Abstract
OBJECTIVES: Recent epidemiological reports indicate that asymptomatic human infections with Leishmania donovani, the causative agent of visceral leishmaniasis or Kala-azar (KA), occur frequently in India. We explored markers of infection. METHODS: Blood samples were collected from 286 healthy subjects from 16 villages in the Muzaffarpur district of Bihar. These individuals were classified into three groups: (i) persons with no history of KA and living in a house where no KA cases were previously reported, (ii) persons with no history of KA but living in a house where KA cases were diagnosed at the time of sampling or in the past, and (iii) successfully treated KA patients. Each sample was tested using a Leishmania-specific PCR to detect Leishmania DNA, and two serological tests to demonstrate anti-Leishmania antibodies: the Direct Agglutination Test and rK39 ELISA. RESULTS: PCR positivity was similar among the three groups (20-25%). In contrast, among treated patients, the percentage of serologically positive individuals was roughly five times that of healthy individuals with no KA history, as measured with either test. Living in a house where KA had been reported did not affect seropositivity. CONCLUSION: A significant proportion of asymptomatic infections of Leishmania exist in endemic regions. Using a combination of molecular and serological tests increases the capacity to detect infections at different stages. Further work is required to understand the kinetics of the markers.
Original language | English |
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Journal | Tropical Medicine and International Health |
Volume | 18 |
Issue number | 5 |
Pages (from-to) | 548-554 |
Number of pages | 7 |
ISSN | 1360-2276 |
DOIs | |
Publication status | Published - 2013 |
Keywords
- Protozoal diseases
- Visceral
- Leishmaniasis
- Kala azar
- Vectors
- Sandflies
- Phlebotomus argentipes
- Infection
- Serological
- Markers
- Molecular markers
- Asymptomatic infections
- Polymerase chain reaction
- PCR
- DAT
- rK-39 strip test
- Comparative study
- India
- Asia-South