The potential impact of human visceral leishmaniasis vaccines on population incidence

Epke A. Le Rutte*, Luc E. Coffeng, Stefano Malvolti, Paul M. Kaye, Sake J. de Vlas

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

13 Citations (Scopus)
8 Downloads (Pure)

Abstract

Human visceral leishmaniasis (VL) vaccines are currently under development and there is a need to understand their potential impact on population wide VL incidence. We implement four characteristics from different human VL vaccine candidates into two published VL transmission model variants to estimate the potential impact of these vaccine characteristics on population-wide anthroponotic VL incidence on the Indian subcontinent (ISC). The vaccines that are simulated in this study 1) reduce the infectiousness of infected individuals towards sand flies, 2) reduce risk of developing symptoms after infection, 3) reduce the risk of developing post-kala-azar dermal leishmaniasis (PKDL), or 4) lead to the development of transient immunity. We also compare and combine a vaccine strategy with current interventions to identify their potential role in elimination of VL as a public health problem. We show that the first two simulated vaccine characteristics can greatly reduce VL incidence. For these vaccines, an approximate 60% vaccine efficacy would lead to achieving the ISC elimination target (<1 VL case per 10,000 population per year) within 10 years’ time in a moderately endemic setting when vaccinating 100% of the population. Vaccinating VL cases to prevent the development of PKDL is a promising tool to sustain the low incidence elimination target after regular interventions are halted. Vaccines triggering the development of transient immunity protecting against infection lead to the biggest reduction in VL incidence, but booster doses are required to achieve perduring impact. Even though vaccines are not yet available for implementation, their development should be pursued as their potential impact on transmission can be substantial, both in decreasing incidence at the population level as well as in sustaining the ISC elimination target when other interventions are halted.

Original languageEnglish
Article numbere0008468
Pages (from-to)1-13
Number of pages13
JournalPLoS Neglected Tropical Diseases (print)
Volume14
Issue number7
DOIs
Publication statusPublished - 2 Jul 2020

Bibliographical note

Funding Information:
Funding:EALR,LEC,andSJDVgratefully acknowledgefundingoftheNTDModelling ConsortiumbytheBillandMelindaGates Foundation(OPP1184344).LECfurther acknowledgesfundingfromtheDutchResearch Council(NWO,grant016.Veni.178.023).PMKand SMaresupportedbyTheWelcomeTrust(grant numbersWT108518andWT1063203).The fundershadnoroleinstudydesign,datacollection andanalysis,decisiontopublish,orpreparationof themanuscript.

Publisher Copyright:
© 2020 Le Rutte et al.

Research programs

  • EMC NIHES-02-65-01

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