title: Asymptomatic leishmaniasis in kala-azar endemic areas of Malda district, West Bengal, India.
abstract: Asymptomatic leishmaniasis may drive the epidemic and an important challenge to reach the goal of joint Visceral Leishmaniasis (VL) elimination initiative taken by three Asian countries. The role of these asymptomatic carriers in disease transmission, prognosis at individual level and rate of transformation to symptomatic VL/Post Kala-azar Dermal Leishmaniasis (PKDL) needs to be evaluated. Asymptomatic cases were diagnosed by active mass survey in eight tribal villages by detecting antileishmanial antibody using rK39 based rapid diagnostic kits and followed up for three years to observe the pattern of sero-conversion and disease transformation. Out of 2890 total population, 2603 were screened. Antileishmanial antibody was detected in 185 individuals of them 96 had a history of VL/PKDL and 89 without such history. Seventy nine such individuals were classified as asymptomatic leishmaniasis and ten as active VL with a ratio of 7.9:1. Out of 79 asymptomatic cases 2 were lost to follow up as they moved to other places. Amongst asymptomatically infected persons, disease transformation in 8/77 (10.39%) and sero-conversion in 62/77 (80.52%) cases were noted. Seven (9.09%) remained sero-positive even after three years. Progression to clinical disease among asymptomatic individuals was taking place at any time up to three years after the baseline survey. If there are no VL /PKDL cases for two or more years, it does not mean that the area is free from leishmaniasis as symptomatic VL or PKDL may appear even after three years, if there are such asymptomatic cases. So, asymptomatic infected individuals need much attention for VL elimination programme that has been initiated by three adjoining endemic countries.
authors.affiliation: Department of Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India.|Department of Zoology, A. P. C. Roy Govt. College, Himachal Bihar, Matigara, Siliguri, West Bengal, India.
authors.forename: Pabitra
authors.initials: P
authors.lastname: Saha
authors.affiliation: Department of Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India.|Department of Microbiology, N. R. S. Medical College & Hospital, Kolkata, West Bengal, India.
authors.forename: Swagata
authors.initials: S
authors.lastname: Ganguly
authors.affiliation: Department of Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India.
authors.forename: Moytrey
authors.initials: M
authors.lastname: Chatterjee
authors.affiliation: Department of Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India.
authors.forename: Soumendu Bikash
authors.initials: SB
authors.lastname: Das
authors.affiliation: Department of Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India.|Malda Medical College, Malda, West Bengal, India.
authors.forename: Pratip K
authors.initials: PK
authors.lastname: Kundu
authors.affiliation: Department of Tropical Medicine, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India.
authors.forename: Subhasish K
authors.initials: SK
authors.lastname: Guha
authors.affiliation: Department of Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India.|Medinipur Medical College, West Medinipur, West Bengal, India.
authors.forename: Tamal K
authors.initials: TK
authors.lastname: Ghosh
authors.affiliation: Department of Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India.
authors.forename: Dilip K
authors.initials: DK
authors.lastname: Bera
authors.affiliation: Calcutta School of Tropical Medicine, Kolkata, West Bengal, India.
authors.forename: Nandita
authors.initials: N
authors.lastname: Basu
authors.affiliation: Department of Microbiology, Calcutta School of Tropical Medicine, Kolkata, West Bengal, India.
authors.forename: Ardhendu K
authors.identifier: 0000-0002-7693-6863
authors.initials: AK
authors.lastname: Maji
mesh_terms: D000293:Adolescent; D000328:Adult; D000967:Antimony Sodium Gluconate / Q000008:administration & dosage; D000981:Antiprotozoal Agents / Q000008:administration & dosage; D058070:Asymptomatic Diseases; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D055815:Young Adult
chemical_list: D000981:Antiprotozoal Agents; D000967:Antimony Sodium Gluconate