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A longitudinal study on the transmission dynamics of human Leishmania (Leishmania) infantum chagasi infection in Amazonian Brazil, with special reference to its prevalence and incidence

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Abstract

This was a longitudinal study carried out during a period over 2 years with a cohort of 946 individuals of both sexes, aged 1 year and older, from an endemic area of American visceral leishmaniasis (AVL) in Pará State, Brazil. The object was to analyze the transmission dynamics of human Leishmania (Leishmania) infantum chagasi infection based principally on the prevalence and incidence. For diagnosis of the infection, the indirect fluorescent antibody test (IFAT) and leishmanin skin test (LST) were performed with amastigote and promastigote antigens of the parasite, respectively. The prevalence by LST (11.2%) was higher (p < 0.0001) than that (3.4%) by IFAT, and the combined prevalence by both tests was 12.6%. The incidences by LST were also higher (p < 0.05) than those by IFAT at 6 (4.7% × 0.6%), 12 (4.7% × 2.7%), and 24 months (2.9% × 0.3%). Moreover, there were no differences (p > 0.05) between the combined incidences by both tests on the same point surveys, 5.2%, 6.3%, and 3.6%. During the study, 12 infected persons showed high IFAT IgG titers with no LST reactions: five children and two adults developed AVL (2,560–10,120), and two children and three adults developed subclinical oligosymptomatic infection (1,280–2,560). The combined tests diagnosed a total of 231 cases of infection leading to an accumulated prevalence of 24.4%.

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Acknowledgments

We are grateful for the technical assistance of the following people: Raimundo Nonato Pires, João Alves Brandão, Zuila Corrêa, Edna Leão, Domingas Everdosa, Roseli de Jesus, Raimundo Negrão, Antonio Júlio Monteiro, Raimundo Machado, João Batista Palheta, Antonio Martins, José Aprígio Lima, Iorlando Barata, Maria Suely Pinheiro, Fábio Medeiros, and Maria das Graças Soares Silva. This research was supported by the Instituto Evandro Chagas (Secretaria de Vigilância em Saúde, Ministério da Saúde, Brazil); Instituto de Medicina Tropical (Universidade Federal do Pará, Brazil); Wellcome Trust (London); Laboratório de Investigação Médica (LIM)-50 (Hospital de Clínicas (HC)-Faculdade de Medicina (FM)-Universidade de São Paulo (USP), Brazil); and Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP: 06/56319-1, Brazil). This study was approved by the Ethics Committee in human research of the Instituto Evandro Chagas, from the Surveillance Secretary of Health, Ministry of Health, Brazil, with the protocol number CEP (Comitê de Ética em Pesquisa)/IEC 16/2003 and the CAPPesq (Comitê Avaliador de Programas em Pesquisa)/FMUSP (Faculdade de Medicina da Universidade de São Paulo) 0255/07.

Conflicts of interest statement

The authors have no conflicts of interest concerning the work reported in this paper.

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Authors and Affiliations

  1. Parasitology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Av. Almirante Barroso, 492, 66090-000, Belém, Pará State, Brazil

    Fernando T. Silveira, Ralph Lainson, Adelson A. A. de Souza & Marliane B. Campos

  2. Tropical Medicine Institute, Federal University of Pará, Belém, Pará State, Brazil

    Fernando T. Silveira

  3. Control Department of Endemic Diseases, Executive Secretary of Public Health, Belém, Pará State, Brazil

    Elza A. Pereira

  4. Public Health Department, Health Secretary of Barcarena Municipality, Barcarena, Pará State, Brazil

    Eugênia J. Chagas

  5. Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo State, Brazil

    Claudia M. C. Gomes, Márcia D. Laurenti & Carlos E. P. Corbett

Authors
  1. Fernando T. Silveira
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  2. Ralph Lainson
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  3. Elza A. Pereira
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  4. Adelson A. A. de Souza
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  5. Marliane B. Campos
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  6. Eugênia J. Chagas
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  7. Claudia M. C. Gomes
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  8. Márcia D. Laurenti
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  9. Carlos E. P. Corbett
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Correspondence to Fernando T. Silveira.

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Silveira, F.T., Lainson, R., Pereira, E.A. et al. A longitudinal study on the transmission dynamics of human Leishmania (Leishmania) infantum chagasi infection in Amazonian Brazil, with special reference to its prevalence and incidence. Parasitol Res 104, 559–567 (2009). https://doi.org/10.1007/s00436-008-1230-y

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