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Leishmania infantum: illness, transmission profile and risk factors for asymptomatic infection in an endemic metropolis in Brazil

Published online by Cambridge University Press:  29 November 2016

LETÍCIA HELENA DOS SANTOS MARQUES ,
IARA CAIXETA MARQUES DA ROCHA ,
ILKA AFONSO REIS ,
GISELE MACEDO RODRIGUES DA CUNHA ,
EDWARD OLIVEIRA ,
THAIS RIBEIRO PFEILSTICKER ,
VALDELAINE ETELVINA MIRANDA DE ARAÚJO ,
MARIA HELENA FRANCO MORAIS ,
ANA RABELLO  and
MARIÂNGELA CARNEIRO
LETÍCIA HELENA DOS SANTOS MARQUES
Affiliation:
Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
IARA CAIXETA MARQUES DA ROCHA
Affiliation:
Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil Secretaria Municipal de Saúde, Prefeitura de Belo Horizonte, 30710-040, Belo Horizonte, MG, Brazil
ILKA AFONSO REIS
Affiliation:
Departamento de Estatística, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
GISELE MACEDO RODRIGUES DA CUNHA
Affiliation:
Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
EDWARD OLIVEIRA
Affiliation:
Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, 30190-002, Belo Horizonte, MG, Brazil
THAIS RIBEIRO PFEILSTICKER
Affiliation:
Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil
VALDELAINE ETELVINA MIRANDA DE ARAÚJO
Affiliation:
Ministério da Saúde, 70058-900, Esplanada dos Ministérios, DF, Brazil
MARIA HELENA FRANCO MORAIS
Affiliation:
Secretaria Municipal de Saúde, Prefeitura de Belo Horizonte, 30710-040, Belo Horizonte, MG, Brazil
ANA RABELLO
Affiliation:
Laboratório de Pesquisas Clínicas, Centro de Pesquisas René Rachou, Fundação Oswaldo Cruz, 30190-002, Belo Horizonte, MG, Brazil
MARIÂNGELA CARNEIRO*
Affiliation:
Laboratório de Epidemiologia de Doenças Infecciosas e Parasitárias, Departamento de Parasitologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, 31270-901, Belo Horizonte, MG, Brazil Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
*
*Corresponding author: Laboratório de Epidemiologia das Doenças Infecciosas e Parasitárias, Parasitologia, Instituto de Ciências Biológicas, Campus Pampulha, Universidade Federal de Minas Gerais, Avenida Antônio Carlos, 6627, CEP 31270-901, Belo Horizonte, MG, Brazil. E-mail: [email protected]
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Summary

To evaluate the distribution of asymptomatic infection by Leishmania infantum in a metropolis in Brazil with different relative risks (RRs) for disease and risk factors associated with the infection, an ecological study was conducted using a Bayesian approach to estimate the RR of human visceral leishmaniasis (HVL) based on cases between 2008 and 2011. The areas were categorized and selected according to disease incidence: low (area-1), medium (area-2) and high (area-3). Cross-sectional study enrolling 935 children was used to estimate the prevalence of infection by L. infantum. Volunteers from these three areas were tested for L. infantum infection by ELISA (rK39 and soluble antigens). Infection prevalence rates were estimated and compared with the RR of disease. Multilevel logistic regression model evaluated the relationship between infection and the analysed variables. The RR of HVL was distributed heterogeneously in the municipality. The infection prevalence rates were: 34·9% in area-1; 29·3% in area-2; and 33·6% in area-3, with no significant differences between these areas. The variables ‘Presence of backyards in the neighbourhood’ and ‘Younger children’ were associated with L. infantum infection. We conclude that infection by L. infantum affects a significant proportion of the infant population regardless of the RR of disease.

Keywords

visceral leishmaniasisasymptomatic infectioninfectionrelative riskBrazil
Type
Research Article
Information
Parasitology , Volume 144 , Issue 4 , April 2017 , pp. 546 - 556
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Copyright
Copyright © Cambridge University Press 2016 

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