Department of - Instituut voor Tropische Geneeskunde

Unit of Molecular Parasitology
In the course of 2007, the Unit of Molecular Parasitology
Unit has made considerable progress in its two main,
closely related research lines on leishmaniasis, i.e.
treatment failure and drug resistance, and parasite
genotyping.
Our studies on drug resistance were highlighted in the
PhD thesis of Saskia Decuypere “Antimony treatment
failure in anthroponotic visceral leishmaniasis: towards
improved tools and strategies for epidemiological
surveillance and disease control”, which provides
a synthesis of five years work on drug resistance
leishmaniasis. Saskia joined the University of Strathclyde
(Prof. G. Coombs) with a Marie-Curie scholarship, where
she will pursue the biochemical characterisation of drugresistant
strains for two years before continuing her
postdoctoral work at the ITM. By the end of 2007, Meriem
Ouakad joined the unit for postdoctoral studies on drug
resistance.
Our research on parasite genotyping consists of three
main activities and PhD projects:
• dissemination, standardisation and quality control of
existing typing methods
• new and simple methods for species identification
• the application of molecular methods to specific
epidemiological questions
The composition of our team, with PhD and postdoctoral
fellows from Cuba, Peru, Algeria, Kenya and Nepal
illustrate the success of our intercontinental networking.
Among the major findings of 2007, we quote the first
extensive description of the L. donovani population
structure among healthy carriers in Nepal.
The Euro-Mediterranean consortium “Leishmed”,
which we coordinated, concluded its activities with
two workshops on immunological and environmental
control of leishmaniasis, both in Tunisia. A main
deliverable of this project was the digital compendium
on geo-referenced publications on the epidemiology
of leishmaniasis in the Mediterranean, developed
in close collaboration with the Leishmed partners
and WHO. Another networking milestone was the
“Leishrisk” conference in November 2007 in Antwerp
(see highlights) which brought together 150 world class
leishmaniacs.
The unit pursued its contribution simplified molecular
diagnosis of Leishmania and genotyping of Plasmodium
by the other units in the Department.
Unit of Parasite Diagnostics
The Unit of Parasite Diagnostics conducts research
on parasitological, serological, bioclinical and genetic
markers for the diagnosis, stage determination and
follow-up of trypanosomiasis (African and South-
American) and leishmaniaisis. We collaborate with
partners in DR Congo, Uganda, Kenya, Sudan, Malawi,
Ethiopia, South Africa, Mozambique, Zambia, Burkina
Faso, Venezuela, Chile and Spain, and are a partner in
WHO and FIND-Diagnostics consortia aiming to develop
new diagnostics for sleeping sickness.
The results of the first randomised clinical trial on
combination therapy for sleeping sickness were
published. This pioneer study was conducted in
Bwamanda (DR Congo), in collaboration with national
partners and the Drugs for Neglected Diseases Initiative
(DNDi). It allowed the identification of biological markers
in cerebrospinal fluid (CSF) as risk factors for relapse
and provided a rationale for shortening post-treatment
follow-up. These results should be confirmed in a new
study conducted in Mbuji-Mayi (DR Congo), where rates
of treatment failure are uncommonly high. The first in
vitro drug sensitivity tests on parasite strains isolated
from such patients seem to reject the hypothesis that the
high relapse rates are caused by parasite drug resistance.
The unit is partner in the NEUROTRYP consortium, which
intends to unravel the mechanisms by which African
trypanosomes invade the brain. We have constructed
recombinant Trypanosoma brucei strains that express
Renilla luciferase enabling in vivo tracking of the parasites
in mice (see highlight). Within the same project, an
RESEARCH | 51