HIV Clinic, Satun Hospital, Satun Province, Thailand.
Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, Thailand.
Am J Trop Med Hyg. 2024 Jul 16;111(3):462-471. doi: 10.4269/ajtmh.24-0155. Print 2024 Sep 4.
Leishmaniasis, a neglected tropical disease, imposes a notable health burden, especially on immunocompromised individuals such as HIV patients. Recognizing its prevalence and risk factors in specific populations is vital for effective prevention. This study in Satun Province, southern Thailand, aimed to ascertain leishmaniasis prevalence and identify associated risks among HIV-infected patients. A cross-sectional study was conducted among 650 HIV-infected individuals at a tertiary care hospital. Data on demographic characteristics, clinical parameters, and potential risk factors were collected. Individual plasma, buffy coat, and saliva samples were collected. Leishmania infection was determined using the direct agglutination test and nested polymerase chain reaction (nPCR) of nPCR-buffy coat and nPCR-saliva. The association between risk factors and Leishmania infection was assessed with logistic regression analysis. The prevalence of Leishmania infection was 8.61% (56/650). Species was identified among 20 HIV-infected patients as follows: Leishmania orientalis (n = 14), Leishmania martiniquensis (n = 4), and Leishmania donovani complex (n = 2). The factors associated with Leishmania infection included age (adjusted odds ratio [OR] = 1.03), intravenous drug use (adjusted OR = 2.39), CD4 cell count <500 cells/mm3 (adjusted OR = 2.40), and a viral load ≥50 copies/mL (adjusted OR = 5.16). The prevalence of Leishmania infection among HIV-infected patients in Satun Province was considerable. These findings underscore the need for integrated care and targeted interventions to address this infection and improve public health outcomes. Further research and collaborative efforts are warranted to develop effective prevention and control strategies for Leishmania infection in the HIV-infected Thai population.
利什曼病是一种被忽视的热带病,给人类健康带来了巨大负担,尤其是对艾滋病毒感染者等免疫功能低下的人群。了解特定人群中利什曼病的流行情况和风险因素对于有效预防至关重要。本研究在泰国南部的沙敦省,旨在确定利什曼病的流行情况,并确定艾滋病毒感染者中的相关风险因素。在一家三级保健医院进行了一项横断面研究,共纳入 650 名艾滋病毒感染者。收集了人口统计学特征、临床参数和潜在风险因素的数据。采集了个体血浆、血涂片和唾液样本。使用直接凝集试验和 nPCR-血涂片和 nPCR-唾液的巢式聚合酶链反应 (nPCR) 确定利什曼原虫感染。使用逻辑回归分析评估危险因素与利什曼原虫感染的关系。利什曼原虫感染的患病率为 8.61%(56/650)。在 20 名感染艾滋病毒的患者中鉴定出以下物种:东方利什曼原虫(n = 14)、马提尼克利什曼原虫(n = 4)和杜氏利什曼原虫复合物(n = 2)。与利什曼原虫感染相关的因素包括年龄(调整后的优势比 [OR] = 1.03)、静脉吸毒(调整后的 OR = 2.39)、CD4 细胞计数 <500 个细胞/mm3(调整后的 OR = 2.40)和病毒载量≥50 拷贝/mL(调整后的 OR = 5.16)。沙敦省艾滋病毒感染者中利什曼原虫感染的流行率相当高。这些发现强调需要综合护理和有针对性的干预措施来解决这一感染问题,改善公共卫生结果。需要进一步的研究和合作努力,以制定针对泰国艾滋病毒感染者的利什曼原虫感染的有效预防和控制策略。