title: Asymptomatic Leishmania infections in northern India: a threat for the elimination programme?
abstract: Visceral leishmaniasis (VL) continues to embody as a mammoth public health problem and hurdle to the socioeconomic development of Bihar, India. Interestingly, all leishmanial infections do not lead to overt clinical disease and may stay asymptomatic for a period of time. Asymptomatic cases of VL are considered as probable potential reservoirs of VL, and thus can play a major role in transmission of the disease in highly endemic areas of Bihar, India. They outnumber the exact disease burden in endemic areas of this region, thus jeopardizing the goal of the elimination program that is due by 2015. This article discusses the potential risk factors, epidemiological markers of transmission and requirement of highly sensitive diagnostic tools for efficient recognition of the high risk groups of conversion to symptomatic for proper designing of strategies for implementation of the control programs.
authors.affiliation: Department of Microbiology, All-India Institute of Medical Sciences, Phulwarisharif, Patna, Bihar, India sushmita.de2008@gmail.com.
authors.forename: Sushmita
authors.initials: S
authors.lastname: Das
authors.affiliation: Department of Microbiology and Immunology, McGill University, Montreal, Quebec, Canada.
authors.forename: Greg
authors.initials: G
authors.lastname: Matlashewski
authors.affiliation: Departments of Molecular Parasitology and Vector Biology, Rajendra Memorial Research Institute of Medical Sciences, Indian Council of Medical Research, Agamkuan, Patna, Bihar, India.
authors.forename: Gouri Sankar
authors.initials: GS
authors.lastname: Bhunia
authors.affiliation: Departments of Molecular Parasitology and Vector Biology, Rajendra Memorial Research Institute of Medical Sciences, Indian Council of Medical Research, Agamkuan, Patna, Bihar, India.
authors.forename: Sreekanth
authors.initials: S
authors.lastname: Kesari
authors.affiliation: Departments of Molecular Parasitology and Vector Biology, Rajendra Memorial Research Institute of Medical Sciences, Indian Council of Medical Research, Agamkuan, Patna, Bihar, India.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Das
mesh_terms: D000372:Agglutination Tests / Q000379:methods; D058345:Asymptomatic Infections / Q000453:epidemiology*; D015331:Cohort Studies; D018450:Disease Progression; D004197:Disease Reservoirs / Q000469:parasitology*; D019353:Endemic Diseases; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007893:Leishmania donovani / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000453:epidemiology / Q000635:transmission; D012307:Risk Factors
keywords: Asymptomatic; Bihar; Elimination program; Leishmaniasis; Transmission