BP Koirala Institute of Health Sciences, Dharan, Nepal.
Parasitology. 2010 Sep;137(11):1597-603. doi: 10.1017/S0031182010000521. Epub 2010 May 12.
Visceral leishmaniasis (VL) is a major public health problem in the Indian subcontinent where the Leishmania donovani transmission cycle is described as anthroponotic. However, the role of animals (in particular domestic animals) in the persistence and expansion of VL is still a matter of debate. We combined Direct Agglutination Test (DAT) results in humans and domestic animals with Geographic Information System technology (i.e. extraction maps and scan statistic) to evaluate the exposure to L. donovani on these 2 populations in a recent VL focus in Nepal. A Poisson regression model was used to assess the risk of infection in humans associated with, among other factors, the proportion of DAT-positive animals in the proximities of the household. The serological results showed that both humans and domestic animals were exposed to L. donovani. DAT-positive animals and humans were spatially clustered. The presence of serologically positive goats (IRR=9.71), past VL cases (IRR=2.62) and the proximity to a forest island dividing the study area (IRR=3.67) increased the risk of being DAT-positive in humans. Even if they are not a reservoir, domestic animals, and specially goats, may play a role in the distribution of L. donovani, in particular in this new VL focus.
内脏利什曼病(VL)是印度次大陆的一个主要公共卫生问题,在那里,利什曼原虫的传播周期被描述为人间型。然而,动物(特别是家畜)在 VL 的持续和扩散中的作用仍存在争议。我们将人类和家畜的直接凝集试验(DAT)结果与地理信息系统技术(即提取地图和扫描统计)相结合,以评估在尼泊尔最近的一个 VL 焦点地区,这两种人群接触 L. donovani 的情况。我们使用泊松回归模型评估了与家庭周边 DAT 阳性动物比例等因素相关的人类感染风险。血清学结果表明,人类和家畜都接触过 L. donovani。DAT 阳性动物和人类在空间上呈聚集性。存在血清学阳性山羊(IRR=9.71)、过去的 VL 病例(IRR=2.62)和靠近将研究区域分隔开来的森林岛(IRR=3.67)会增加人类 DAT 阳性的风险。即使它们不是储存宿主,家畜,特别是山羊,可能在 L. donovani 的分布中发挥作用,特别是在这个新的 VL 焦点地区。
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