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Challenges in Modeling Complexity of Neglected Tropical Diseases: Assessment of Visceral Leishmaniasis Dynamics in Resource Limited Settings

Neglected tropical diseases (NTD), particularly vector-borne diseases (VBD), account for a large proportion of the global disease burden, and their control faces several challenges including diminishing human and financial resources for those distressed from such diseases. Visceral Leishmaniasis (VL), the second-largest parasitic killer in the world (after malaria) affects poor populations in endemic countries and causes considerable cost to the affected individuals and their society. Mathematical models can serve as a critical tool for understanding the driving mechanisms of a NTD such as VL. The WHO promotes integrated control programs for VL but this policy is not well supported by systematic quantitative and dynamic evidence and so potential benefits of the policy are limited. Moreover, mathematical models can be readily developed and used to understand the functioning of the VL system cheaply and systematically. The focus of this research is three-fold: (i) to identify non-traditional but critical mechanisms for ongoing VL transmission in resource limited regions, (ii) to review mathematical models used for other infectious diseases that have the potential to capture identified factors of VL, and (iii) to suggest novel quantitative models for understanding VL dynamics and for evaluating control programs in such frameworks for achieveing VL elimination goals.