委内瑞拉皮肤利什曼病流行区利什曼原虫无症状感染的监测：利什曼菌素皮肤试验和使用血凝块的聚合酶链反应相结合可提高检测率并实现虫种鉴定。
Surveillance for Leishmania asymptomatic infection in endemic foci of cutaneous leishmaniasis in Venezuela: a combination of leishmanin skin test and PCR using blood clots improves detection and enables identification of species.
作者信息
Torrellas Annhymariet, Ferrer Elizabeth, Cruz Israel, De Lima Hector, Borges Rafael, Delgado Olinda, Moffi Pablo, Miles Michael A, Feliciangeli M Dora
机构信息
Centro Nacional de Referencia de Flebotomos y otros Vectores (CNRFV), Instituto de Investigaciones Biomedicas "Dr. Francisco J.Triana-Alonso" (BIOMED), Facultad de Ciencias de la Salud, Universidad de Carabobo, Maracay, Venezuela.
Instituto de Investigaciones Biomedicas "Dr. Francisco J.Triana-Alonso" (BIOMED), Facultad de Ciencas de la Salud Sede Aragua, Universidad de Carabobo, Maracay, Venezuela.
出版信息
Trans R Soc Trop Med Hyg. 2020 Jun 1;114(6):433-439. doi: 10.1093/trstmh/trz130.
BACKGROUND
Little is known about the prevalence of asymptomatic leishmaniasis in Venezuela. The objective of this study was to quantify Leishmania asymptomatic infection in six endemic foci of cutaneous leishmaniasis (CL) in Portuguesa State, Venezuela, where no previous data were available.
METHODS
Study of the prevalence of Leishmania asymptomatic infection was carried out in 841 individuals from six endemic foci of CL in the municipalities Sucre and Ospino, Portuguesa State. We applied the leishmanin skin test (LST) and the internal transcribed spacer 1 (ITS1) PCR to DNA from sera and blood clots of all LST-positive and 20% of LST-negative patients.
RESULTS
Of 841 inhabitants tested by LST, 197 returned a positive reaction (23.42%); all of the LST-positives (197) and 121 negatives were screened by nested PCR using serum and blood clots. Among the LST-positive group, 2.54% were PCR-positive with sera, while 44.67% were positive with blood clots. In the LST-negative group, PCR was positive in 2.48% of serum samples and in 38.84% of blood clots.
CONCLUSIONS
It is recommended that LST and PCR on blood clots are used together to detect exposure and asymptomatic infection and for identification of the Leishmania species.
背景
委内瑞拉无症状利什曼病的患病率鲜为人知。本研究的目的是对委内瑞拉波图格萨州六个皮肤利什曼病（CL）流行病灶中利什曼原虫无症状感染进行量化，此前该地尚无相关数据。
方法
对来自波图格萨州苏克雷市和奥斯皮诺市六个CL流行病灶的841人进行利什曼原虫无症状感染患病率研究。我们对所有利什曼菌素皮肤试验（LST）阳性患者以及20%的LST阴性患者的血清和血凝块DNA应用利什曼菌素皮肤试验（LST）和内转录间隔区1（ITS1）聚合酶链反应（PCR）。
结果
在接受LST检测的841名居民中，197人反应呈阳性（23.42%）；对所有LST阳性者（197人）和121名阴性者使用血清和血凝块进行巢式PCR筛查。在LST阳性组中，血清PCR阳性率为2.54%，血凝块PCR阳性率为44.67%。在LST阴性组中，血清样本PCR阳性率为2.48%，血凝块PCR阳性率为38.84%。
结论
建议联合使用LST和血凝块PCR来检测暴露情况和无症状感染，并鉴定利什曼原虫种类。
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