Skip to main content Accessibility help
×
Home

Leishmania infantum: illness, transmission profile and risk factors for asymptomatic infection in an endemic metropolis in Brazil

  • LETÍCIA HELENA DOS SANTOS MARQUES (a1), IARA CAIXETA MARQUES DA ROCHA (a1) (a2), ILKA AFONSO REIS (a3), GISELE MACEDO RODRIGUES DA CUNHA (a1), EDWARD OLIVEIRA (a4), THAIS RIBEIRO PFEILSTICKER (a1), VALDELAINE ETELVINA MIRANDA DE ARAÚJO (a5), MARIA HELENA FRANCO MORAIS (a2), ANA RABELLO (a4) and MARIÂNGELA CARNEIRO (a1) (a6)...

Summary

To evaluate the distribution of asymptomatic infection by Leishmania infantum in a metropolis in Brazil with different relative risks (RRs) for disease and risk factors associated with the infection, an ecological study was conducted using a Bayesian approach to estimate the RR of human visceral leishmaniasis (HVL) based on cases between 2008 and 2011. The areas were categorized and selected according to disease incidence: low (area-1), medium (area-2) and high (area-3). Cross-sectional study enrolling 935 children was used to estimate the prevalence of infection by L. infantum. Volunteers from these three areas were tested for L. infantum infection by ELISA (rK39 and soluble antigens). Infection prevalence rates were estimated and compared with the RR of disease. Multilevel logistic regression model evaluated the relationship between infection and the analysed variables. The RR of HVL was distributed heterogeneously in the municipality. The infection prevalence rates were: 34·9% in area-1; 29·3% in area-2; and 33·6% in area-3, with no significant differences between these areas. The variables ‘Presence of backyards in the neighbourhood’ and ‘Younger children’ were associated with L. infantum infection. We conclude that infection by L. infantum affects a significant proportion of the infant population regardless of the RR of disease.

Copyright

Corresponding author

*Corresponding author: Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Parasitologia, Instituto de Ciências Biológicas, Campus Pampulha, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, CEP 31270-901, Belo Horizonte, MG, Brazil. E-mail: mcarneir@icb.ufmg.br

References

Hide All
ABEP (2012). Associação Brasileira de Empresas de Pesquisa. Vol. 2012. Available: http://www.abep.org/Default.aspx. Accessed April 2014.
Alonso, D. P., Ferreira, A. F., Ribolla, P. E., de Miranda Santos, I. K., do Socorro Pires e Cruz, M., Aecio de Carvalho, F., Abatepaulo, A. R., Lamounier Costa, D., Werneck, G. L., Farias, T. J., Soares, M. J. and Costa, C. H. (2007). Genotypes of the mannan-binding lectin gene and susceptibility to visceral leishmaniasis and clinical complications. Journal of Infectious Diseases 195, 12121217.
Alvar, J., Velez, I. D., Bern, C., Herrero, M., Desjeux, P., Cano, J., Jannin, J. and den Boer, M. (2012). Leishmaniasis worldwide and global estimates of its incidence. PLoS ONE 7, e35671.
Assuncao, R. M., Barreto, S. M., Guerra, H. L. and Sakurai, E. (1998). Maps of epidemiological rates: a Bayesian approach. Cadernos de saude publica 14, 713723.
Assuncao, R. M., Reis, I. A. and Oliveira, C. D. (2001). Diffusion and prediction of Leishmaniasis in a large metropolitan area in Brazil with a Bayesian space-time model. Statistics in Medicine 20, 23192335.
Badaro, R., Jones, T. C., Lorenco, R., Cerf, B. J., Sampaio, D., Carvalho, E. M., Rocha, H., Teixeira, R. and Johnson, W. D. Jr. (1986). A prospective study of visceral leishmaniasis in an endemic area of Brazil. Journal of Infectious Diseases 154, 639649.
Besag, J., York, J. C. and Mollié, A. (1991). Bayesian image restoration, with two applications in spatial statistics (with discussion). Annals of the Institute of Statistical Mathematics 43, 159.
Caldas, A. J., Costa, J. M., Silva, A. A., Vinhas, V. and Barral, A. (2002). Risk factors associated with asymptomatic infection by Leishmania chagasi in north-east Brazil. Transactions of the Royal Society of Tropical Medicine and Hygiene 96, 2128.
Carneiro, M., Moreno, E. C., Goncalves, A. V., Lambertucci, J. R. and Antunes, C. M. F. (2011). Visceral leishmaniasis: challenges in identifying subclinical Leishmania infection. Drug Development Research 72, 442450.
Costa, C. H., Pereira, H. F. and Araujo, M. V. (1990). Visceral leishmaniasis epidemic in the State of Piaui, Brazil, 1980–1986. Revista de Saude Publica 24, 361372.
Costa, C. H., Stewart, J. M., Gomes, R. B., Garcez, L. M., Ramos, P. K., Bozza, M., Satoskar, A., Dissanayake, S., Santos, R. S., Silva, M. R., Shaw, J. J., David, J. R. and Maguire, J. H. (2002). Asymptomatic human carriers of Leishmania chagasi . American Journal of Tropical Medicine and Hygiene 66, 334337.
Custodio, E., Gadisa, E., Sordo, L., Cruz, I., Moreno, J., Nieto, J., Chicharro, C., Aseffa, A., Abraham, Z., Hailu, T. and Canavate, C. (2012). Factors associated with Leishmania asymptomatic infection: results from a cross-sectional survey in highland northern Ethiopia. PLoS Neglected Tropical Diseases 6, e1813.
de Almeida, A. S., Medronho Rde, A. and Werneck, G. L. (2011). Identification of risk areas for visceral leishmaniasis in Teresina, Piaui State, Brazil. American Journal of Tropical Medicine and Hygiene 84, 681687.
de Araujo, V. E., Morais, M. H., Reis, I. A., Rabello, A. and Carneiro, M. (2012). Early clinical manifestations associated with death from visceral leishmaniasis. PLoS Neglected Tropical Diseases 6, e1511.
de Araujo, V. E., Pinheiro, L. C., Almeida, M. C., de Menezes, F. C., Morais, M. H., Reis, I. A., Assuncao, R. M. and Carneiro, M. (2013). Relative risk of visceral leishmaniasis in Brazil: a spatial analysis in urban area. PLoS Neglected Tropical Diseases 7, e2540.
de Gouvea Viana, L., de Assis, T. S., Orsini, M., da Silva, A. R., de Souza, G. F., Caligiorne, R., da Silva, A. C., Peruhype-Magalhaes, V., Marciano, A. P., Martins-Filho, O. A. and Rabello, A. (2008). Combined diagnostic methods identify a remarkable proportion of asymptomatic Leishmania (Leishmania) chagasi carriers who present modulated cytokine profiles. Transactions of the Royal Society of Tropical Medicine and Hygiene 102, 548555.
dos Santos Marques, L. H., Gomes, L. I., da Rocha, I. C., da Silva, T. A., Oliveira, E., Morais, M. H., Rabello, A. and Carneiro, M. (2012). Low parasite load estimated by qPCR in a cohort of children living in urban area endemic for visceral leishmaniasis in Brazil. PLoS Neglected Tropical Diseases 6, e1955.
Elnaiem, D. E., Schorscher, J., Bendall, A., Obsomer, V., Osman, M. E., Mekkawi, A. M., Connor, S. J., Ashford, R. W. and Thomson, M. C. (2003). Risk mapping of visceral leishmaniasis: the role of local variation in rainfall and altitude on the presence and incidence of kala-azar in eastern Sudan. American Journal of Tropical Medicine and Hygiene 68, 1017.
Gavgani, A. S., Hodjati, M. H., Mohite, H. and Davies, C. R. (2002). Effect of insecticide-impregnated dog collars on incidence of zoonotic visceral leishmaniasis in Iranian children: a matched-cluster randomised trial. Lancet 360, 374379.
Goldstein, H. (1995). Multilevel Statistical Models. Edward Arnold/Halstead, Londres/Nova York.
Gouvea, M. V., Werneck, G. L., Costa, C. H. and de Amorim Carvalho, F. A. (2007). Factors associated to Montenegro skin test positivity in Teresina, Brazil. Acta Tropica 104, 99107.
Ho, M., Leeuwenburg, J., Mbugua, G., Wamachi, A. and Voller, A. (1983). An enzyme-linked immunosorbent assay (ELISA) for field diagnosis of visceral leishmaniasis. American Journal of Tropical Medicine and Hygiene 32, 943946.
Hosmer, D. W. Jr. and Lemeshow, S. (1989). Applied Logisitic Regression. John Wiley & Sons, New York, NY.
Karplus, T. M., Jeronimo, S. M., Chang, H., Helms, B. K., Burns, T. L., Murray, J. C., Mitchell, A. A., Pugh, E. W., Braz, R. F., Bezerra, F. L. and Wilson, M. E. (2002). Association between the tumor necrosis factor locus and the clinical outcome of Leishmania chagasi infection. Infection and Immunity 70, 69196925.
Maciel, B. L., Lacerda, H. G., Queiroz, J. W., Galvao, J., Pontes, N. N., Dimenstein, R., McGowan, S. E., Pedrosa, L. F. and Jeronimo, S. M. (2008). Association of nutritional status with the response to infection with Leishmania chagasi . American Journal of Tropical Medicine and Hygiene 79, 591598.
Maia, Z., Viana, V., Muniz, E., Goncalves, L. O., Mendes, C. M., Mehta, S. R. and Badaro, R. (2016). Risk factors associated with Human Visceral Leishmaniasis in an urban area of Bahia, Brazil. Vector Borne and Zoonotic Diseases 16, 368376.
Margonari, C., Freitas, C. R., Ribeiro, R. C., Moura, A. C., Timbo, M., Gripp, A. H., Pessanha, J. E. and Dias, E. S. (2006). Epidemiology of visceral leishmaniasis through spatial analysis, in Belo Horizonte municipality, state of Minas Gerais, Brazil. Memorias do Instituto Oswaldo Cruz 101, 3138.
Marzochi, M. C., Marzochi, K. B. and Carvalho, R. W. (1994). Visceral leishmaniasis in Rio de Janeiro. Parasitology Today 10, 3740.
Moreno, E. C., Melo, M. N., Lambertucci, J. R., Serufo, J. C., Andrade, A. S., Antunes, C. M., Genaro, O. and Carneiro, M. (2006). Diagnosing human asymptomatic visceral leishmaniasis in an urban area of the State of Minas Gerais, using serological and molecular biology techniques. Revista da Sociedade Brasileira de Medicina Tropical 39, 421427.
Moreno, E. C., Goncalves, A. V., Chaves, A. V., Melo, M. N., Lambertucci, J. R., Andrade, A. S., Negrao-Correa, D., de Figueiredo Antunes, C. M. and Carneiro, M. (2009). Inaccuracy of enzyme-linked immunosorbent assay using soluble and recombinant antigens to detect asymptomatic infection by Leishmania infantum . PLoS Neglected Tropical Diseases 3, e536.
Nascimento Mdo, D., Souza, E. C., da Silva, L. M., Leal Pda, C., Cantanhede Kde, L., Bezerra, G. F. and Viana, G. M. (2005). Prevalence of infection by Leishmania chagasi using ELISA (rK39 and CRUDE) and the Montenegro skin test in an endemic leishmaniasis area of Maranhao, Brazil. Cadernos de saude publica 21, 18011807.
Oliveira, C. D., Diez-Roux, A., Cesar, C. C. and Proietti, F. A. (2006). A case-control study of microenvironmental risk factors for urban visceral leishmaniasis in a large city in Brazil, 1999–2000. Revista Panamericana de Salud Publica 20, 369376.
PBH (2014). Prefeitura Municipal de Belo Horizonte. Informaçoes sobre Leishmaniose Visceral. Available: http://portalpbh.pbh.gov.br/pbh/ecp/comunidade.do?evento=portlet&pIdPlc=ecpTaxonomiaMenuPortal&app=saude&lang=pt_BR&pg=5571&tax=12768. Last Accessed July 2014.
Romero, G. A. and Boelaert, M. (2010). Control of visceral leishmaniasis in latin america-a systematic review. PLoS Neglected Tropical Diseases 4, e584.
Romero, H. D., Silva Lde, A., Silva-Vergara, M. L., Rodrigues, V., Costa, R. T., Guimaraes, S. F., Alecrim, W., Moraes-Souza, H. and Prata, A. (2009). Comparative study of serologic tests for the diagnosis of asymptomatic visceral leishmaniasis in an endemic area. American Journal of Tropical Medicine and Hygiene 81, 2733.
Saraiva, L., Andrade Filho, J. D., Falcao, A. L., de Carvalho, D. A., de Souza, C. M., Freitas, C. R., Gomes Lopes, C. R., Moreno, E. C. and Melo, M. N. (2011). Phlebotominae fauna (Diptera: Psychodidae) in an urban district of Belo Horizonte, Brazil, endemic for visceral leishmaniasis: characterization of favored locations as determined by spatial analysis. Acta Tropica 117, 137145.
Silva, L. A., Romero, H. D., Nogueira Nascentes, G. A., Costa, R. T., Rodrigues, V. and Prata, A. (2011). Antileishmania immunological tests for asymptomatic subjects living in a visceral leishmaniasis-endemic area in Brazil. American Journal of Tropical Medicine and Hygiene 84, 261266.
Singh, S., Kumari, V. and Singh, N. (2002). Predicting kala-azar disease manifestations in asymptomatic patients with latent Leishmania donovani infection by detection of antibody against recombinant K39 antigen. Clinical and Diagnostic Laboratory Immunology 9, 568572.
Souza, V. M. M., Julião, F. S., Neves, R. C. S., Magalhães, P. B., Bisinotto, T. V., Lima, A. S., Oliveira, S. S. and Moreira Júnior, E. D. (2008). Ensaio comunitário para avaliação da efetividade de estratégias de prevenção e controle da leishmaniose visceral humana no Município de Feira de Santana, Estado da Bahia, Brasil. Epidemiologia e Serviços de Saúde 17, 97106.

Keywords

Type Description Title
PDF
Supplementary materials

Dos Santos Marques supplementary material
Dos Santos Marques supplementary material 1

 PDF (19 KB)
19 KB

Leishmania infantum: illness, transmission profile and risk factors for asymptomatic infection in an endemic metropolis in Brazil

  • LETÍCIA HELENA DOS SANTOS MARQUES (a1), IARA CAIXETA MARQUES DA ROCHA (a1) (a2), ILKA AFONSO REIS (a3), GISELE MACEDO RODRIGUES DA CUNHA (a1), EDWARD OLIVEIRA (a4), THAIS RIBEIRO PFEILSTICKER (a1), VALDELAINE ETELVINA MIRANDA DE ARAÚJO (a5), MARIA HELENA FRANCO MORAIS (a2), ANA RABELLO (a4) and MARIÂNGELA CARNEIRO (a1) (a6)...

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed