Minimally Invasive Microbiopsies as an Improved Sampling Method for the Diagnosis of Cutaneous Leishmaniasis

Churiso, Gemechu; Henten, Saskia van; Cnops, Lieselotte; Pollmann, Julia; Melkamu, Roma; Lemma, Mulualem; Kiflie, Amare; Fikre, Helina; Griensven, Johan van; Adriaensen, Wim

doi:10.1093/ofid/ofaa364

Cited by 7 publications

(8 citation statements)

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“…In line with previous pilot studies, our results from an Indian setting suggest that the microbiopsy device provides a promising tool to measure skin parasite load in the Indian setting, andif validated by xenodiagnosis studiescould facilitate much needed larger scale studies on infectiousness of human subgroups. The main strength of this study is that it is the first study to our knowledge that pilots the use of the microbiopsy device in the setting of the Indian subcontinent, and only the third to pilot this on different disease/infection subgroups for leishmaniasis worldwide (Kirstein et al, 2017;Churiso et al, 2020). An additional strength of this study lies in the fact that four different tests (DAT, rK39 ELISA, WBA, and blood parasite load) were used to identify asymptomatically infected individuals.…”

Section: Discussionmentioning

confidence: 99%

“…The main strength of this study is that it is the first study to our knowledge that pilots the use of the microbiopsy device in the setting of the Indian subcontinent, and only the third to pilot this on different disease/infection subgroups for leishmaniasis worldwide ( Kirstein et al, 2017 ; Churiso et al, 2020 ). An additional strength of this study lies in the fact that four different tests (DAT, rK39 ELISA, WBA, and blood parasite load) were used to identify asymptomatically infected individuals.…”

Section: Discussionmentioning

confidence: 99%

“…A study assessing the microbiopsy device as an alternative for slit skin smears for the diagnosis of CL was recently published ( Churiso et al, 2020 ). The authors found the microbiopsy device to outperform routine skin slit sampling in the Ethiopian setting, identifying it as a promising alternative for CL diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…Studies directly linking the results of this microbiopsy tool to those of xenodiagnosis would be able to shed light on the association between parasite DNA presence in the skin and infectiousness to sand flies. A study assessing the microbiopsy device as an alternative for slit skin smears for the diagnosis of CL was recently published (Churiso et al, 2020). The authors found the microbiopsy device to outperform routine skin slit sampling in the Ethiopian setting, identifying it as a promising alternative for CL diagnosis.…”

Section: Arm + N(%)mentioning

confidence: 99%

“…This device takes minimally invasive and virtually painless skin samples that mimic the amount and the composition of the tissue ingested by a sand fly. Two studies performed in Ethiopia have illustrated the potential of this MB tool to take up Leishmania DNA ( L. ethiopica and L. donovani ) in both patients and a part of asymptomatically infected individuals ( Kirstein et al, 2017 ; Churiso et al, 2020 ). We set out to pilot this microbiopsy device in an Indian setting.…”

Section: Introductionmentioning

confidence: 99%

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Assessing L. donovani Skin Parasite Load: A Proof of Concept Study of a Microbiopsy Device in an Indian Setting

Cloots

Singh

et al. 2021

Front. Cell. Infect. Microbiol.

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BackgroundIn the endgame of the elimination initiative of visceral leishmaniasis (VL) on the Indian subcontinent, one of the main questions remaining is whether asymptomatically infected individuals also contribute to transmission. We piloted a minimally invasive microbiopsy device that could help answer this question. While the potential of this device has been previously illustrated in Ethiopia, no such information is available for the setting of the Indian subcontinent. In this proof of concept study we aimed to assess 1) to what extent skin parasite load obtained with the new microbiopsy device correlates with disease status, 2) to what extent skin parasite load correlates with blood parasite load in the same subject, and 3) to what extent the skin parasite load obtained from different sampling sites on the body correlates with one another.MethodsWe performed a pilot study in Bihar, India, including 29 VL patients, 28 PKDL patients, 94 asymptomatically infected individuals, 22 endemic controls (EC), and 28 non-endemic controls (NEC). Presence of infection with L. donovani in the blood was assessed using Direct Agglutination Test, rK39 ELISA, Whole Blood Analysis measuring IFN-γ and qPCR. A skin sample was collected with the microbiopsy device on two different locations on the body. PKDL patients provided a third skin sample from the edge of a PKDL lesion. Parasite load in the skin was measured by qPCR.FindingsWe found a clear correlation between the skin parasite load obtained with the microbiopsy device and disease status, with both higher skin parasite loads and higher proportions of positive skin samples in VL and PKDL patients compared to asymptomatics, EC, and NEC. No clear correlation between skin parasite load and blood parasite load was found, but a moderate correlation was present between the skin parasite load in arm and neck samples. In addition, we found four positive skin samples among asymptomatic individuals, and 85% of PKDL lesions tested positive using this microbiopsy device.ConclusionsIn line with previous pilot studies, our results from an Indian setting suggest that the microbiopsy device provides a promising tool to measure skin parasite load, and – if validated by xenodiagnosis studies – could facilitate much needed larger scale studies on infectiousness of human subgroups. In addition, we advocate further evaluation of this device as a diagnostic tool for PKDL.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Arm + N(%)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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