Ziel
The aim of this study is to elucidate the epidemiology of visceral leishmaniasis in Uzbekistan, assess risk factors and establish a comprehensive surveillance strategy for the control of the disease. A classical retrospective case study will be combined with a prospective study on identification of the causative agents, sand fly vectors and animal reservoir hosts. The study will integrate sero-epidemiological surveys for estimating the prevalence of the disease in human and animal hosts with molecular biological techniques for direct detection and identification of parasites in patients, putative animal reservoir hosts and sand fly vectors. Highly variable genetic markers will be employed for characterizing the parasites to the strain level. Changes in three risk factors associated with VL will be assessed: environmental changes caused by humans, immuno-suppression and refractoriness to the treatment with antimonials, the first line chemotherapeutic agents. A national database on VL will be established using the data generated by this study. The knowledge acquired from the basic research components and general surveying will be used to create a comprehensive surveillance system and implement effective control measures. This project will provide both training and professional development for young NIS researchers and strengthen the research capability, infrastructure and training capacities of the NIS partners. Our specific objectives are: - To carry out a 10-year retrospective study and analysis of VL in Uzbekistan b - To actively detect VL cases in a prospective study - To identify maximum of human cases, reservoir hosts and vectors by subjecting tissue samples from humans and animals to direct PCR-based analysis. - To isolate, characterize and identify, as many Leishmania strains as possible from humans, reservoir hosts and sand flies. - To assess genetic polymorphisms among Leishmania isolates and compare it with leishmanial strains of other geographical origins. - To assess infection rates in dog populations and exposed animal hosts using sero-diagnosis and PCR-based techniques; - To identify sand fly vectors and assess their roles in transmission. - To design a suitable strategy for controlling VL in Uzbekistan. Expected deliverables are i) personnel trained in methods for field work, ii) Collection of well-documented isolates from Uzbek VL foci, iii) Regional centre for collection, identification and storage of leishmanial parasites, v) implementation of modern serological and PCR-based diagnostics in Uzbekistan, vi) report about epidemiology of VL in Uzbekistan, vii) risk factor assessment, viii) identification of causative agents, vectors and reservoir hosts as prerequisite for the implementation of appropriate control measures.
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BERLIN
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