Armauer Hansen Research Institute, Addis Ababa, Ethiopia.
Am J Trop Med Hyg. 2012 May;86(5):792-8. doi: 10.4269/ajtmh.2012.11-0196.
In areas where visceral leishmaniasis is anthroponotic, asymptomatically infected patients may play a role in transmission. Additionally, the number of asymptomatic patients in a disease-endemic area will also provide information on transmission dynamics. Libo Kemkem and Fogera districts (Amhara State, Ethiopia) are now considered newly established areas to which visceral leishmaniasis is endemic. In selected villages in these districts, we conducted a study to assess the usefulness of different approaches to estimate the asymptomatic infection rate. Of 605 participants, the rK39 immunochromatographic test was able to detect asymptomatic infection in 1.5% (9 of 605), direct agglutination test in 5.3% (32 of 605), and leishmanin skin test in 5.6% (33 of 589); the combined use of serologic methods and leishmanin skin test enabled detecting asymptomatic infection in 10.1% (61 of 605). We conclude that the best option to detect asymptomatic infection in this new visceral leishmaniasis-endemic focus is the combined use of the direct agglutination test and the leishmanin skin test.
在内脏利什曼病呈人际传播的地区，无症状感染者可能在传播中发挥作用。此外，疾病流行地区的无症状感染者数量也将提供有关传播动态的信息。利博·肯克姆和福格拉区（埃塞俄比亚阿姆哈拉州）现在被认为是新出现的内脏利什曼病流行地区。在这些地区的选定村庄，我们开展了一项研究，评估了不同方法估计无症状感染率的有用性。在 605 名参与者中，rK39 免疫层析试验能够检测到 1.5%（605 例中的 9 例）的无症状感染，直接凝集试验能够检测到 5.3%（605 例中的 32 例），利什曼原虫皮肤试验能够检测到 5.6%（589 例中的 33 例）；联合使用血清学方法和利什曼原虫皮肤试验可检测到 10.1%（605 例中的 61 例）的无症状感染。我们得出结论，在这个新的内脏利什曼病流行地区，检测无症状感染的最佳选择是联合使用直接凝集试验和利什曼原虫皮肤试验。
