Journal
NATURE COMMUNICATIONS
Volume 8, Issue -, Pages -Publisher
NATURE RESEARCH
DOI: 10.1038/s41467-017-00103-8
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Funding
- Wellcome Senior Investigator Award [WT106203]
- MRC Programme Grant [G1000230]
- Wellcome Trust
- Wellcome Trust [104726/Z/14/Z] Funding Source: Wellcome Trust
- EPSRC [EP/N014391/1] Funding Source: UKRI
- MRC [G1000230] Funding Source: UKRI
- Engineering and Physical Sciences Research Council [EP/N014391/1] Funding Source: researchfish
- Wellcome Trust [104726/Z/14/Z] Funding Source: researchfish
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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.
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