patients can act as an infection reservoir.
methodsWe conducted xenodiagnosis on 47 PKDL patients and 15 VL patients using laboratory-reared Phlebotomus argentipes. In direct xenodiagnosis, flies were allowed to feed on the patient's skin for 15 minutes. For indirect xenodiagnosis, flies were fed through a membrane on the patient's blood. Five days later, blood-fed flies were dissected and examined by microscopy and/or polymerase chain reaction (PCR). A 3-mm skin snip biopsy (PKDL) or venous blood (VL) was processed by quantitative PCR.
resultsTwenty-seven PKDL patients (57.4%) had positive results by direct and/or indirect xenodiagnosis. Direct was significantly more sensitive than indirect xenodiagnosis (55.3% vs 6.4%, P < .0001). Those with positive xenodiagnosis had median skin parasite loads >1 log10 unit higher than those with negative results (2.88 vs 1.66, P < .0001). In a multivariable model, parasite load, nodular lesions, and positive skin microscopy were significantly associated with positive xenodiagnosis. Blood parasite load was the strongest predictor for VL. Compared to VL, nodular PKDL was more likely and macular PKDL less likely to result in positive xenodiagnosis, but neither difference reached statistical significance.
conclusionsNodular and macular PKDL, and VL, can be infectious to sand flies. Active PKDL case detection and prompt treatment should be instituted and maintained as an integral part of VL control and elimination programs.
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