Asymptomatic Infection with Visceral Leishmaniasis in a Disease-Endemic Area in Bihar, India

Roshan K. Topno Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Vidya N. R. Das Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Alok Ranjan Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Krishna Pandey Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Dharmender Singh Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Nawin Kumar Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Niyamat A. Siddiqui Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Vijay P. Singh Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Shreekant Kesari Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Narendra Kumar Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Sanjeev Bimal Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Annadurai Jeya Kumar Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Chetram Meena Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Ranjeet Kumar Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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Pradeep Das Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar, India

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A prospective study was carried out in a cohort of 355 persons in a leishmaniasis-endemic village of the Patna District in Bihar, India, to determine the prevalence of asymptomatic persons and rate of progression to symptomatic visceral leishmaniasis (VL) cases. At baseline screening, 50 persons were positive for leishmaniasis by any of the three tests (rK39 strip test, direct agglutination test, and polymerase chain reaction) used. Point prevalence of asymptomatic VL was 110 per 1,000 persons and the rate of progression to symptomatic cases was 17.85 per 1,000 person-months. The incidence rate ratio of progression to symptomatic case was 3.36 (95% confidence interval [CI] = 0.75–15.01, P = 0.09) among case-contacts of VL compared with neighbors. High prevalence of asymptomatic persons and clinical VL cases and high density of Phlebotomus argentipes sand flies can lead to transmission of VL in VL-endemic areas.

Author Notes

*Address correspondence to Roshan K. Topno, Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar 800 007, India. E-mail: roshanktopno@yahoo.co.in

Authors' addresses: Roshan K. Topno, Vidya N. R. Das, Alok Ranjan, Krishna Pandey, Dharmender Singh, Nawin Kumar, Niyamat A. Siddiqui, Vijay P. Singh, Shreekant Kesari, Narendra Kumar, Sanjeev Bimal, Annadurai Jeya Kumar, Chetram Meena, Ranjeet Kumar, and Pradeep Das, Rajendra Memorial Research Institute of Medical Science, Agamkuan Patna, Bihar 800 007, India.

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