1921
Volume 96, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

Several epidemiological studies have indicated the presence of asymptomatic infections with in the Indian subcontinent, where parasite transmission is considered anthroponotic. In India, such asymptomatic cases have been identified in the state of Bihar. We explored here, the presence of asymptomatic infection among healthy individuals living in two districts in the state of West Bengal, India, using serological and molecular tests. Blood samples of 246 healthy individuals were collected from nine villages of Malda and Murshidabad districts in West Bengal, considered endemic for visceral leishmaniasis (VL). Real-time quantitative polymerase chain reaction (qPCR) was performed for the quantification of parasite load in the blood. In addition, two serological tests were carried out to demonstrate anti- antibodies: rK39 strip test and anti-total soluble antigen IgG using enzyme-linked immunosorbent assay method. Nearly one-fifth (53/246) of the screened population was positive in qPCR as against 10.97% (27/246) positive in rK39 strip test. A range of parasite load was observed in the blood of identified asymptomatic cases with a median value of 7.7 parasites/mL (range = 1–65). There was poor agreement between qPCR and serological tests (κ = 0.089, = 0.13), and 29.62% and 20.54% of the population were qPCR positive in seropositive and seronegative groups, respectively. Combined molecular and serological tests enhanced the capacity to detect asymptomatic infection in healthy individuals residing in the endemic areas of VL. A significant proportion of asymptomatic individuals was detected in the examined endemic regions of West Bengal that might play a role in promoting VL transmission.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.16-0592
2017-06-07
2018-07-17
Loading full text...

Full text loading...

/deliver/fulltext/14761645/96/6/1448.html?itemId=/content/journals/10.4269/ajtmh.16-0592&mimeType=html&fmt=ahah

References

  1. Alvar J, Vélez ID, Bern C, Herrero M, Desjeux P, Cano J, Jannin J, de Boer M, WHO Leishmaniasis Control Team; , 2012. Leishmaniasis worldwide and global estimates of its incidence. PLoS One 7: e35671.[Crossref]
  2. Zijlstra EE, Khalil EA, Kager PA, El-Hassan AM, , 2000. Post-kala-azar dermal leishmaniasis in the Sudan: clinical presentation and differential diagnosis. Br J Dermatol 143: 136143.[Crossref]
  3. Ramesh V, Singh R, Salotra P, , 2007. Short communication: post-kala-azar dermal leishmaniasis-an appraisal. Trop Med Int Health 12: 848851.[Crossref]
  4. Rahman KM, Islam S, Rahman MWM, Kenah E, Ghalib CM, Galive CM, Zahid MM, Maguire J, Rahman MWM, Haque R, Luby SP, Bern C, , 2010. Increasing incidence of post-kala-azar dermal leishmaniasis in a population-based study in Bangladesh. Clin Infect Dis 50: 7376.[Crossref]
  5. Mondal D, Nasrin KN, Huda MM, Kabir M, Hossain MS, Kroeger A, Thomas T, Haque R, , 2010. Enhanced case detection and improved diagnosis of PKDL in a Kala-azar-endemic area of Bangladesh. PLoS Negl Trop Dis 4: e832.[Crossref]
  6. Bora D, , 1999. Epidemiology of visceral leishmaniasis in India. Natl Med J India 12: 6268.
  7. Kesari S, Bhunia GS, Kumar V, Jeyaram A, Ranjan A, Das P, , 2011. A comparative evaluation of end-emic and non-endemic region of visceral leishmaniasis (Kala-azar) in India with ground survey and space technology. Mem Inst Oswaldo Cruz 106: 515523.[Crossref]
  8. Bhattacharya SK, Rinzin N, Chusak P, Dash AP, Chowdhury R, Tobgay T, Narain JP, , 2010. Occurrence & significance of Kala-Azar in Bhutan. Indian J Med Res 132: 337338.
  9. WHO, 2012. Post-Kala-Azar Dermal Leishmaniasis: A Manual for Case Management and Control. Kolkata, India: Report of a WHO Consultative Meeting, July 2–3, 2012.
  10. Bhattacharya SK, Dash AP, , 2016. Treatment of visceral leishmaniasis: options and choice. Lancet Infect Dis 16: 142143.[Crossref]
  11. WHO, 2010. Control of the Leishmaniases. Geneva, Switzerland: WHO Technical Report Series 949, March 22–26, 2010.
  12. Stauch A, Sarkar RR, Picado A, Ostyn B, Sundar S, Rijal S, Boelaert M, Dujardin J-CC, Duerr H-PP, , 2011. Visceral leishmaniasis in the Indian subcontinent: modelling epidemiology and control. PLoS Negl Trop Dis 5: e1405.[Crossref]
  13. Ostyn B, Gidwani K, Khanal B, Picado A, Chappuis F, Singh SP, Rijal S, Sundar S, Boelaert M, , 2011. Incidence of symptomatic and asymptomatic Leishmania donovani infections in high-endemic foci in India and Nepal: a prospective study. PLoS Negl Trop Dis 5: e1284.[Crossref]
  14. Das VNR, Siddiqui NA, Verma RB, Topno RK, Singh D, Das S, Ranjan A, Pandey K, Kumar N, Das P, , 2011. Asymptomatic infection of visceral leishmaniasis in hyperendemic areas of Vaishali district, Bihar, India: a challenge to kala-azar elimination programmes. Trans R Soc Trop Med Hyg 105: 661666.[Crossref]
  15. Sharma MC, Gupta AK, Das VNR, Verma N, Kumar N, Saran R, Kar SK, , 2000. Leishmania donovani in blood smears of asymptomatic persons. Acta Trop 76: 195196.[Crossref]
  16. Srividya G, Kulshrestha A, Singh R, Salotra P, , 2012. Diagnosis of visceral leishmaniasis: developments over the last decade. Parasitol Res 110: 10651078.[Crossref]
  17. Le Fichoux Y, Quaranta JF, Aufeuvre JP, Lelievre A, Marty P, Suffia I, Rousseau D, Kubar J, , 1999. Occurrence of Leishmania infantum parasitemia in asymptomatic blood donors living in an area of endemicity in southern France. J Clin Microbiol 37: 19531957.
  18. Topno RK, Das VNR, Ranjan A, Pandey K, Singh D, Kumar NN, Siddiqui NA, Singh VP, Kesari S, Kumar NN, Bimal S, Kumar AJ, Meena C, Kumar R, Das P, , 2010. Asymptomatic infection with visceral leishmaniasis in a disease-endemic area in Bihar, India. Am J Trop Med Hyg 83: 502506.[Crossref]
  19. Sudarshan M, Singh T, Singh AK, Chourasia A, Singh B, Wilson ME, Chakravarty J, Sundar S, , 2014. Quantitative PCR in epidemiology for early detection of visceral leishmaniasis cases in India. PLoS Negl Trop Dis 8: e3366.[Crossref]
  20. Chapman LAC, Dyson L, Courtenay O, Chowdhury R, Bern C, Medley GF, Hollingsworth TD, , 2015. Quantification of the natural history of visceral leishmaniasis and consequences for control. Parasit Vectors 8: 521.[Crossref]
  21. Le Rutte EA, Coffeng LE, Bontje DM, Hasker EC, Postigo JAR, Argaw D, Boelaert MC, De Vlas SJ, , 2016. Feasibility of eliminating visceral leishmaniasis from the Indian subcontinent: explorations with a set of deterministic age-structured transmission models. Parasit Vectors 9: 24.[Crossref]
  22. Singh R, Subba Raju BV, Jain RK, Salotra P, , 2005. Potential of direct agglutination test based on promastigote and amastigote antigens for serodiagnosis of post-kala-azar dermal leishmaniasis. Clin Diagn Lab Immunol 12: 11911194.
  23. Salotra P, Raina A, Ramesh V, , 1999. Western blot analysis of humoral immune response to Leishmania donovani antigens in patients with post-kala-azar dermal leishmaniasis. Trans R Soc Trop Med Hyg 93: 98101.[Crossref]
  24. Salotra P, Sreenivas G, Pogue GP, Lee N, Nakhasi HL, Ramesh V, Negi NS, , 2001. Development of a species-specific PCR assay for detection of Leishmania donovani in clinical samples from patients with kala-azar and post-kala-azar dermal leishmaniasis. J Clin Microbiol 39: 849854.[Crossref]
  25. Sreenivas G, Ansari NA, Kataria J, Salotra P, , 2004. Nested PCR assay for detection of Leishmania donovani in slit aspirates from post-kala-azar dermal leishmaniasis lesions. J Clin Microbiol 42: 17771778.[Crossref]
  26. Sundar S, Singh RK, Maurya R, Kumar B, Chhabra A, Singh V, Rai M, , 2006. Serological diagnosis of Indian visceral leishmaniasis: direct agglutination test versus rK39 strip test. Trans R Soc Trop Med Hyg 100: 533537.[Crossref]
  27. Verma S, Kumar R, Katara GK, Singh LC, Negi NS, Ramesh V, Salotra P, , 2010. Quantification of parasite load in clinical samples of leishmaniasis patients: IL-10 level correlates with parasite load in visceral leishmaniasis. PLoS One 5: e10107.[Crossref]
  28. Kaushal H, Bras-Gonçalves R, Negi NS, Lemesre J-L, Papierok G, Salotra P, , 2014. Role of CD8+ T cells in protection against Leishmania donovani infection in healed visceral leishmaniasis individuals. BMC Infect Dis 14: 653.[Crossref]
  29. Salotra P, Sreenivas G, Nasim AA, Subba Raju BV, Ramesh V, , 2002. Evaluation of enzyme-linked immunosorbent assay for diagnosis of post-kala-azar dermal leishmaniasis with crude or recombinant k39 antigen. Clin Diagn Lab Immunol 9: 370373.
  30. Chamakh-Ayari R, Bras-Gonçalves R, Bahi-Jaber N, Petitdidier E, Markikou-Ouni W, Aoun K, Moreno J, Carrillo E, Salotra P, Kaushal H, Negi NS, Arevalo J, Falconi-Agapito F, Privat A, Cruz M, Pagniez J, Papierok G-MM, Rhouma FBH, Torres P, Lemesre J-LL, Chenik M, Meddeb-Garnaoui A, , 2014. In vitro evaluation of a soluble Leishmania promastigote surface antigen as a potential vaccine candidate against human leishmaniasis. PLoS One 9: e92708.[Crossref]
  31. Bern C, Haque R, Chowdhury R, Ali M, Kurkjian KM, Vaz L, Amann J, Wahed MA, Wagatsuma Y, Breiman RF, Williamson J, Secor WE, Maguire JH, , 2007. The epidemiology of visceral leishmaniasis and asymptomatic leishmanial infection in a highly endemic Bangladeshi village. Am J Trop Med Hyg 76: 909914.
  32. Gadisa E, Custodio E, Cañavate C, Sordo L, Abebe Z, Nieto J, Chicharro C, Aseffa A, Yamuah L, Engers H, Moreno J, Cruz I, , 2012. Usefulness of the rK39-immunochromatographic test, direct agglutination test, and leishmanin skin test for detecting asymptomatic Leishmania infection in children in a new visceral leishmaniasis focus in Amhara State, Ethiopia. Am J Trop Med Hyg 86: 792798.[Crossref]
  33. Mahmoodi M, Khamesipour A, Dowlati Y, Rafati S, Momeni AZ, Emamjomeh M, Hejazi H, Modabber F, , 2003. Immune response measured in human volunteers vaccinated with autoclaved Leishmania major vaccine mixed with low dose of BCG. Clin Exp Immunol 134: 303308.[Crossref]
  34. Sinha PK, Bimal S, Pandey K, Singh SK, Ranjan A, Kumar N, Lal CS, Barman SB, Verma RB, Jeyakumar A, Das P, Bhattacharya M, Sur D, Bhattacharya SK, , 2008. A community-based, comparative evaluation of direct agglutination and rK39 strip tests in the early detection of subclinical Leishmania donovani infection. Ann Trop Med Parasitol 102: 119125.[Crossref]
  35. Sinha PK, Bimal S, Pandey K, Singh SK, Ranjan A, Kumar N, Lal CS, Barman SB, Verma RB, Jeyakumar A, Das P, Bhattacharya M, Sur D, Bhattacharya SK, , 2008. A community-based, comparative evaluation of direct agglutination and rK39 strip tests in the early detection of subclinical Leishmania donovani infection. Ann Trop Med Parasitol 102: 119125.[Crossref]
  36. Gidwani K, Kumar R, Rai M, Sundar S, , 2009. Longitudinal seroepidemiologic study of visceral leishmaniasis in hyperendemic regions of Bihar, India. Am J Trop Med Hyg 80: 345346.
  37. Bhattarai NR, Van der Auwera G, Khanal B, De Doncker S, Rijal S, Das ML, Uranw S, Ostyn B, Praet N, Speybroeck N, Picado A, Davies C, Boelaert M, Dujardin J-C, , 2009. PCR and direct agglutination as Leishmania infection markers among healthy Nepalese subjects living in areas endemic for Kala-Azar. Trop Med Int Health 14: 404411.[Crossref]
  38. Alvar J, Yactayo S, Bern C, , 2006. Leishmaniasis and poverty. Trends Parasitol 22: 552557.[Crossref]
  39. Srivastava P, Gidwani K, Picado A, Van der Auwera G, Tiwary P, Ostyn B, Dujardin JC, Boelaert M, Sundar S, , 2013. Molecular and serological markers of Leishmania donovani infection in healthy individuals from endemic areas of Bihar, India. Trop Med Int Health 18: 548554.[Crossref]
  40. Zijlstra EE, Nur Y, Desjeux P, Khalil EA, El-Hassan AM, Groen J, , 2001. Diagnosing visceral leishmaniasis with the recombinant K39 strip test: experience from the Sudan. Trop Med Int Health 6: 108113.[Crossref]
  41. Maurya R, Singh RK, Kumar B, Salotra P, Rai M, Sundar S, , 2005. Evaluation of PCR for diagnosis of Indian kala-azar and assessment of cure. J Clin Microbiol 43: 30383041.[Crossref]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.16-0592
Loading
/content/journals/10.4269/ajtmh.16-0592
Loading

Data & Media loading...

  • Received : 20 Jul 2016
  • Accepted : 19 Dec 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error