Epidemiological and immunological aspects of human visceral leishmaniasis on Margarita Island, Venezuela.
Sixty-five patients were diagnosed with visceral leishmaniasis (VL) on Margarita Island in the decade from 1990 to1999; 86.2% were <= 3 years old. All were leishmanin-negative at diagnosis. Evaluation of 23 cured patients in 1999 revealed that 22/23 had converted to leishmanin-positive; five had persisting antibodies to rK39 antigen, with no clinical evidence of disease. Leishmanin tests were positive in 20.2% of 1,643 healthy individuals from 417 households in endemic areas. Of the positive reactors, 39.8% were identified in 35 (8.4%) of the households, 15 of which had an antecedent case of VL, a serologically positive dog or both. Weak serological activity to rK39 antigen was detected in 3 of 488 human sera from the endemic areas. The presence of micro-foci of intense peri-urban transmission and the apparent absence of other Trypanosomatidae causing human disease offer a unique opportunity for the study of reservoirs, alternative vectors and evaluation of control measures on the Island.
Zerpa
Olga
O
Instituto de Biomedicina, Universidad Central de Venezuela, Caracas, Venezuela. ozerpa@telcel.net.ve
Ulrich
Marian
M
Benitez
Margarita
M
Avila
Concepción
C
Rodríguez
Vestalia
V
Centeno
Marta
M
Belizario
Doris
D
Reed
Steven G
SG
Convit
Jacinto
J
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000704:Analysis of Variance; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood*; D000953:Antigens, Protozoan; D002648:Child; D002675:Child, Preschool; D004283:Dog Diseases / Q000175:diagnosis / Q000453:epidemiology; D004285:Dogs; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007893:Leishmania donovani; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015800:Protozoan Proteins / Q000097:blood*; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D014687:Venezuela / Q000453:epidemiology
D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D015800:Protozoan Proteins; C079253:K39 antigen, Leishmania