study rapidly spreading parasitic disease
Yale researchers have been awarded a $5.4 million National Institutes of Health grant for the study of a parasitic disease that affects thousands of children each year.
The four and a half year grant from the International Collaboration in Infectious Disease Research (ICIDR) will fund research on the epidemiological and immunological aspects of cutaneous leishmaniasis (CL) in Colombia.
CL is a parasitic disease that is spread by the female sand fly and causes severe skin lesions. In Colombia, the number of cases reported almost doubled from 5,000 in 2002 to nearly 10,000 in 2003. At least 23% of these are children under age 12.
In addition to comprising a high percentage of CL cases, children have a poor response to pentavalent antimonial drugs, the standard drug therapy used in adults.
Diane McMahon-Pratt, professor in the Division of Epidemiology of Microbial Diseases (EMD) in the Department of Epidemiology and Public Health, is the co-principal investigator of the study and the Yale program director on the grant.
"This study will be used to impact mechanisms of control addressing the host response and effective treatments in endemic areas," she explains.
The ICIDR grant will support three projects in the research program. The first will develop the infrastructure for clinical trials within the endemic area. This will lead to future studies to address the lack of a more effective treatment for children. The initial focus will be on comparing the success and the tolerability of a new oral drug, miltefosine, with the standard drug therapy in children. "Miltefosine has fewer side effects," says McMahon-Pratt. "It could provide a less toxic measure of intervention."
The second study will identify factors that are responsible for transmission as well as the most efficacious measures for vector control and for reducing the risk of parasitic infection. The third project will be to determine the immunologic mechanisms associated with development of the lesions and the factors needed to encourage the body's elimination of the parasite and to promote healing.
"We are bringing the three dimensions of CL together in this study. We are working with the human cases together with the roles of the vector and of the reservoir animals," says Leonard Munstermann, senior research scientist in EMD and co-principal investigator on the study. "This has never been successfully done in a single study.
"With over 400 species of sand flies in the Americas alone and at least a dozen species of CL occurring all over the world, the epidemiology of leishmaniasis is complex," says Munstermann. "However, we believe that the current study in Colombia can become a sound epidemiological model for other endemic regions."
The program is a collaborative effort with the Centro Internacional de Entrenamiento e Investigaciones Medicas, located in Cali, Colombia.
Other Yale researchers in the program include Theodore Holford, Dr. Richard Bucala, Dr. Prakash Nadkarni and Lee Cohnstaedt. CIDEIM researchers include Dr. Lyda Osorio, Nancy G. Saravia, Neal Alexander and Clara B. Ocampo.
For further information on this grant, contact Marcie Foley at (203) 785-5476.
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