title: Asymptomatic infection with visceral leishmaniasis in a disease-endemic area in bihar, India.
abstract: A prospective study was carried out in a cohort of 355 persons in a leishmaniasis-endemic village of the Patna District in Bihar, India, to determine the prevalence of asymptomatic persons and rate of progression to symptomatic visceral leishmaniasis (VL) cases. At baseline screening, 50 persons were positive for leishmaniasis by any of the three tests (rK39 strip test, direct agglutination test, and polymerase chain reaction) used. Point prevalence of asymptomatic VL was 110 per 1,000 persons and the rate of progression to symptomatic cases was 17.85 per 1,000 person-months. The incidence rate ratio of progression to symptomatic case was 3.36 (95% confidence interval [CI] = 0.75-15.01, P = 0.09) among case-contacts of VL compared with neighbors. High prevalence of asymptomatic persons and clinical VL cases and high density of Phlebotomus argentipes sand flies can lead to transmission of VL in VL-endemic areas.
authors.affiliation: Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India. roshanktopno@yahoo.co.in
authors.forename: Roshan K
authors.initials: RK
authors.lastname: Topno
authors.forename: Vidya N R
authors.initials: VN
authors.lastname: Das
authors.forename: Alok
authors.initials: A
authors.lastname: Ranjan
authors.forename: Krishna
authors.initials: K
authors.lastname: Pandey
authors.forename: Dharmender
authors.initials: D
authors.lastname: Singh
authors.forename: Nawin
authors.initials: N
authors.lastname: Kumar
authors.forename: Niyamat A
authors.initials: NA
authors.lastname: Siddiqui
authors.forename: Vijay P
authors.initials: VP
authors.lastname: Singh
authors.forename: Shreekant
authors.initials: S
authors.lastname: Kesari
authors.forename: Narendra
authors.initials: N
authors.lastname: Kumar
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Bimal
authors.forename: Annadurai Jeya
authors.initials: AJ
authors.lastname: Kumar
authors.forename: Chetram
authors.initials: C
authors.lastname: Meena
authors.forename: Ranjeet
authors.initials: R
authors.lastname: Kumar
authors.forename: Pradeep
authors.initials: P
authors.lastname: Das
mesh_terms: D015331:Cohort Studies; D019353:Endemic Diseases; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000453:epidemiology*; D016133:Polymerase Chain Reaction
references.citation: J Assoc Physicians India. 2003 Aug;51:753-5
references.pmid: 14651132
references.citation: Indian J Med Microbiol. 2004 Jan-Mar;22(1):57-60
references.pmid: 17642689
references.citation: Mem Inst Oswaldo Cruz. 1997 Jan-Feb;92(1):15-20
references.pmid: 9302407
references.citation: Acta Trop. 2000 Sep 18;76(2):195-6
references.pmid: 10936579
references.citation: Ann Trop Med Parasitol. 2008 Mar;102(2):119-25
references.pmid: 18318933
references.citation: J Infect Dis. 1996 Mar;173(3):758-61
references.pmid: 8627048
references.citation: J Assoc Physicians India. 2003 Aug;51:759-61
references.pmid: 14651134
references.citation: J Vector Borne Dis. 2006 Sep;43(3):115-22
references.pmid: 17024860
references.citation: Am J Trop Med Hyg. 1992 Apr;46(4):480-8
references.pmid: 1575296
references.citation: J Clin Microbiol. 1988 Jul;26(7):1321-5
references.pmid: 3410946
references.citation: Trans R Soc Trop Med Hyg. 2006 Jun;100(6):533-7
references.pmid: 16325874
references.citation: Trans R Soc Trop Med Hyg. 2000 Mar-Apr;94(2):156-7
references.pmid: 10897353
references.citation: Clin Diagn Lab Immunol. 1998 Sep;5(5):717-20
references.pmid: 9729541
references.citation: Ann Trop Med Parasitol. 2005 Dec;99(8):743-9
references.pmid: 16297287
references.citation: J Commun Dis. 2002 Dec;34(4):302-3
references.pmid: 14710862
references.citation: Med Sci Monit. 2004 Jan;10(1):MT1-5
references.pmid: 14704640
references.citation: Clin Dermatol. 1996 Sep-Oct;14(5):417-23
references.pmid: 8889319
references.citation: N Engl J Med. 2002 Nov 28;347(22):1793-4
references.pmid: 12456856
references.citation: J Clin Microbiol. 1997 Oct;35(10):2454-7
references.pmid: 9316888
references.citation: Am J Trop Med Hyg. 2005 Jul;73(1):74-8
references.pmid: 16014837
references.citation: J Infect Dis. 1992 Nov;166(5):1124-32
references.pmid: 1402024
references.citation: Natl Med J India. 1999 Mar-Apr;12(2):62-8
references.pmid: 10416321
references.citation: J Clin Microbiol. 1998 Aug;36(8):2173-7
references.pmid: 9665985
references.citation: J Clin Microbiol. 2005 Jul;43(7):3038-41
references.pmid: 16000412
references.citation: Clin Diagn Lab Immunol. 2002 May;9(3):568-72
references.pmid: 11986261