Towards better diagnostics and a simplified treatment regimen for visceral leishmaniasis in southern Ethiopia

  • Degaga, Tamiru Shibiru (PhD Student)
  • van Griensven, Johan (Promotor)
  • Pareyn, Myrthe (Promotor)
  • Dujardin, Jean-Claude (Promotor)
  • Hailu, Asrat (Promotor)
  • Diro, Ermias (Promotor)

Project Details

Layman's description

Visceral Leishmaniasis (VL), also called kala-azar, is a neglected tropical disease (NTD) that is reported from about 79 countries in the world. With effective control measures undertaken in the Indian subcontinent, the East Africa has become the region with the highest disease burden. VL is caused by a protozoan parasite of the Leishmania donovani complex. Infection manifests with irregular bouts of fever, weight loss, enlargement of the spleen and liver, and anemia. If not treated, VL is fatal in 95% of the cases.

In Ethiopia, 3.2 million people are at risk of VL infection and estimated 2,500 to 4,000 new cases occur every year. However, these numbers area probably still an underestimation, as many cases presumably do not seek healthcare or do not get diagnosed with the current diagnostic algorithm. VL is mainly endemic in the lowlands of the northwest and southwest parts of Ethiopia. While most of the studies and trials on VL in Ethiopia have been conducted in the north, there are evidences that indicated that VL in the south is distinct in the clinical presentation and treatment response. The current treatment regimen is mainly based on findings from the north, but it may not suite to the southern region. Therefore, better diagnostic and treatment approaches for the southern region of Ethiopia need to be explored.

This PhD project aims at providing insights on the gap in the current diagnostic algorithm and factors that explain the variability in clinical manifestations and treatment response between VL patients in the northwest and southwest regions of Ethiopia. Moreover, it aims to generate evidence on the effectiveness and safety of a simplified treatment regimen in southern Ethiopia.

The project will include a scoping review of existing articles on differences in the clinical presentation and treatment outcomes of VL in East-Africa. Moreover, a cross sectional prospective study will be conducted to generate a detailed clinical characterization of VL patients and their parasitological response to treatment, which will be formally compared a cohort study performed by Ethiopian partners in the northern part of the country. Furthermore, the proportion of undiagnosed VL cases with the current diagnostic algorithm will be determined and the potential added value of molecular methods will be assessed. Lastly, a non-inferiority randomized controlled trial to compare a single dose of AmBisome to the existing 17 days of treatment with pentavalent antimonials and paromomycin will be conducted.

Overall, the findings of these studies will help to improve the clinical management of VL patients, particularly in the southern part of Ethiopia, aiming to incorporate research findings into policy and practice.
Effective start/end date1/01/2331/12/23

IWETO expertise domain

  • B780-tropical-medicine


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