Premium
Visceral Leishmaniasis: Challenges in identifying subclinical Leishmania infection
Author(s) -
Carneiro Mariângela,
Moreno Elizabeth Castro,
Gonçalves Andréa Vieira,
Lambertucci José Roberto,
Antunes Carlos M.F.
Publication year - 2011
Publication title -
drug development research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.582
H-Index - 60
eISSN - 1098-2299
pISSN - 0272-4391
DOI - 10.1002/ddr.20451
Subject(s) - visceral leishmaniasis , asymptomatic , subclinical infection , serology , population , transmission (telecommunications) , medicine , leishmaniasis , leishmania infantum , immunology , disease , leishmania , environmental health , parasite hosting , antibody , electrical engineering , world wide web , computer science , engineering
The major constraint in conducting visceral leishmaniasis (VL) population studies is the difficulty of diagnosing asymptomatic infection. The aims of the present study, conducted in an urban area in the southeast of Brazil, were to appraise the performance of serological techniques in identifying VL asymptomatic cases and to follow up a cohort of Leishmania infantum ‐exposed individuals living in an active transmission area, in an effort to understand infection dynamics and disease natural history. After an initial population‐based survey, three evaluations were carried out, covering a 7‐year follow‐up period. In addition to diagnostic tests, with polymerase chain reaction (PCR)‐hybridization as the reference test, the study population was interviewed and clinically examined; the last evaluation included abdominal ultrasonography. Our results showed that serological tests are not adequate in diagnosing asymptomatic VL; they also did not permit conclusions concerning parasite transmission and infection dynamics. Diagnostic techniques using molecular biology methods were more promising in identifying asymptomatic infection, but the meaning of a positive PCR‐hybridization test was unclear. In the present study, with one exception, after the follow‐up period, all participants had at least one positive molecular test, but none developed clinical disease. The meaning of a positive PCR in areas with active parasite transmission needs to be better evaluated. Drug Dev Res 72:442–450, 2011. © 2011 Wiley‐Liss, Inc.