Abstract
Leishmania donovani is the causative agent of historically
anthroponotic visceral leishmaniasis (VL) on the Indian subcontinent
(ISC). L. donovani is transmitted by the sand fly species
Phlebotomus argentipes. Our collaborative group and others have
shown that sand flies trapped outside in endemic villages have fed on
cattle and dogs in addition to people. Domestic animals are reservoirs
for L. donovani complex spp., particularly L. infantum, in
other endemic areas. Multiple studies using quantitative PCR or
serological detection methods have demonstrated that goats, cattle, rats
and dogs were diagnostically positive for L. donovani infection
or exposure in eastern Africa, Bangladesh, Nepal and India. There is a
limited understanding of the extent to which L. donovani
infection of domestic animals drives transmission to other animals or
humans on the ISC. Evidence from other vector-borne disease elimination
strategies indicated that emerging infections in domestic species
hindered eradication. The predominant lesson learned from these other
situations is that non-human reservoirs must be identified, controlled
and/or prevented. Massive efforts are underway for VL elimination on the
Indian subcontinent. Despite these herculean efforts, residual VL
incidence persists. The specter of an animal reservoir complicating
elimination efforts haunts the final push toward full VL control. Better
understanding of L. donovani transmission on the Indian
subcontinent and rigorous consideration of how non-human reservoirs
alter VL ecology are critical to sustain elimination goals.