Incidence of Symptomatic and Asymptomatic Leishmania donovani Infections in High-Endemic Foci in India and Nepal: A Prospective Study
2011; Public Library of Science; Volume: 5; Issue: 10 Linguagem: Inglês
10.1371/journal.pntd.0001284
ISSN1935-2735
AutoresBart Ostyn, Kamlesh Gidwani, Basudha Khanal, Albert Picado, François Chappuis, Shri Prakash Singh, Suman Rijal, Shyam Sundar, Marleen Boelaert,
Tópico(s)Trypanosoma species research and implications
ResumoIncidence of Leishmania donovani infection and Visceral Leishmaniasis (VL) was assessed in a prospective study in Indian and Nepalese high-endemic villages. DAT-seroconversion was used as marker of incident infection in 3 yearly surveys. The study population was followed up to month 30 to identify incident clinical cases. In a cohort of 9034 DAT-negative individuals with neither active signs nor history of VL at baseline, 42 VL cases and 375 asymptomatic seroconversions were recorded in the first year, giving an infection:disease ratio of 8.9 to 1. In the 18 months' follow-up, 7 extra cases of VL were observed in the seroconverters group (N=375), against 14 VL cases among the individuals who had not seroconverted in the first year (N=8570) (RR=11.5(4.5<RR<28.3)). Incident asymptomatic L. donovani infection in VL high-endemic foci in India and Nepal is nine times more frequent than incident VL disease. About 1 in 50 of these new but latent infections led to VL within the next 18 months.
Referência(s)