Davies C R, Llanos-Cuentas E A, Pyke S D, Dye C
Department of Medical Parasitology, London School of Hygiene and Tropical Medicine, UK.
Epidemiol Infect. 1995 Apr;114(2):297-318. doi: 10.1017/s0950268800057964.
A prospective longitudinal survey of cutaneous leishmaniasis (Leishmania peruviana) was carried out in Peru on a study population of 4716 persons living in 38 villages (Departments of Lima, Ancash and Piura). Demographic and clinical data were collected from all individuals, and a Montenegro skin test (MST) was carried out on 72% (3418) of the study population. Each household was revisited at 3-monthly intervals for up to 2 years to detect new leishmaniasis cases; 497 people received a second MST at the end of the study. Analysis of the epidemiological data indicated that (i) 17% (16/94) of all infections were subclinical, (ii) this percentage increased significantly with age, (iii) clinical infections led to 73.9% protective immunity (95% C.I. 53.0-85.5%) and relatively permanent MST responsiveness (recovery rate = 0.0098/year; 95% C.I. 0.000-0.020/year), (iv) sub-clinical infections led to protective immunity, which was positively correlated with their MST induration size (increasing by 17.9% per mm; P < 0.0001), and a mean MST recovery rate of 0.114/year (4/421 man-months), and (v) recurrent leishmaniasis was dominated by reactivations, not by reinfections.
在秘鲁对居住在38个村庄（利马、安卡什和皮斯科省）的4716人进行了一项关于皮肤利什曼病（秘鲁利什曼原虫）的前瞻性纵向调查。收集了所有个体的人口统计学和临床数据，并对72%（3418人）的研究人群进行了蒙特内格罗皮肤试验（MST）。每隔3个月对每个家庭进行一次回访，为期2年，以发现新的利什曼病病例；497人在研究结束时接受了第二次MST。对流行病学数据的分析表明：（i）所有感染中有17%（16/94）为亚临床感染；（ii）这一比例随年龄显著增加；（iii）临床感染导致73.9%的保护性免疫（95%置信区间53.0 - 85.5%）和相对持久的MST反应性（恢复率 = 0.0098/年；95%置信区间0.000 - 0.020/年）；（iv）亚临床感染导致保护性免疫，其与MST硬结大小呈正相关（每毫米增加17.9%；P < 0.0001），平均MST恢复率为0.114/年（4/421人月）；（v）复发性利什曼病以复发为主，而非再感染。
