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
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
Externí odkaz: