leishmaniasis

Dr. Gosia Domagalska: Outwitting Leishmania

In the quiet corridors of the Institute of Tropical Medicine (ITM) in Antwerp, Belgium, Dr. Malgorzata “Gosia” Domagalska is leading the fight against one of the world’s most neglected yet devastating diseases: leishmaniasis. As head of ITM’s newly established Unit of Experimental Parasitology, she has dedicated her career to understanding how parasites adapt, survive, and outwit medicine.

Domagalska’s path to parasitology was anything but straightforward. Trained as a geneticist, she earned her PhD in Plant Genetics at the Max Planck Institute in Cologne, followed by a Marie Curie Fellowship at the University of York. Early on, her research focused on plant development and hormones. But a shift came when she joined ITM in 2015: “This work is compelling not just scientifically, but socially,” she has said.

Leishmaniasis – Plain and Simple

Leishmaniasis is a parasitic disease that few people have heard of, but one you definitely don’t want to catch. Caused by Leishmania parasites and spread by the bite of female sand flies, it can silently linger in the body for years or surface in devastating ways, from painful skin sores to organ damage that can be fatal. The disease affects both humans and dogs, with our canine companions often acting as unwitting reservoirs that keep the infection circulating.

As climate change expands the habitat of sand flies into new regions, the threat of leishmaniasis continues to grow. With no reliable cure and limited vaccine options, prevention is key. Protecting yourself and your pets with repellents, protective gear, and vigilance is the most effective way to guard against this serious but often overlooked disease.

Sand Flies: The Silent Biters Spreading A Deadly Disease

Phlebotomine sand flies are notorious biters. They not only cause great irritation but are also capable of spreading a deadly disease – visceral leishmaniasis.

While the World Health Organization states that currently 1 billion people live in areas endemic for leishmaniasis and at risk of contracting the disease, a recent study using a statistical model, predicted that visceral leishmaniasis (VL) is undergoing geographic expansion and 5.3 billion people could be at risk of acquiring the disease in the future.

Leishmaniasis currently occurs in approximately 90 countries. These countries are located in the warmer climates where sand flies thrive: in the tropics, subtropics, and in Southern Europe. Climate change and other variations in the environment have the potential to expand the geographical range of where sand flies can live and therefore where the disease can infiltrate the human population.

Epidemiology of Leishmaniasis

Leishmaniasis is a parasitic disease spread by the bite of infected female sandflies. It can affect the skin, mucous membranes, or internal organs. The most serious form, visceral leishmaniasis (VL), damages the liver, spleen, bone marrow, and kidneys, and is caused mainly by Leishmania donovani and Leishmania infantum.

Every year, 1–2 million people are affected, with over 90% of cases concentrated in just 13 countries. While many infections show no symptoms, untreated VL is usually fatal. Malnutrition, HIV co-infection, genetics, and young age (especially under 5) increase the risk of severe disease.

Tracking the Global Burden of Vector-Borne Disease

The burden of vector-borne diseases (VBDs) is one of public health’s most pressing challenges. VBDs are caused by pathogens such as arboviruses (arthropod-borne virus), bacteria, and parasites that are transmitted to humans and animals through the bites of infected arthropods including mosquitoes, ticks, sandflies, and fleas, among others. According to the World Health Organization (WHO) , “vector-borne diseases account for more than 17% of all infectious diseases, causing more than 700,000 deaths annually worldwide”.

Beyond these broad statistics, attempts to quantify the global burden of VBDs is extremely challenging – for a number of reasons. At the highest level, even “burden” has an underlying complexity in public health terms: burden may refer to the number of cases of a given disease as well as the number of deaths.

Burden can also represent Disability-adjusted Life Years (DALYs), a measure that accounts for the long-term effects of disability among the afflicted, as well as the economic impact of disease from regions and countries all the way down to households and individuals. These economic impacts can be further scrutinized as reduced productivity among the populace, increased healthcare costs, and negative impacts on tourism; all of which can directly affect the GDP and economic growth of local and regional economies. And that’s just the beginning.