Measurement of Recent Exposure to Phlebotomus argentipes, the Vector of Indian Visceral Leishmaniasis, by Using Human Antibody Responses to Sand Fly Saliva

Meredith F. Clements London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Kamlesh Gidwani London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Rajiv Kumar London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Jitka Hostomska London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Diwakar S. Dinesh London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Vijay Kumar London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Pradeep Das London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Ingrid Müller London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Gordon Hamilton London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Vera Volfova London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Marleen Boelaert London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Murari Das London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Suman Rijal London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Albert Picado London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Petr Volf London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Shyam Sundar London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Clive R. Davies London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Matthew E. Rogers London School of Hygiene and Tropical Medicine, London, United Kingdom; Banaras Hindu University, Varanasi, India; Charles University, Prague, Czech Republic; Rajendra Memorial Research Institute, Patna, India; Imperial College of Science, Technology and Medicine, London, United Kingdom; Keele University, Keele, United Kingdom; Institute of Tropical Medicine, Antwerp, Belgium; BP Koirala Institute of Health Sciences, Dharan, Nepal

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Antibody (IgG) responses to the saliva of Phlebotomus argentipes were investigated using serum samples from regions of India endemic and non-endemic for visceral leishmaniasis (VL). By pre-adsorbing the sera against the saliva of the competing human-biting but non-VL vector P. papatasi, we significantly improved the specificity of a P. argentipes saliva enzyme-linked immunosorbent assay. Using this method, we observed a statistically significant correlation between antibodies to P. argenitpes saliva and the average indoor density of female sand flies. Additionally, the method was able to detect recent changes in vector exposure when sera from VL patients were assayed before, during, and after hospitalization and protected from sand fly bites under untreated bed nets. Collectively, these results highlight the utility of antibodies to P. argentipes saliva as an important tool to evaluate VL vector control programs.

Author Notes

*Address correspondence to Matthew E. Rogers, Division of Investigative Science, Department of Immunology, Imperial College of Science, Technology and Medicine, St. Mary's Campus, Norfolk Place, Paddington, London, W2 1PG, United Kingdom. E-mail: matthew.rogers@imperial.ac.uk
†These authors contributed equally to this study.

Financial support: This study was supported by the Wellcome Trust, UK (advanced training fellowship, project WT078223MA to Matthew E. Rogers), the Indian Council of Medical Research (junior fellowship to Rajiv Kumar), the Czech Republic Ministry of Education (LC 06009 and MSM0021620828), and the European Union (Project 015374, KALANET).

Authors' addresses: Meredith F. Clements, Albert Picado, and Clive Davies, Department of Disease Vector Biology and Control, London School of Hygiene and Tropical Medicine, London, United Kingdom, E-mail: albert.picado@lshtm.ac.uk. Kamlesh Gidwani, Rajiv Kumar, and Shyam Sundar, Kala-azar Medical Research Center, Banaras Hindu University, Varanasi, India, E-mail: drshyamsundar@hotmail.com. Jitka Hostomska, Vera Volfova, and Petr Volf, Department of Parasitology, Charles University, Prague, Czech Republic, E-mail: volf@cesnet.cz. Diwakar S. Dinesh, Vijay Kumar, and Pradeep Das, Rajendra Memorial Research Institute of Medical Sciences (Indian Council of Medical Research), Patna, Bihar, India, E-mail: dasp@cal2.vsnl.net.in. Ingrid Müller and Matthew E. Rogers, Division of Investigative Science, Department of Immunology, Imperial College of Science, Technology and Medicine, St. Mary's Campus, London, United Kingdom, E-mail: matthew.rogers@imperial.ac.uk. Gordon Hamilton, Institute of Science and Technology in Medicine, Keele University, Keele, United Kingdom, E-mail: j.g.c.hamilton@biol.keele.ac.uk. Marleen Boelaert, Unit of Epidemiology and Disease Control, Institute of Tropical Medicine, Antwerp, Belgium, E-mail: mboelaert@itg.be. Murari Das and Suman Rijal, BP Koirala Institute of Health Sciences, Dharan, Nepal, E-mail: sumanrijal2@yahoo.com.

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