Prevalence and associated risk factors of Leishmania infection among immunocompetent hosts, a community-based study in Chiang Rai, Thailand
Autor: | Jamnong Sankwan, Natheeporn Kobpungton, Sakarn Charoensakulchai, Suradej Siripattanapipong, Saovanee Leelayoova, Theethach Eamchotchawalit, Mathirut Mungthin, Kittiphat Lacharojana, Jidapa Manomat, Taweesak Sriwongpun, Toon Ruang-areerate, Pamornsri Sriwongpan, Phunlerd Piyaraj, Supalert Nedsuwan, Tawee Naaglor |
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Rok vydání: | 2021 |
Předmět: |
Male
0301 basic medicine Epidemiology RC955-962 Social Sciences Antibodies Protozoan Artificial Gene Amplification and Extension Disease Vectors Polymerase Chain Reaction Medical Conditions 0302 clinical medicine Sociology Residence Characteristics Zoonoses Arctic medicine. Tropical medicine Direct agglutination test Medicine and Health Sciences Child Leishmaniasis Index case Protozoans Leishmania Mammals Schools biology Eukaryota Thailand Insects Infectious Diseases Animals Domestic Child Preschool Vertebrates Female Public aspects of medicine RA1-1270 Research Article Neglected Tropical Diseases medicine.medical_specialty Arthropoda Adolescent 030231 tropical medicine 030106 microbiology Animals Wild Research and Analysis Methods Termites Education Young Adult 03 medical and health sciences Dogs Acquired immunodeficiency syndrome (AIDS) Cutaneous leishmaniasis Internal medicine Parasitic Diseases medicine Animals Humans Molecular Biology Techniques Molecular Biology Protozoan Infections business.industry Organisms Public Health Environmental and Occupational Health Biology and Life Sciences Infant Outbreak Tropical Diseases medicine.disease biology.organism_classification Invertebrates Parasitic Protozoans Insect Vectors Sand Flies Species Interactions Cross-Sectional Studies Visceral leishmaniasis Medical Risk Factors Amniotes Psychodidae business Zoology Entomology |
Zdroj: | PLoS Neglected Tropical Diseases, Vol 15, Iss 7, p e0009545 (2021) PLoS Neglected Tropical Diseases |
ISSN: | 1935-2735 |
Popis: | Background Leishmaniasis is an emerging infectious disease reported in the north and south of Thailand of which patients with HIV/AIDS are a high risk group for acquiring the infection. A lack of information regarding prevalence, and the risk association of Leishmania infection among asymptomatic immunocompetent hosts needs further investigation. Information on potential vectors and animal reservoirs in the affected areas is also important to control disease transmission. Methods An outbreak investigation and a cross-sectional study were conducted following one index case of cutaneous leishmaniasis (CL) caused by L. martiniquensis in an immunocompetent male patient reported in August 2015, Chiang Rai Province, Thailand. From September to November 2015, a total of 392 participants at two study areas who were related to the index case, 130 students at a semi-boarding vocational school and 262 hill tribe villagers in the patient’s hometown, were recruited in this study. The nested internal transcribed spacer 1-PCR (ITS1-PCR) was performed to detect Leishmania DNA in buffy coat, and nucleotide sequencing was used to identify species. Antibody screening in plasma was performed using the Direct Agglutination Test (DAT), and associated risk factors were analyzed using a standardized questionnaire. Captured sandflies within the study areas were identified and detected for Leishmania DNA using nested ITS1-PCR. Moreover, the animal reservoirs in the study areas were also explored for Leishmania infection. Results Of 392 participants, 28 (7.1%) were positive for Leishmania infection of which 1 (4.8%) was L. martiniquensis, 12 (57.1%) were L. orientalis and 8 (38.1%) were Leishmania spp. Of 28, 15 (53.6%) were DAT positive. None showed any symptoms of CL or visceral leishmaniasis. Risk factors were associated with being female (adjusted odds ratio, AOR 2.52, 95%CI 1.01–6.26), increasing age (AOR 1.05, 95%CI 1.02–1.08), having an animal enclosure in a housing area (AOR 3.04, 95%CI 1.13–8.22), being exposed to termite mounds (AOR 3.74, 95%CI 1.11–12.58) and having domestic animals in a housing area (AOR 7.11, 95%CI 2.08–24.37). At the semi-boarding vocational school, six Sergentomyia gemmea samples were PCR positive for DNA of L. orientalis and one S. gemmea was PCR positive for DNA of L. donovani/L. infantum. Additionally, one Phlebotomus stantoni was PCR positive for DNA of L. martiniquensis, and one black rat (Rattus rattus) was PCR positive for DNA of L. martiniquensis. Conclusion This information could be useful for monitoring Leishmania infection among immunocompetent hosts in affected areas and also setting up strategies for prevention and control. A follow-up study of asymptomatic individuals with seropositive results as well as those with positive PCR results is recommended. Author summary This is the first community-based study investigating the prevalence and associated risk factors of Leishmania infection among immunocompetent individuals, demonstrating the situation of Leishmania infection in endemic areas of Thailand. An outbreak investigation and a cross-sectional study were conducted following one index case of cutaneous leishmaniasis (CL) caused by L. martiniquensis in an immunocompetent male patient reported in August 2015, Chiang Rai Province, Thailand. Of 392 participants, 28 (7.1%) were positive for Leishmania infection of which 1 (4.8%) was L. martiniquensis, 12 (57.1%) were L. orientalis and 8 (38.1%) were Leishmania spp. The factors associated with Leishmania infection included being female, increasing age, having an animal enclosure in a housing area, being exposed to termite mounds and having domestic animals in a housing area. This information revealed the first burden and risk factors of Leishmania infection among immunocompetent individuals in Thailand and highlighted the urgent need for effective interventions to prevent and control the disease in high risk populations in endemic areas. |
Databáze: | OpenAIRE |
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