title: A prospective sero-epidemiological study of visceral leishmaniasis in Baringo District, Rift Valley Province, Kenya.
abstract: The incidence of visceral leishmaniasis (VL) was studied in 30 clusters with an average of 98 individuals in each cluster in a defined, endemic rural area of Baringo District, Kenya. The clusters were centred around recent cases of VL. Anti-leishmanial antibodies were measured by the direct agglutination test (DAT) and a clinical examination was performed on 2 occasions between April 1991 and May 1993. Of 2934 individuals tested by the DAT during the first visit, 78 (2.7%) were seropositive, 54 with and 24 without a history of VL. The seroconversion rate was 9/1000 person-years of observation (95% confidence interval 5.1-12.92) among 2332 seronegative individuals retested the following year. During the entire study period, VL was diagnosed in 10 patients, with an incidence rate of 2.2/1000 person-years of observation (95% confidence interval 0.8-3.6). Household contacts of individuals with previously confirmed VL had a higher frequency of DAT positivity than the rest of the population. This difference was significant for both sexes. These results suggest transmission in and around houses.
authors.affiliation: Department of Infectious Diseases, 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: G S
authors.initials: GS
authors.lastname: Gachihi
authors.forename: A S
authors.initials: AS
authors.lastname: Muller
authors.forename: P A
authors.initials: PA
authors.lastname: Kager
mesh_terms: D000293:Adolescent; D000328:Adult; D000372:Agglutination Tests; D000913:Antibodies, Protozoan / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D018562:Disease Transmission, Infectious; D005260:Female; D006798:Housing; D006801:Humans; D015994:Incidence; D007223:Infant; D007630:Kenya / Q000453:epidemiology; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000276:immunology / Q000635:transmission; D008297:Male; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000913:Antibodies, Protozoan