The epidemiology of Leishmania donovani infection in high transmission foci in India

SP Singh, A Picado, M Boelaert, K Gidwani, EW Andersen, B Ostyn, F Meheus, M Rai, F Chappuis, C Davies, S Sundar

    Research output: Contribution to journalA1: Web of Science-article

    Abstract

    Summary Objective Visceral Leishmaniasis (VL) is highly prevalent in Bihar, India. India and its neighbours aim at eliminating VL, but several knowledge gaps in the epidemiology of VL may hamper that effort. The prevalence of asymptomatic infections with Leishmania donovani and their role in transmission dynamics are not well understood. We report data from a sero-survey in Bihar. Methods Demographic and immunological surveys were carried out in July and November 2006, respectively in 16 highly VL endemic foci in Muzaffarpur district in Bihar. Household and individual information was gathered and capillary blood samples were collected on filter papers. Direct agglutination test (DAT) was used to determine infected individuals (cut-off titre 1:1600). DAT results were tabulated against individual and household variables. A multivariate generalized estimating equation (GEE) model was used to study the prevalence of serologically positive individuals taking into account the clustering at household and cluster levels. Results Of study subjects 18% were DAT positive, and this proportion increased with age. Women had a significantly lower prevalence than men >14 years old. Owning domestic animals (cows, buffaloes or goats) was associated with a higher risk of being DAT positive [OR 1.16 (95% CI 1.01-1.32)], but socio-economic status was not. Conclusions Prevalence of leishmanial antibodies was high in these communities, but variable. Demographic factors (i.e. marriage) may explain the lower DAT positivity in women >14 years of age. Within these homogeneously poor communities, socio-economic status was not linked to L. donovani infection risk at the individual level, but ownership of domestic animals was
    Original languageEnglish
    JournalTropical Medicine and International Health
    Volume15
    Issue numberSuppl. 2
    Pages (from-to)12-20
    Number of pages9
    ISSN1360-2276
    DOIs
    Publication statusPublished - 2010

    Keywords

    • B780-tropical-medicine
    • Protozoal diseases
    • Leishmaniasis
    • Visceral
    • Kala azar
    • Leishmania donovani
    • Vectors
    • Sandflies
    • Phlebotomus
    • Epidemiology
    • Prevalence
    • Detection
    • Direct agglutination test
    • DAT
    • Age
    • Gender
    • Risk factors
    • Domestic animals
    • Demographic aspects
    • India
    • Asia-South

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