Correction: Age trends in asymptomatic and symptomatic Leishmania donovani infection in the Indian subcontinent: A review and analysis of data from diagnostic and epidemiological studies
Correction: Age trends in asymptomatic and symptomatic Leishmania donovani infection in the Indian subcontinent: A review and analysis of data from diagnostic and epidemiological studies
复制标题
更正：印度次大陆无症状和有症状杜氏利什曼原虫感染的年龄趋势：诊断和流行病学研究数据的回顾和分析
DOI：
10.1371/journal.pntd.0007150
复制
发表时间：
2018
影响因子：
3.8
通讯作者：
D. Hollingsworth
中科院分区：
文献类型：
--
作者：
L. Chapman;Alex L. K. Morgan;E. Adams;C. Bern;G. Medley;T.;D. Hollingsworth
背景杜氏利什曼原虫（印度次大陆内脏利什曼病（VL）的病原体）无症状和有症状感染的年龄模式目前知之甚少。分层血清学和感染发生率已被用于评估其他疾病的传播水平，这表明它们也可能用于监测和靶向控制方案，以实现消除VL，并应包括在VL传播动态模型。因此，我们分析了关于疾病发病率和免疫标志物患病率的可用年龄分层数据，目的是整理目前可用的数据，估计感染率，并为建模和未来的数据收集提供信息。方法学/主要发现系统性文献检索获得了13项符合纳入标准的感染患病率和7项VL发病率研究。进行了统计学检验，以确定按年龄和根据诊断临界值的趋势。简单的可逆催化模型与年龄无关和年龄相关的感染率进行拟合的流行率数据估计感染和逆转率，并测试不同的假设，在这些利率的变化的起源。大多数研究表明，感染率随年龄增长而增加：从0-10岁的血清阳性率（<20%利什曼宁皮肤试验（LST）阳性）到30-40岁的血清阳性率>10%（>20% LST阳性），但总体患病率在研究之间差异很大。在大多数研究中，0-5岁儿童的VL发病率低于年龄较大的年龄组;大多数研究显示5 - 20岁之间的发病率达到高峰。年龄无关的催化模型提供了最好的整体拟合的感染流行率数据，但不太吝啬的年龄依赖模型的估计率更接近纵向研究的估计，这表明感染率可能会随着年龄的增长。结论/意义ISC中无症状感染流行率和VL发病率的年龄模式随地理位置和时间段而变化很大。随着年龄的增长，感染率和峰值年龄VL发病率分布的增加可能是由于较低的暴露于感染性白蛉叮咬的幼儿，但也表明，获得性免疫寄生虫随着年龄的增长。然而，血清学检测标准化较差，难以比较不同研究的数据，并就观察到的年龄模式变化的驱动因素得出明确的结论。
Background Age patterns in asymptomatic and symptomatic infection with Leishmania donovani, the causative agent of visceral leishmaniasis (VL) in the Indian subcontinent (ISC), are currently poorly understood. Age-stratified serology and infection incidence have been used to assess transmission levels of other diseases, which suggests that they may also be of use for monitoring and targeting control programmes to achieve elimination of VL and should be included in VL transmission dynamic models. We therefore analysed available age-stratified data on both disease incidence and prevalence of immune markers with the aim of collating the currently available data, estimating rates of infection, and informing modelling and future data collection. Methodology/Principal findings A systematic literature search yielded 13 infection prevalence and 7 VL incidence studies meeting the inclusion criteria. Statistical tests were performed to identify trends by age, and according to diagnostic cut-off. Simple reversible catalytic models with age-independent and age-dependent infection rates were fitted to the prevalence data to estimate infection and reversion rates, and to test different hypotheses about the origin of variation in these rates. Most of the studies showed an increase in infection prevalence with age: from ≲10% seroprevalence (<20% Leishmanin skin test (LST) positivity) for 0-10-year-olds to >10% seroprevalence (>20% LST-positivity) for 30-40-year-olds, but overall prevalence varied considerably between studies. VL incidence was lower amongst 0-5-year-olds than older age groups in most studies; most showing a peak in incidence between ages 5 and 20. The age-independent catalytic model provided the best overall fit to the infection prevalence data, but the estimated rates for the less parsimonious age-dependent model were much closer to estimates from longitudinal studies, suggesting that infection rates may increase with age. Conclusions/Significance Age patterns in asymptomatic infection prevalence and VL incidence in the ISC vary considerably with geographical location and time period. The increase in infection prevalence with age and peaked age-VL-incidence distribution may be due to lower exposure to infectious sandfly bites in young children, but also suggest that acquired immunity to the parasite increases with age. However, poor standardisation of serological tests makes it difficult to compare data from different studies and draw firm conclusions about drivers of variation in observed age patterns.