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THE EPIDEMIOLOGY OF VISCERAL LEISHMANIASIS AND ASYMPTOMATIC LEISHMANIAL INFECTION IN A HIGHLY ENDEMIC BANGLADESHI VILLAGE

2007; American Society of Tropical Medicine and Hygiene; Volume: 76; Issue: 5 Linguagem: Inglês

10.4269/ajtmh.2007.76.909

1476-1645

Caryn Bern, RAJIB CHOWDHURY, Robert F. Breiman, M A Wahed, YUKIKO WAGATSUMA, W. Evan Secor, James H. Maguire, Mustakim Ali, Louise E. Vaz, Josef Amann, Katie Kurkjian, John Williamson, Rashidul Haque,

Leptospirosis research and findings

We examined the epidemiology of kala-azar and asymptomatic leishmanial infection measured by serologic and leishmanin skin test results in a Bangladeshi community. In a subset, we measured serum retinol, zinc and C-reactive protein (CRP). Kala-azar and seroconversion incidence were 15.6 and 63.1 per 1,000 person-years, respectively. Proximity to a previous kala-azar case increased the likelihood of both kala-azar and asymptomatic infection. Bed net use protected against kala-azar (rate ratio = 0.35, P < 0.01), but not subclinical infection (rate ratio = 1.1, P = 0.82). Kala-azar patients were younger (P < 0.001) and reported lower red meat consumption (P < 0.01) than asymptomatic seropositive individuals. Retinol and zinc levels were lower in current kala-azar patients and those who later developed kala-azar compared with uninfected and asymptomatically infected subjects. The CRP levels were higher in kala-azar patients compared with the other two groups. Low red meat intake and poor zinc and retinol status may characterize a group at higher risk of symptomatic disease.