Implications of co-infection ofLeptomonasin visceral leishmaniasis in India

Abstract

SUMMARYProtozoan parasitesLeishmania donovani(family: Trypanosomatidae) cause fatal visceral leishmaniasis (VL) and the infection relapses in apparently cured population as post kala-azar dermal leishmaniasis (PKDL) in the Indian subcontinent. In recent years co-infection of another Trypanosomatid parasiteLeptomonaswithL. donovaniduring VL/PKDL in this region has become prominent. The observation of clinically lesser-known insect parasite,Leptomonasin leishmaniasis is intriguing to researchers. The presence of Leishmania look alikeLeptomonasin the cultures of clinical isolates ofLeishmaniahas been worrisome to those, who prefer to work with pureLeishmaniacultures for drug and vaccine development or immune response studies. The exact implications of such a co-habitation, which might lead to a delay in the diagnostics of VL and elevate mortality, need a thorough investigation. Also whetherLeptomonasis involved in leishmaniasis manifestation needs to be ascertained. Thus we are currently witnessing a new paradigm of a parasitic co-infection in VL/PKDL cases in India and this review outlines various opportunities for further research in understanding such emerging co-infection.