Evidence map›Paper›PMID 40012028›Full record

ArticleBMC infectious diseases2025

Can cutaneous leishmaniasis provoke a resurgence of kala-azar in the Indian subcontinent?

Narayan Raj Bhattarai, Keshav Rai, Surendra Uranw, Dhan Keshar Khadka, Basudha Khanal, Gokarna Dahal, Sushmita Pradhan, Sushil Dhakal, Pieter Monsieurs, Tanyth de Gooyer and 3 more

Abstract read
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Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Narayan Raj Bhattarai *B. P. Koirala Institute of Health Sciences, Dharan, Nepal. bhattarai03@yahoo.com.
Keshav Rai *B. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Surendra UranwB. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Dhan Keshar KhadkaB. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Basudha KhanalB. P. Koirala Institute of Health Sciences, Dharan, Nepal.
Gokarna DahalEpidemiology Disease Control Division, Ministry of Health, Kathmandu, Nepal.
Sushmita PradhanDepartment of Dermatology, Province Hospital, Birendranagar, Surkhet, Karnali Province, Nepal.
Sushil DhakalMaya Metro Hospital, Dhanagadhi, Nepal.
Pieter MonsieursInstitute of Tropical Medicine, Antwerp, Belgium.
Tanyth de GooyerInstitute of Tropical Medicine, Antwerp, Belgium.
Kristien ClootsInstitute of Tropical Medicine, Antwerp, Belgium.
Epco HaskerInstitute of Tropical Medicine, Antwerp, Belgium.
Gert Van der AuweraInstitute of Tropical Medicine, Antwerp, Belgium.

Funding

Fifth Framework Agreement of the Directorate-General for Development Cooperation of Belgium and Humanitarian Aid 2022-2026 DGD/ITM Program BE-BCE_KBO-0410057701
6 · The paper itself

Abstract

backgroundThe ongoing kala-azar elimination program in Nepal is based on the assumption of anthroponotic transmission of the protozoan parasite Leishmania donovani. This parasite species was recently also found in lesions of cutaneous leishmaniasis (CL) cases, which are increasingly reported mainly from western Nepal. The question whether or not CL causing L. donovani can also contribute to VL is a crucial one to answer if the success of the VL elimination initiative in the Indian subcontinent is to be sustained, though evidence on sub-species level genomic differences between CL and VL causing L. donovani is currently lacking. This study aims to provide a genomic comparison of L. donovani parasites currently causing CL in Nepal with previously described L. donovani isolates.

methodsA case series study was carried out in sentinel dermatological sites in Western Nepal. Skin punch biopsies were collected from clinically suspected CL lesions. Molecular tests based on the ribosomal RNA gene array were used to detect and characterize the Leishmania parasites.

resultsLeishmania parasites detected in 26 cutaneous leishmaniasis patients were identified as L. donovani. Importantly, their analyzed DNA sequences were identical, and shared with previously documented sequences from both cutaneous and visceral disease-causing parasites in Nepal, India and Bhutan.

conclusionsOur study suggests that CL and VL are caused by similar if not identical L. donovani parasite strains, though additional sequencing is required to corroborate this finding. If confirmed, cutaneous lesions could act as a kala-azar parasite reservoir, which would have important implications for the kala-azar elimination program.

Indexed as

Leishmania donovaniLeishmaniasis, CutaneousLeishmaniasis, VisceralAdolescentAdultChildDNA, ProtozoanFemaleHumansIndiaMaleMiddle AgedNepalPhylogenySkinYoung AdultDNA, ProtozoanCutaneous leishmaniasisGenomic surveillanceKala-azar elimination initiativeLeishmania donovaniNepalParasite characterizationVisceral leishmaniasis

Identifiers

PMID40012028
PMCPMC11866896

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.