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Cutaneous leishmaniasis in the Peruvian Andes: an epidemiological study of infection and immunity

Published online by Cambridge University Press:  15 May 2009

C. R. Davies ,
E. A. Llanos-Cuentas ,
S. D. M. Pyke  and
C. Dye
C. R. Davies
Affiliation:
Department of Medical Parasitology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
E. A. Llanos-Cuentas
Affiliation:
Instituto de Medicina Tropical ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, A.P. 4314, Lima 100, Peru
S. D. M. Pyke
Affiliation:
Department of Epidemiology and Population Sciences, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
C. Dye
Affiliation:
Department of Medical Parasitology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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Summary

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A prospective longitudinal survey of cutaneous leishmaniasis (Leishmania peruviana) was carried out in Peru on a study population of 4716 persons living in 38 villages (Departments of Lima, Ancash and Piura). Demographic and clinical data were collected from all individuals, and a Montenegro skin test (MST) was carried out on 72% (3418) of the study population. Each household was revisited at 3-monthly intervals for up to 2 years to detect new leishmaniasis cases; 497 people received a second MST at the end of the study. Analysis of the epidemiological data indicated that (i) 17% (16/94) of all infections were subclinical, (ii) this percentage increased significantly with age, (iii) clinical infections led to 73·9 % protective immunity (95 % C.I. 53·0–85·5 %) and relatively permanent MST responsiveness (recovery rate = 0·0098/year; 95% C.I. 0·000–0·020/year), (iv) sub-clinical infections led to protective immunity, which was positively correlated with their MST induration size (increasing by 17·9% per mm; P < 0·0001), and a mean MST recovery rate of 0·114/year (4/421 man-months), and (v) recurrent leishmaniasis was dominated by reactivations, not by reinfections.

Type
Research Article
Information
Epidemiology & Infection , Volume 114 , Issue 2 , April 1995 , pp. 297 - 318
Copyright
Copyright © Cambridge University Press 1995

References

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