Table 1.

Research Agenda for Future Work on Asymptomatic Infection

Research Questions
1. Can people without clinical symptoms infect sand flies? If, yes, then how many people fit into that category (infectious but asymptomatic), and what are their characteristics?
2. Can we identify the infectious subset of persons in a population affected by Leishmania donovani? Which assay markers for this infectious subset of persons can be used?
3. How does the number of infectious people change over time and over the course of their infections?
4. Can the identification and validation of novel Leishmania-specific biomarkers help to distinguish between latent Leishmania infection and active disease?
5. How does test assay performance vary between high- and low-VL-incidence settings? In addition to geographical variability, are there racial/ethnic differences in tests performance and accuracy?
6. Will treating or vaccinating these asymptomatically infected individuals affect the intensity of transmission, and will it have a significant impact on the VL epidemic?

Abbreviation: VL, visceral leishmaniasis.