JDWNR-Hospital and Vector Borne Diseases Control Programme, Timphu, Bhutan.
Am J Trop Med Hyg. 2012 Dec;87(6):1028-37. doi: 10.4269/ajtmh.2012.12-0211. Epub 2012 Oct 22.
Visceral leishmaniasis was first reported in Bhutan in 2006. We conducted studies of the parasite, possible vectors and reservoirs, and leishmanin skin test and risk factor surveys in three villages. Nineteen cases were reported from seven districts. Parasite typing yielded two novel microsatellite sequences, both related to Indian L. donovani. In one case village, 40 (18.5%) of 216 participants had positive leishmanin skin test results, compared with 3 (4.2%) of 72 in the other case village and 0 of 108 in the control village. Positive results were strongly associated with the village and increasing age. None of the tested dogs were infected. Eighteen sand flies were collected, 13 Phlebotomus species and 5 Sergentomyia species; polymerase chain reaction for leishmanial DNA was negative. This assessment suggests that endemic visceral leishmaniasis transmission has occurred in diverse locations in Bhutan. Surveillance, case investigations, and further parasite, vector, and reservoir studies are needed. The potential protective impact of bed nets should be evaluated.
内脏利什曼病于 2006 年首次在不丹报告。我们在三个村庄开展了寄生虫、可能的媒介和宿主以及利什曼菌素皮肤试验和危险因素调查研究。从七个区报告了 19 例病例。寄生虫分型产生了两个新的微卫星序列，均与印度的 L. donovani 有关。在一个病例村，216 名参与者中有 40 名（18.5%）利什曼菌素皮肤试验阳性，而另一个病例村的 72 名中有 3 名（4.2%），对照村的 108 名中没有阳性。阳性结果与村庄和年龄的增加有很强的相关性。检测的狗均未感染。共收集了 18 只沙蝇，13 种 Phlebotomus 种和 5 种 Sergentomyia 种；聚合酶链反应检测利什曼原虫 DNA 为阴性。该评估表明，地方性内脏利什曼病在不丹的不同地区已经发生了传播。需要进行监测、病例调查以及进一步的寄生虫、媒介和宿主研究。还应评估蚊帐的潜在保护作用。
