title: Studies on the prevalence of leishmanin skin test positivity in the Baringo District, Rift Valley, Kenya.
abstract: The leishmanin skin test (LST) was applied in 26 clusters of an average of 97 individuals in Baringo District, Kenya. These clusters were centered around recent cases of visceral leishmaniasis (VL). Of 2,411 individuals tested, 254 (10.5%, 155 males and 99 females) had a positive reaction. Among cured VL patients, the frequency was approximately 30% and no sex difference was observed. In the population as a whole, LST positivity increased with age to a stable level from approximately 15 years of age, reflecting an endemic situation. The level of LST positivity was 25-30% and 10-15% in males and females, respectively. Uninfected household contacts of VL cases had a higher frequency of LST reactivity than the rest of the population. This relationship was significant only in females and children, the prevalence ratio being 2.3 (95% confidence interval 1.3-4.1), 1.9 (1.1-3.5), and 1.4 (0.8-2.5) for females, children, and males, respectively. The frequency of LST positivity was higher individuals living in wood houses than in individuals living in house with mud or stone walls. Again, this difference was significant only in females and children (P = 0.02 and P = 0.04), but not in males (P = 0.7). The results suggest that children and women are exposed to the parasite in or around their houses, whereas adult males are, in addition, exposed elsewhere.
authors.affiliation: Unit for Infectious Diseases and Tropical Medicine, University of Amsterdam, The Netherlands.
authors.forename: K U
authors.initials: KU
authors.lastname: Schaefer
authors.forename: J A
authors.initials: JA
authors.lastname: Kurtzhals
authors.forename: P A
authors.initials: PA
authors.lastname: Kager
authors.forename: G S
authors.initials: GS
authors.lastname: Gachihi
authors.forename: M
authors.initials: M
authors.lastname: Gramiccia
authors.forename: J M
authors.initials: JM
authors.lastname: Kagai
authors.forename: J A
authors.initials: JA
authors.lastname: Sherwood
authors.forename: A S
authors.initials: AS
authors.lastname: Muller
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000818:Animals; D000953:Antigens, Protozoan; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006798:Housing; D006801:Humans; D007223:Infant; D007428:Intradermal Tests; D007630:Kenya / Q000453:epidemiology; D007893:Leishmania donovani / Q000276:immunology; D018314:Leishmania infantum / Q000276:immunology; D007898:Leishmaniasis, Visceral / Q000453:epidemiology*; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D012424:Rural Population; D012737:Sex Factors
chemical_list: D000953:Antigens, Protozoan; C032127:leishmanin