title: Leishmania infantum: illness, transmission profile and risk factors for asymptomatic infection in an endemic metropolis in Brazil.
abstract: To evaluate the distribution of asymptomatic infection by Leishmania infantum in a metropolis in Brazil with different relative risks (RRs) for disease and risk factors associated with the infection, an ecological study was conducted using a Bayesian approach to estimate the RR of human visceral leishmaniasis (HVL) based on cases between 2008 and 2011. The areas were categorized and selected according to disease incidence: low (area-1), medium (area-2) and high (area-3). Cross-sectional study enrolling 935 children was used to estimate the prevalence of infection by L. infantum. Volunteers from these three areas were tested for L. infantum infection by ELISA (rK39 and soluble antigens). Infection prevalence rates were estimated and compared with the RR of disease. Multilevel logistic regression model evaluated the relationship between infection and the analysed variables. The RR of HVL was distributed heterogeneously in the municipality. The infection prevalence rates were: 34·9% in area-1; 29·3% in area-2; and 33·6% in area-3, with no significant differences between these areas. The variables 'Presence of backyards in the neighbourhood' and 'Younger children' were associated with L. infantum infection. We conclude that infection by L. infantum affects a significant proportion of the infant population regardless of the RR of disease.
authors.affiliation: Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias,Departamento de Parasitologia,Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais,31270-901, Belo Horizonte, MG,Brazil.
authors.forename: Letícia Helena
authors.initials: LH
authors.lastname: Dos Santos Marques
authors.affiliation: Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias,Departamento de Parasitologia,Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais,31270-901, Belo Horizonte, MG,Brazil.
authors.forename: Iara Caixeta Marques
authors.initials: IC
authors.lastname: DA Rocha
authors.affiliation: Departamento de Estatística,Instituto de Ciências Exatas,Universidade Federal de Minas Gerais,Belo Horizonte, Minas Gerais,Brazil.
authors.forename: Ilka Afonso
authors.initials: IA
authors.lastname: Reis
authors.affiliation: Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias,Departamento de Parasitologia,Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais,31270-901, Belo Horizonte, MG,Brazil.
authors.forename: Gisele Macedo Rodrigues
authors.initials: GM
authors.lastname: DA Cunha
authors.affiliation: Laboratório de Pesquisas Clínicas,Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz,30190-002, Belo Horizonte, MG,Brazil.
authors.forename: Edward
authors.initials: E
authors.lastname: Oliveira
authors.affiliation: Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias,Departamento de Parasitologia,Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais,31270-901, Belo Horizonte, MG,Brazil.
authors.forename: Thais Ribeiro
authors.initials: TR
authors.lastname: Pfeilsticker
authors.affiliation: Ministério da Saúde,70058-900, Esplanada dos Ministérios, DF,Brazil.
authors.forename: Valdelaine Etelvina Miranda
authors.initials: VE
authors.lastname: DE Araújo
authors.affiliation: Secretaria Municipal de Saúde, Prefeitura de Belo Horizonte,30710-040, Belo Horizonte, MG,Brazil.
authors.forename: Maria Helena Franco
authors.initials: MH
authors.lastname: Morais
authors.affiliation: Laboratório de Pesquisas Clínicas,Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz,30190-002, Belo Horizonte, MG,Brazil.
authors.forename: Ana
authors.initials: A
authors.lastname: Rabello
authors.affiliation: Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias,Departamento de Parasitologia,Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais,31270-901, Belo Horizonte, MG,Brazil.
authors.forename: Mariângela
authors.initials: M
authors.lastname: Carneiro
mesh_terms: D001499:Bayes Theorem; D001938:Brazil / Q000453:epidemiology; D002947:Cities; D003430:Cross-Sectional Studies; D019353:Endemic Diseases / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D018314:Leishmania infantum; D007898:Leishmaniasis, Visceral / Q000453:epidemiology* / Q000635:transmission*; D008954:Models, Biological; D012307:Risk Factors; D016036:Seroepidemiologic Studies
keywords: Brazil; asymptomatic infection; infection; relative risk; visceral leishmaniasis