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Annual leishmanin skin test (LST) surveys were conducted in a visceral leishmaniasis-endemic Bangladeshi community from 2002 through 2004, using Leishmania infantum antigen from the same manufacturer and batch. In 2002, 530 (35%) of 1,532 had positive LST results; the prevalence increased with increasing age. The LST result was positive in 24 (51%) of 47, 18 (72%) of 25, and 11 (85%) of 13 kala-azar patients treated in the previous 1–11, 12–23, and 24–35 months. A positive LST result in 2002 was associated with protection against subsequent kala-azar (P < 0.0001). In 2003–2004, decreased antigen sensitivity was observed. Among 686 participants, 34% were LST-positive in 2002, 29% in 2003, and 19% in 2004. Of 63 cured kala-azar patients, 70% were positive in 2002, 53% in 2003, and only 30% in 2004. Among 171 participants tested with both antigens, L. infantum study antigen sensitivity was 70% compared with L. amazonensis antigen. Our data underscore the need for better production, standardization, and documentation of sensitivity, potency, and stability of leishmanin antigens.
Received April 5, 2006. Accepted for publication June 4, 2006.
Acknowledgments: We are grateful to our fieldworkers for their dedication and the residents of the study community for their willing participation. We thank Marina Gramiccia and Selma Jeronimo for providing the leishmanin skin test antigens, and Steve Luby, Dilara Sultana, Milton Quiah, Hasnat Iftekhar Hossain, Pradip Lawrence Rozario, Mustak Ahmed, Emily Gurley, A. S.G. Faruque, David Sack, M. G. Datta, A. Hamid, S. M. Alam, I. Khalil, Allen Hightower, John Williamson, Selma Jeronimo, Alan Magill, and Jorge Alvar for support in the field and scientific advice..
Financial support: This research study was supported by a grant from the Centers for Disease Control and Prevention Emerging Infections Initiative and by core donors to the ICDDR,B Centre for Health and Population Research..
* Address correspondence to Caryn Bern, Division of Parasitic Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta GA 30341. E-mail: CBern{at}cdc.gov
Authors’ addresses: Caryn Bern and W. Evan Secor, Division of Parasitic Diseases, Coordinating Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta GA 30341, Telephone: 770-488-7654, Fax: 770-488-7761, E-mail: CBern{at}cdc.gov. Josef Amann, Office of Global Health, Centers for Disease Control and Prevention, Atlanta GA 30341. Rashidul Haque, Rajib Chowdhury, and Mustakim Ali, ICDDR,B Centre for Health and Population Research, Mohakhali, Dhaka, Bangladesh. Katie Kurkjian, School of Public Health, University of North Carolina, Chapel Hill, NC 27599. Louise Vaz, Vanderbilt University School of Medicine, 21st Avenue South, Nashville, TN 37232. Yukiko Wagatsuma, Department of Epidemiology, University of Tsukuba, 1-1-1 Tennodai, Ibaraki 305-8575, Japan. Robert F. Breiman, Centers for Disease Control and Prevention, International Emerging Infections Program, Nairobi, Kenya. James H. Maguire, Division of International Health, Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore, MD 21201.
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  C. BERN, R. HAQUE, R. CHOWDHURY, M. ALI, K. M. KURKJIAN, L. VAZ, J. AMANN, M. A. WAHED, Y. WAGATSUMA, R. F. BREIMAN, et al. THE EPIDEMIOLOGY OF VISCERAL LEISHMANIASIS AND ASYMPTOMATIC LEISHMANIAL INFECTION IN A HIGHLY ENDEMIC BANGLADESHI VILLAGE Am J Trop Med Hyg, May 1, 2007; 76(5): 909 - 914. [Abstract] [Full Text] [PDF]
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