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Spatial analysis of Leishmania donovani exposure in humans and domestic animals in a recent kala azar focus in Nepal

Published online by Cambridge University Press:  12 May 2010

BASUDHA KHANAL ,
ALBERT PICADO ,
NARAYAN RAJ BHATTARAI ,
GERT VAN DER AUWERA ,
MURARI LAL DAS ,
BART OSTYN ,
CLIVE RICHARD DAVIES ,
MARLEEN BOELAERT ,
JEAN-CLAUDE DUJARDIN  and
SUMAN RIJAL
BASUDHA KHANAL
Affiliation:
B.P. Koirala Institute of Health Sciences, Dharan, Nepal
ALBERT PICADO
Affiliation:
Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, LondonWC1E7HT, UK
NARAYAN RAJ BHATTARAI
Affiliation:
B.P. Koirala Institute of Health Sciences, Dharan, Nepal Department Molecular Parasitology, Institute of Tropical Medicine Antwerp, B-2000Antwerpen, Belgium Department of Biomedical Sciences, University of Antwerp, AntwerpenB-2080, Belgium
GERT VAN DER AUWERA
Affiliation:
Department Molecular Parasitology, Institute of Tropical Medicine Antwerp, B-2000Antwerpen, Belgium
MURARI LAL DAS
Affiliation:
B.P. Koirala Institute of Health Sciences, Dharan, Nepal
BART OSTYN
Affiliation:
Department of Public Health, Institute of Tropical Medicine, Antwerp, B-2000Antwerpen, Belgium
CLIVE RICHARD DAVIES
Affiliation:
Department of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, LondonWC1E7HT, UK
MARLEEN BOELAERT
Affiliation:
Department of Public Health, Institute of Tropical Medicine, Antwerp, B-2000Antwerpen, Belgium
JEAN-CLAUDE DUJARDIN*
Affiliation:
Department Molecular Parasitology, Institute of Tropical Medicine Antwerp, B-2000Antwerpen, Belgium Department of Biomedical Sciences, University of Antwerp, AntwerpenB-2080, Belgium
SUMAN RIJAL
Affiliation:
B.P. Koirala Institute of Health Sciences, Dharan, Nepal
*
*Corresponding author: Department Molecular Parasitology, Institute of Tropical Medicine Antwerp, Nationalestraat 155, B-2000Antwerpen, Belgium. Tel: +3232476355. Fax: +3232476359. E-mail: [email protected]
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Summary

Visceral leishmaniasis (VL) is a major public health problem in the Indian subcontinent where the Leishmania donovani transmission cycle is described as anthroponotic. However, the role of animals (in particular domestic animals) in the persistence and expansion of VL is still a matter of debate. We combined Direct Agglutination Test (DAT) results in humans and domestic animals with Geographic Information System technology (i.e. extraction maps and scan statistic) to evaluate the exposure to L. donovani on these 2 populations in a recent VL focus in Nepal. A Poisson regression model was used to assess the risk of infection in humans associated with, among other factors, the proportion of DAT-positive animals in the proximities of the household. The serological results showed that both humans and domestic animals were exposed to L. donovani. DAT-positive animals and humans were spatially clustered. The presence of serologically positive goats (IRR=9·71), past VL cases (IRR=2·62) and the proximity to a forest island dividing the study area (IRR=3·67) increased the risk of being DAT-positive in humans. Even if they are not a reservoir, domestic animals, and specially goats, may play a role in the distribution of L. donovani, in particular in this new VL focus.

Keywords

visceral leishmaniasisNepalspatial analysiskernel density
Type
Research Article
Information
Parasitology , Volume 137 , Issue 11 , September 2010 , pp. 1597 - 1603
Copyright
Copyright © Cambridge University Press 2010

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