The epidemiology of Leishmania donovani infection in high transmission foci in India

Research output: Contribution to journalJournal articleResearchpeer-review

  • Shri P Singh
  • Albert Picado
  • Marleen Boelaert
  • Kamlesh Gidwani
  • Andersen, Elisabeth Anne Wreford
  • Bart Ostyn
  • Filip Meheus
  • Madhukar Rai
  • François Chappuis
  • Clive Davies
  • Shyam Sundar
OBJECTIVE: Visceral 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. METHODS: Demographic 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. RESULTS: Of 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. CONCLUSIONS: Prevalence 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.
Original languageEnglish
JournalTropical Medicine & International Health
Volume15
Issue numberSuppl.2
Pages (from-to)12-20
Number of pages8
ISSN1360-2276
DOIs
Publication statusPublished - 2010

ID: 22478415