title: Epidemiology of cutaneous leishmaniasis in Colombia: a longitudinal study of the natural history, prevalence, and incidence of infection and clinical manifestations.
abstract: This prospective study measured the incidence of Leishmania infection, by Leishmanin skin test (LST) conversion, and leishmaniasis, by new acquisition of lesions, in a Leishmania braziliensis endemic area of Colombia, during 7243 person-years. The incidence rate of infection and leishmaniasis varied greatly by village, ranging from 2.8 to 23.0/100 person-years and 0.0 to 20.4/1000 person-years, respectively. Adult males experienced greater rates of both infection and leishmaniasis. Most primary infections (91%) were subclinical initially. Typical scars were predictive of subsequent leishmaniases both for persons initially LST-reactive (risk ratio = 11.3, P = .003) and for those initially nonreactive (risk ratio = 3.2, P = .02). Only one-third of the diagnosed leishmaniasis cases (24/77) were due to newly acquired infections in naive hosts. The relative contribution of existing lesions, recurrences, and new infections to the burden of disease should be considered in the planning of leishmaniasis control programs.
authors.affiliation: Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill 27599-7400.
authors.forename: K A
authors.initials: KA
authors.lastname: Weigle
authors.forename: C
authors.initials: C
authors.lastname: Santrich
authors.forename: F
authors.initials: F
authors.lastname: Martinez
authors.forename: L
authors.initials: L
authors.lastname: Valderrama
authors.forename: N G
authors.initials: NG
authors.lastname: Saravia
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000818:Animals; D000953:Antigens, Protozoan / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003105:Colombia / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007892:Leishmania braziliensis; D016773:Leishmaniasis, Cutaneous / Q000175:diagnosis / Q000453:epidemiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D011446:Prospective Studies; D012137:Respiratory System / Q000473:pathology; D012424:Rural Population; D012737:Sex Factors; D012867:Skin / Q000473:pathology; D012882:Skin Tests; D013997:Time Factors
chemical_list: D000953:Antigens, Protozoan; C032127:leishmanin