The epidemiology of Leishmania donovani infection in high transmission foci in India
The epidemiology of Leishmania donovani infection in high transmission foci in India
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DOI：
10.1111/j.1365-3156.2010.02519.x
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发表时间：
2010-07-01
影响因子：
3.3
通讯作者：
Sundar, Shyam
中科院分区：
文献类型：
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作者：
Singh, Shri P.;Picado, Albert;Sundar, Shyam
P>Objective 内脏利什曼病 (VL) 在印度比哈尔邦非常流行。印度及其邻国的目标是消除 VL，但 VL 流行病学方面的一些知识差距可能会阻碍这一努力。杜氏利什曼原虫无症状感染的流行情况及其在传播动态中的作用尚不清楚。我们报告了比哈尔邦血清调查的数据。方法分别于 2006 年 7 月和 11 月在比哈尔邦 Muzaffarpur 地区的 16 个高 VL 流行疫区进行了人口统计和免疫学调查。收集家庭和个人信息，并在滤纸上收集毛细血管血样。使用直接凝集试验（DAT）来确定感染个体（滴度截止值1:1600）。 DAT 结果根据个人和家庭变量制成表格。使用多元广义估计方程（GEE）模型来研究血清学阳性个体的患病率，并考虑到家庭和集群水平的聚类。结果研究对象中 18% 为 DAT 阳性，并且这一比例随着年龄的增长而增加。 14 岁以上女性的患病率明显低于男性。拥有家畜（牛、水牛或山羊）与 DAT 阳性的较高风险相关 [OR 1.16 (95% CI 1.01-1.32)]，但社会经济地位则不然。 结论 在这些社区中，利什曼原虫抗体的患病率很高，但存在差异。人口因素（即婚姻）可能解释 14 岁以上女性 DAT 阳性率较低的原因。在这些同样贫穷的社区中，社会经济地位与个人层面的杜氏乳杆菌感染风险无关，但家畜的所有权却与此相关。
P>ObjectiveVisceral Leishmaniasis (VL) is highly prevalent in Bihar, India. India and its neighbours aim at eliminating VL, but several knowledge gaps in the epidemiology of VL may hamper that effort. The prevalence of asymptomatic infections with Leishmania donovani and their role in transmission dynamics are not well understood. We report data from a sero-survey in Bihar.MethodsDemographic and immunological surveys were carried out in July and November 2006, respectively in 16 highly VL endemic foci in Muzaffarpur district in Bihar. Household and individual information was gathered and capillary blood samples were collected on filter papers. Direct agglutination test (DAT) was used to determine infected individuals (cut-off titre 1:1600). DAT results were tabulated against individual and household variables. A multivariate generalized estimating equation (GEE) model was used to study the prevalence of serologically positive individuals taking into account the clustering at household and cluster levels.ResultsOf study subjects 18% were DAT positive, and this proportion increased with age. Women had a significantly lower prevalence than men > 14 years old. Owning domestic animals (cows, buffaloes or goats) was associated with a higher risk of being DAT positive [OR 1.16 (95% CI 1.01-1.32)], but socio-economic status was not.ConclusionsPrevalence of leishmanial antibodies was high in these communities, but variable. Demographic factors (i.e. marriage) may explain the lower DAT positivity in women > 14 years of age. Within these homogeneously poor communities, socio-economic status was not linked to L. donovani infection risk at the individual level, but ownership of domestic animals was.