Further evidences on a new diagnostic approach for monitoring human Leishmania (L.) infantum chagasi infection in Amazonian Brazil

Author(s)

Silveira, Fernando Tobias ^{[1, 2]} ; Lainson, Ralph ^[2] ; Almeida De Souza, Adelson Alcimar ^[2] ; Campos, Marliane Batista ^[2] ; Carneiro, Liliane Almeida ^[2] ; Rego Lima, Luciana Vieira ^[2] ; Santos Ramos, Patricia Karla ^[2] ; de Castro Gomes, Claudia Maria ^[3] ; Laurenti, Marcia Dalastra ^[3] ; Pereira Corbett, Carlos Eduardo ^[3]

Affiliation

^[1] Fed Univ Para, Inst Trop Med, BR-66059 Belem, Para - Brazil

^[2] Minist Hlth, Dept Parasitol, Evandro Chagas Inst Surveillance Secretary Hlth, Belem, Para - Brazil

^[3] Univ Sao Paulo, Sch Med, Dept Pathol, Sao Paulo - Brazil

• Document type: Journal article
• Source: Parasitology Research; v. 106, n. 2, p. 377-386, JAN 2010.
• Web of Science Citations: 6

Abstract

This was a prospective study carried out during a period over 2 years (May/2006-September/2008) with a cohort of 1,099 individuals of both genders, aged 1 year old and older, from an endemic area of American visceral leishmaniasis (AVL) in Para state, Brazil. The object was to analyze the prevalence and incidence of human Leishmania (L.) infantum chagasi infection as well as the dynamics evolution of its clinical-immunological profiles prior identified: (1) asymptomatic infection (AI); (2) symptomatic infection (SI = AVL); (3) sub-clinical oligosymptomatic infection (SOI); (4) sub-clinical resistant infection (SRI) and; (5) indeterminate initial infection (III). The infection diagnosis was performed by using both the indirect fluorescent antibody test and leishmanin skin test with amastigotes and promastigotes antigens of L. (L.) i. chagasi, respectively. A total of 187 cases of infection were recorded in the prevalence (17%), 117 in the final incidence (6.9%), and 304 in the accumulated prevalence (26.7%), which provided the following distribution into the clinical-immunological profiles: AI, 51.6%; III, 22.4%; SRI, 20.1%; SOI, 4.3%; and SI (=AVL), 1.6%. The major finding regarding the dynamics evolution of infection was concerned to III profile, from which the cases of infection evolved to either the resistant profiles, SRI (21 cases, 30.8%) and AI (30 cases, 44.1%), or the susceptible SI (=AVL; 1 case, 1.5%); the latter 16 cases remained as III till the end of the study. These results provided the conclusion that this diagnostic approach may be useful for monitoring human L. (L.) i. chagasi infection in endemic area and preventing the high morbidity of severe AVL cases. (AU)

• FAPESP's process: 06/56319-1 - Leishmaniasis in Brazil: clinical and immunopathogenetic aspects of the human and experimental disease
• Grantee: Carlos Eduardo Pereira Corbett
• Support Opportunities: Research Projects - Thematic Grants