title: Epidemiology of visceral leishmaniasis in Georgia.
abstract: This study investigated the transmission and prevalence of Leishmania parasite infection of humans in two foci of Visceral Leishmaniasis (VL) in Georgia, the well known focus in Tbilisi in the East, and in Kutaisi, a new focus in the West of the country. The seroprevalence of canine leishmaniasis was investigated in order to understand the zoonotic transmission. Blood samples of 1575 dogs (stray and pet) and 77 wild canids were tested for VL by Kalazar Detect rK39 rapid diagnostic tests. Three districts were investigated in Tbilisi and one in Kutaisi. The highest proportions of seropositive pet dogs were present in District #2 (28.1%, 82/292) and District #1 (26.9%, 24/89) in Tbilisi, compared to 17.3% (26/150) of pet dogs in Kutaisi. The percentage of seropositive stray dogs was also twice as high in Tbilisi (16.1%, n = 670) than in Kutaisi (8%, n = 50); only 2/58 wild animals screened were seropositive (2. 6%). A total of 873 Phlebotomine sand flies were collected, with 5 different species identified in Tbilisi and 3 species in Kutaisi; 2.3% of the females were positive for Leishmania parasites. The Leishmanin Skin Test (LST) was performed on 981 human subjects in VL foci in urban areas in Tbilisi and Kutaisi. A particularly high prevalence of LST positives was observed in Tbilisi District #1 (22.2%, 37.5% and 19.5% for ages 5-9, 15-24 and 25-59, respectively); lower prevalence was observed in Kutaisi (0%, 3.2% and 5.2%, respectively; P<0.05). This study shows that Tbilisi is an active focus for leishmaniasis and that the infection prevalence is very high in dogs and in humans. Although exposure is as yet not as high in Kutaisi, this is a new VL focus. The overall situation in the country is alarming and new control measures are urgently needed.
authors.affiliation: National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia; Ilia State University, Tbilisi, Georgia.
authors.forename: Giorgi
authors.initials: G
authors.lastname: Babuadze
authors.affiliation: WHO/NTD/Leishmaniasis Program, Geneva, Switzerland.
authors.forename: Jorge
authors.initials: J
authors.lastname: Alvar
authors.affiliation: World Health Organization/NTD, Geneva, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Argaw
authors.affiliation: Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Harry P
authors.initials: HP
authors.lastname: de Koning
authors.affiliation: National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
authors.forename: Merab
authors.initials: M
authors.lastname: Iosava
authors.affiliation: National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
authors.forename: Merab
authors.initials: M
authors.lastname: Kekelidze
authors.affiliation: National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
authors.forename: Nikoloz
authors.initials: N
authors.lastname: Tsertsvadze
authors.affiliation: National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
authors.forename: David
authors.initials: D
authors.lastname: Tsereteli
authors.affiliation: National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
authors.forename: Giorgi
authors.initials: G
authors.lastname: Chakhunashvili
authors.affiliation: National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
authors.forename: Tamar
authors.initials: T
authors.lastname: Mamatsashvili
authors.affiliation: National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
authors.forename: Nino
authors.initials: N
authors.lastname: Beria
authors.affiliation: National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
authors.forename: Irine
authors.initials: I
authors.lastname: Kalandadze
authors.affiliation: World Health Organization, Regional Office for Europe, Copenhagen, Denmark.
authors.forename: Mikhail
authors.initials: M
authors.lastname: Ejov
authors.affiliation: National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia.
authors.forename: Paata
authors.initials: P
authors.lastname: Imnadze
mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000453:epidemiology* / Q000469:parasitology; D004285:Dogs; D005260:Female; D005846:Georgia (Republic) / Q000453:epidemiology; D007891:Leishmania / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000469:parasitology / Q000662:veterinary*; D008297:Male; D057805:Pets; D011576:Psychodidae / Q000469:parasitology; D016036:Seroepidemiologic Studies