Optimizing Surveillance and Treatment for Control of Cutaneous Leishmaniasis

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OVERVIEW SUMMARY Our TMRC program “Optimizing surveillance and treatment for control of cutaneous leishmaniasis”constitutes a concerted transdisciplinary and intersectorialeffort to address fundamental constraints on the control of cutaneous leishmaniasis in Colombia and the Latin American Region. Control of zoonotic cutaneous leishmaniasis is centered on case identification and treatment. However, the dispersed distribution of the populations at risk, underreporting, unavailability of information on the effectiveness of treatments administered, and increasing rates of treatment failure and evidence of drug resistance to the few available antileishmanial drugs undermine and subvert control efforts. The Goal of the TMRC “Optimizing Surveillance and Treatment for Control of Cutaneous Leishmaniasis” will be developed at three inter-related levels of response to treatment: Host innate responses affecting outcome of treatment and corresponding biomarkers; Parasite-dependent factors in drug susceptibility and therapeutic outcome; Active detection of affected Communities, cases and treatment follow-up. 1. To address critical knowledge gaps in the targeting and evaluation of interventions for control of cutaneous leishmaniasis. 2. To determine the relation of parasite susceptibility to anti-leishmanial drugs with the clinical and parasitological response to standard-of-care treatment, and parasite factors defining this relationship. 3. Identify innate host functions that contribute to cure or failure during antileishmanial drug therapy and their related biomarkers. This Center Program will be developed by a multidisciplinary team of national and international investigators that includes recognized experts, mid-career and new investigators in the relevant fields: Epidemiology, Vector Ecology, Molecular Biology and Genomics, Immunology and Cell Biology. The Principal Investigators and Core Leaders have already worked together successfully. Each brings high level specialized capacities to the corresponding projects and together, provide a broad scope of vision to the TMRC. Each Research Project will contribute to more effective control by addressing information and knowledge gaps and barriers to opportune, appropriate treatment to achieve cure, decrease the risk of relapse and by providing information and tools to reduce the prevalence and consequences of cutaneous leishmaniasis. CIDEIM is a WHO Collaborating Center for Leishmaniasis since 1992. The scope and focus of proposed TMRC program on the optimization of surveillance and treatment will be synergistic with our role as a WHOCC allowing the TMRC research and training program to channel and amplify capacity building within the Region and to translate findings to the competent national authorities