Serological Markers of Sand Fly Exposure to Evaluate Insecticidal Nets against Visceral Leishmaniasis in India and Nepal: A Cluster-Randomized Trial

Kamlesh Gidwani, Albert Picado, Suman Rijal, Shri Prakash Singh, Lalita Roy, Vera Volfova, Elisabeth Wreford Andersen, Surendra Uranw, Bart Ostyn, Medhavi Sudarshan, Jaya Chakravarty, Petr Volf, Shyam Sundar, Marleen Boelaert, Matthew Edward Rogers

Research output: Contribution to journalJournal articleResearchpeer-review


Background: Visceral leishmaniasis is the world' second largest vector-borne parasitic killer and a neglected tropical disease, prevalent in poor communities. Long-lasting insecticidal nets (LNs) are a low cost proven vector intervention method for malaria control; however, their effectiveness against visceral leishmaniasis (VL) is unknown. This study quantified the effect of LNs on exposure to the sand fly vector of VL in India and Nepal during a two year community intervention trial.Methods: As part of a paired-cluster randomized controlled clinical trial in VL-endemic regions of India and Nepal we tested the effect of LNs on sand fly biting by measuring the antibody response of subjects to the saliva of Leishmania donovani vector Phlebotomus argentipes and the sympatric (non-vector) Phlebotomus papatasi. Fifteen to 20 individuals above 15 years of age from 26 VL endemic clusters were asked to provide a blood sample at baseline, 12 and 24 months post-intervention.Results: A total of 305 individuals were included in the study, 68 participants provided two blood samples and 237 gave three samples. A random effect linear regression model showed that cluster-wide distribution of LNs reduced exposure to P. argentipes by 12% at 12 months (effect 0.88; 95% CI 0.83-0.94) and 9% at 24 months (effect 0.91; 95% CI 0.80-1.02) in the intervention group compared to control adjusting for baseline values and pair. Similar results were obtained for P. papatasi.Conclusions: This trial provides evidence that LNs have a limited effect on sand fly exposure in VL endemic communities in India and Nepal and supports the use of sand fly saliva antibodies as a marker to evaluate vector control interventions.
Original languageEnglish
Article numbere1296
JournalP L o S Neglected Tropical Diseases (Online)
Issue number9
Number of pages8
Publication statusPublished - 2011
Externally publishedYes


  • India Asia Oriental region
  • Nepal Asia Oriental region
  • Insecta Arthropoda Invertebrata Animalia (Animals, Arthropods, Insects, Invertebrates) - Diptera [75314] Phlebotomus papatasi species disease vector Phlebotomus argentipes species sand fly common disease vector
  • Primates Mammalia Vertebrata Chordata Animalia (Animals, Chordates, Humans, Mammals, Primates, Vertebrates) - Hominidae [86215] human common host
  • Protozoa Invertebrata Animalia (Animals, Invertebrates, Microorganisms, Protozoans) - Flagellata [35200] Leishmania donovani species parasite
  • antibodies
  • 12502, Pathology - General
  • 15002, Blood - Blood and lymph studies
  • 15004, Blood - Blood cell studies
  • 19004, Dental biology - Physiology and biochemistry
  • 34502, Immunology - General and methods
  • 37052, Public health: epidemiology - Communicable diseases
  • 37056, Public health: epidemiology - Miscellaneous
  • 37057, Public health: disease vectors - General
  • 60502, Parasitology - General
  • 60504, Parasitology - Medical
  • 64002, Invertebrata: comparative, experimental morphology, physiology and pathology - Protozoa
  • 64076, Invertebrata: comparative, experimental morphology, physiology and pathology - Insecta: physiology
  • Epidemiology
  • Human Medicine
  • Parasitology
  • Vector Biology
  • visceral leishmaniasis Leishmaniasis, Visceral (MeSH) parasitic disease epidemiology, etiology
  • antibody response
  • long-lasting insecticidal net
  • paired-cluster randomized controlled clinical trial
  • Medical Sciences
  • Population Studies
  • blood blood and lymphatics
  • saliva dental and oral system


Dive into the research topics of 'Serological Markers of Sand Fly Exposure to Evaluate Insecticidal Nets against Visceral Leishmaniasis in India and Nepal: A Cluster-Randomized Trial'. Together they form a unique fingerprint.

Cite this