Institute of Tropical Medicine, Antwerp, Belgium.
PLoS Negl Trop Dis. 2011 Oct;5(10):e1284. doi: 10.1371/journal.pntd.0001284. Epub 2011 Oct 4.
Incidence of Leishmania donovani infection and Visceral Leishmaniasis (VL) was assessed in a prospective study in Indian and Nepalese high-endemic villages. DAT-seroconversion was used as marker of incident infection in 3 yearly surveys. The study population was followed up to month 30 to identify incident clinical cases. In a cohort of 9034 DAT-negative individuals with neither active signs nor history of VL at baseline, 42 VL cases and 375 asymptomatic seroconversions were recorded in the first year, giving an infection:disease ratio of 8.9 to 1. In the 18 months' follow-up, 7 extra cases of VL were observed in the seroconverters group (N=375), against 14 VL cases among the individuals who had not seroconverted in the first year (N=8570) (RR=11.5(4.5<RR<28.3)). Incident asymptomatic L. donovani infection in VL high-endemic foci in India and Nepal is nine times more frequent than incident VL disease. About 1 in 50 of these new but latent infections led to VL within the next 18 months.
在印度和尼泊尔的高流行地区进行的一项前瞻性研究中，评估了利什曼原虫感染和内脏利什曼病（VL）的发病率。DAT 血清转换被用作 3 年调查中感染的标志物。对研究人群进行了 30 个月的随访，以确定新的临床病例。在基线时 DAT 阴性、无活动性症状或 VL 病史的 9034 名个体中，在第一年记录了 42 例 VL 病例和 375 例无症状血清转换，感染：疾病比为 8.9 比 1。在 18 个月的随访中，在血清转换者组（N=375）中观察到 7 例额外的 VL 病例，而在第一年未发生血清转换的个体中（N=8570）观察到 14 例 VL 病例（RR=11.5（4.5<RR<28.3））。在印度和尼泊尔的 VL 高度流行地区，无症状的利什曼原虫感染比新的 VL 疾病发生的频率高 9 倍。在接下来的 18 个月内，这些新的但潜伏的感染中有 1 例导致 VL。
