Incidence of symptomatic and asymptomatic Leishmania donovani infections in high-endemic foci in India and Nepal: a prospective study

Ostyn, Bart; Gidwani, Kamlesh; Khanal, Basudha; Picado, Albert; Chappuis, François; Singh, Shri Prakash; Rijal, Suman; Sundar, Shyam; Boelaert, Marleen

doi:10.1371/journal.pntd.0001284

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Title		Incidence of symptomatic and asymptomatic Leishmania donovani infections in high-endemic foci in India and Nepal: a prospective study
Authors		Ostyn, Bart Gidwani, Kamlesh Khanal, Basudha Picado, Albert Chappuis, François Singh, Shri Prakash Rijal, Suman Sundar, Shyam Boelaert, Marleen show all authors [1 - 9]
Published in		PLOS Neglected Tropical Diseases. 2011, vol. 5, no. 10, p. e1284
Abstract		Incidence 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.
Keywords		Adolescent — Adult — Aged — Aged, 80 and over — Agglutination Tests/methods — Antibodies, Protozoan/blood — Asymptomatic Diseases — Child — Child, Preschool — Cohort Studies — Endemic Diseases — Female — Follow-Up Studies — Humans — Incidence — India/epidemiology — Infant — Infant, Newborn — Leishmania donovani/isolation & purification — Leishmaniasis, Visceral/epidemiology/parasitology/pathology — Male — Middle Aged — Nepal/epidemiology — Prospective Studies — Young Adult
Identifiers		DOI: 10.1371/journal.pntd.0001284 PMID: 21991397
Full text		Article (Published version) (228 Kb) - Free access
Structures		Faculté de médecine / Section de médecine clinique / Département de santé et médecine communautaires / Institut de médecine de premier recours
Research group		Groupe Jean-Michel Gaspoz (23)
Citation (ISO format)		OSTYN, Bart et al. Incidence of symptomatic and asymptomatic Leishmania donovani infections in high-endemic foci in India and Nepal: a prospective study. In: PLOS Neglected Tropical Diseases, 2011, vol. 5, n° 10, p. e1284. doi: 10.1371/journal.pntd.0001284 https://archive-ouverte.unige.ch/unige:25492