Table 4 Gaps and opportunities associated with asymptomatic Leishmania infection

Gaps

 Lack of consensus regarding definition of asymptomatic infection

 Lack of consensus regarding optimal technique for identification of asymptomatic population

 Large variety of test targets and antigens employed by different research groups

 Lack of knowledge pertaining to the potential role of asymptomatic individuals in Leishmania disease transmission and epidemiology

 Lack of knowledge pertaining to the factors associated with development of clinical leishmaniasis by individuals previously considered to be asymptomatically infected

Opportunities

 Establish a standard definition of “asymptomatic Leishmania infection”

 Determine the optimal technique for identification of the asymptomatic population (technique, target/antigen)

 Determine the true prevalence of asymptomatic Leishmania infection in different regions

 Determine the true role of asymptomatic Leishmania-infected subjects (both immunocompetent and immunosuppressed) in transmission of leishmaniasis

 Establish objective, quantifiable markers associated with the development of clinical leishmaniasis by previously asymptomatically infected individuals (differentiate subclinical and asymptomatic infections)

 Determine the principal risk factors related to development of clinical leishmaniasis