Announcement

Collapse
No announcement yet.

Study: Quantifying the Infectiousness of Post-Kala-Azar Dermal Leishmaniasis Toward Sand Flies

Collapse
X
 
  • Filter
  • Time
  • Show
Clear All
new posts

  • Study: Quantifying the Infectiousness of Post-Kala-Azar Dermal Leishmaniasis Toward Sand Flies

    Source: https://academic.oup.com/cid/article/69/2/251/5144025

    Quantifying the Infectiousness of Post-Kala-Azar Dermal Leishmaniasis Toward Sand Flies
    Dinesh Mondal, Caryn Bern, Debashis Ghosh, Masud Rashid, Ricardo Molina, Rajashree Chowdhury, Rupen Nath, Prakash Ghosh, Lloyd A C Chapman, Abdul Alim ... Show more
    Clinical Infectious Diseases, Volume 69, Issue 2, 15 July 2019, Pages 251Ė258, https://doi.org/10.1093/cid/ciy891
    Published:
    24 October 2018

    Abstract
    Background

    On the Indian subcontinent, visceral leishmaniasis (VL) incidence is on track to reach elimination goals by 2020 in nearly all endemic districts. Although not included in official targets, previous data suggest post-kala-azar dermal leishmaniasis (PKDL) patients can act as an infection reservoir.
    Methods

    We conducted xenodiagnosis on 47 PKDL patients and 15 VL patients using laboratory-reared Phlebotomus argentipes. In direct xenodiagnosis, flies were allowed to feed on the patientís skin for 15 minutes. For indirect xenodiagnosis, flies were fed through a membrane on the patientís blood. Five days later, blood-fed flies were dissected and examined by microscopy and/or polymerase chain reaction (PCR). A 3-mm skin snip biopsy (PKDL) or venous blood (VL) was processed by quantitative PCR.
    Results

    Twenty-seven PKDL patients (57.4%) had positive results by direct and/or indirect xenodiagnosis. Direct was significantly more sensitive than indirect xenodiagnosis (55.3% vs 6.4%, P < .0001). Those with positive xenodiagnosis had median skin parasite loads >1 log10 unit higher than those with negative results (2.88 vs 1.66, P < .0001). In a multivariable model, parasite load, nodular lesions, and positive skin microscopy were significantly associated with positive xenodiagnosis. Blood parasite load was the strongest predictor for VL. Compared to VL, nodular PKDL was more likely and macular PKDL less likely to result in positive xenodiagnosis, but neither difference reached statistical significance.
    Conclusions

    Nodular and macular PKDL, and VL, can be infectious to sand flies. Active PKDL case detection and prompt treatment should be instituted and maintained as an integral part of VL control and elimination programs...
Working...
X