Sandfly

This is visceral leishmaniasis (kala-azar), caused by Leishmania donovani and spread by the sandfly.

What our notes say

This is visceral leishmaniasis (kala-azar), caused by Leishmania donovani and spread by the sandfly. (Paediatrics Year 6 MBChB end of semester CAT: clinical case MCQs, 29 of 30 quest)
The stage of Leishmania that develops in the sandfly and is transmitted to humans is the: (Medical Entomology & Parasitology Quiz Q&A)
When the infected sandfly feeds, promastigotes are injected into human skin where they transform into amastigotes within macrophages. (Medical Microbiology Q&A Guide)
The proximity increases sandfly populations and disease transmission risk. (Medical Bacteriology and Entomology)
Vector control — sandfly control programs (insecticide spraying, bed nets) (Pharmacology Cheat Code)
Leishmaniasis *(as marked in this specific paper — likely referring to sandfly-favorable habitat conditions rather than literal anthills; treat with caution and confirm with your lecturer) (Medical Entomology & Parasitology Quiz Q&A)