Widespread transmission in diverse ecotypes challenges visceral leishmaniasis control in East Africa.

Authors

Eva Iniguez, Mercy Tuluso, Steve Kiplagat, Araya Gebresilassie, Esayas Aklilu, Olivia Battistoni, Johnstone Ingonga, John Mark Makwatta, Mohamed Alamin, Osman Dakien, Alphine Chebet, Esther Kaunda, Patrick Huffcutt, Serena Doh, Pedro Cecilio, Galgallo Bonaya, Claudio Meneses, Tiago D Serafim, Myrthe Pareyn, Mohamed Osman, Eltahir A G Khalil, Omran F Osman, Brima M Younis, Sithar Dorjee, Guofa Zhou, Jesus G Valenzuela, Dan K Masiga, Ahmed M Musa, Asrat Hailu, Abhay Satoskar, Shaden Kamhawi, Damaris Matoke-Muhia

Published in

One health (Amsterdam, Netherlands). Volume 23. Pages 101575. Epub Sep 20, 2026.

Abstract

East Africa is emerging as the global hot spot of visceral leishmaniasis (VL), yet efforts to eliminate it are hindered by substantial knowledge gaps in its ecoepidemiology. Here, we report on the high prevalence of Leishmania infection in Phlebotomus orientalis in Marsabit county, Kenya (3.9%), and Gedaref state, Sudan (3.6%), where this species comprised 99.8% (n = 1185) and 100% (n = 1350) of captured Phlebotomus females, respectively. In Aba Roba, Ethiopia, Phlebotomus martini accounted for 94.4% of 184 collected Phlebotomus females and had a lower infection rate of 1.5%. Phlebotomus orientalis and Phlebotomus martini exhibited different habitat and feeding preferences. While Phlebotomus orientalis was abundant in diverse peridomestic and sylvatic microhabitats, Phlebotomus martini was predominantly collected from termite hills. Moreover, Phlebotomus orientalis primarily fed on humans and less on domestic and sylvatic animals. In contrast, Phlebotomus martini exhibited zoophagic behavior, mostly feeding on cows and Ovis. Widespread transmission of Leishmania in our study sites is supported by high rK39 seroprevalence in both Kenya (17.9%) and Sudan (6.2%). An observed greater prevalence of antibodies to rK39 in individuals living near than away from VL cases in both Kenya (19.8% versus 7.4%, P = 0.0015) and Sudan (8.4% versus 2.1%, P = 0.0105) demonstrated that proximity to a VL case carries an increased risk of infection. Our findings highlight the need for a risk-based targeted site-specific one health elimination strategy that accounts for the intensity, diversity, and complexity of VL transmission in today's East Africa.

PMID:
42831020
Bibliographic data and abstract were imported from PubMed on 05 Oct 2026.

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