title: Incidence of symptomatic and asymptomatic Leishmania donovani infections in high-endemic foci in India and Nepal: a prospective study.
abstract: Incidence of Leishmania donovani infection and Visceral Leishmaniasis (VL) was assessed in a prospective study in Indian and Nepalese high-endemic villages. DAT-seroconversion was used as marker of incident infection in 3 yearly surveys. The study population was followed up to month 30 to identify incident clinical cases. In a cohort of 9034 DAT-negative individuals with neither active signs nor history of VL at baseline, 42 VL cases and 375 asymptomatic seroconversions were recorded in the first year, giving an infection:disease ratio of 8.9 to 1. In the 18 months' follow-up, 7 extra cases of VL were observed in the seroconverters group (N=375), against 14 VL cases among the individuals who had not seroconverted in the first year (N=8570) (RR=11.5(4.5<RR<28.3)). Incident asymptomatic L. donovani infection in VL high-endemic foci in India and Nepal is nine times more frequent than incident VL disease. About 1 in 50 of these new but latent infections led to VL within the next 18 months.
authors: Institute of Tropical Medicine, Antwerp, Belgium.
authors: Bart
authors: B
authors: Ostyn
authors: Kamlesh
authors: K
authors: Gidwani
authors: Basudha
authors: B
authors: Khanal
authors: Albert
authors: A
authors: Picado
authors: François
authors: F
authors: Chappuis
authors: Shri Prakash
authors: SP
authors: Singh
authors: Suman
authors: S
authors: Rijal
authors: Shyam
authors: S
authors: Sundar
authors: Marleen
authors: M
authors: Boelaert
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000372:Agglutination Tests / Q000379:methods; D000913:Antibodies, Protozoan / Q000097:blood; D058070:Asymptomatic Diseases; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D019353:Endemic Diseases; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007893:Leishmania donovani / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000469:parasitology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D011446:Prospective Studies; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan