Projets soutenus

Leish1Health: Drug resistance in human and canine leishmaniasis.

Leishmania infantum, life cycle in France, dogs, sandflies, drug resistance

Responsabilité scientifique :

COJEAN Sandrine

Partenariat :

UMR 8076 BioCIS CNRS / Chimiothérapie Antiparasitaire

Financement :


Human visceral Leishmaniasis (HvL) is an emerging and potentially lethal disease in Mediterranean basin and in Western Europe. Leishmania infantum (L.i) is the etiological agent of autochthonous HvL and cutaneous leishmaniasis. The dog is considered as the major reservoir of the parasite for Human infection. The protozoa L.i is mainly transmitted to mammals (Humans, Dogs) by the bites of female sandflies. Climate change, travels to endemic areas and merchandise transits are changing the sandfly distribution and increasing the number of infected dogs. Ten thousand cases of infected dogs are reported each year in France and 1 million dogs are at risk. Infected dog surveillance is essential for human public health. Therefore, WHO recommends setting up annual monitoring of the prevalence of canine leishmaniasis (CanL). But the CanL monitoring remains difficult to set up. Topical treatment of dogs with permethrin or deltamethrin, vaccination, and chemotherapy (pentavalent antimonials plus allopurinol) are the best defense (i) to prevent the dog infection, (ii) to reduce infectiousness of treated dogs, and (iii) to reduce their role as parasite reservoirs for phlebotomine sandflies. In France, miltéfosine is restricted to human administration and prohibited in dogs. Amphotericin B (AmB) is not recommended in dogs because of its toxicity. However, miltefosine is available in border countries as a veterinary product to treat infected dogs. The current treatments do not eliminate completely the parasite and only slow down diseaseprogression, leading to frequent relapses and an often-fatal outcome. A few cases of miltefosine and AmB treatment failures in humans have been reported and involve people at risk (e.g., immunocompromised patients), but neither the canine reservoir nor the vector have been investigated.