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dc.contributor.author | Mondal, Dinesh | |
dc.contributor.author | Bern, Caryn | |
dc.contributor.author | Ghosh, Debashis | |
dc.contributor.author | Rashid, Masud | |
dc.contributor.author | Molina, Ricardo | |
dc.contributor.author | Chowdhury, Rajashree | |
dc.contributor.author | Nath, Rupen | |
dc.contributor.author | Ghosh, Prakash | |
dc.contributor.author | Chapman, Lloyd A C | |
dc.contributor.author | Alim, Abdul | |
dc.contributor.author | Bilbe, Graeme | |
dc.contributor.author | Alvar, Jorge | |
dc.date.accessioned | 2022-03-25T13:22:25Z | |
dc.date.available | 2022-03-25T13:22:25Z | |
dc.date.issued | 2019-07 | |
dc.identifier.citation | Clin Infect Dis. 2019 Jul 2;69(2):251-258. | es_ES |
dc.identifier.uri | http://hdl.handle.net/20.500.12105/13826 | |
dc.description.abstract | Background: On the Indian subcontinent, visceral leishmaniasis (VL) incidence is on track to reach elimination goals by 2020 in nearly all endemic districts. Although not included in official targets, previous data suggest post-kala-azar dermal leishmaniasis (PKDL) patients can act as an infection reservoir. Methods: We conducted xenodiagnosis on 47 PKDL patients and 15 VL patients using laboratory-reared Phlebotomus argentipes. In direct xenodiagnosis, flies were allowed to feed on the patient's skin for 15 minutes. For indirect xenodiagnosis, flies were fed through a membrane on the patient's blood. Five days later, blood-fed flies were dissected and examined by microscopy and/or polymerase chain reaction (PCR). A 3-mm skin snip biopsy (PKDL) or venous blood (VL) was processed by quantitative PCR. Results: Twenty-seven PKDL patients (57.4%) had positive results by direct and/or indirect xenodiagnosis. Direct was significantly more sensitive than indirect xenodiagnosis (55.3% vs 6.4%, P < .0001). Those with positive xenodiagnosis had median skin parasite loads >1 log10 unit higher than those with negative results (2.88 vs 1.66, P < .0001). In a multivariable model, parasite load, nodular lesions, and positive skin microscopy were significantly associated with positive xenodiagnosis. Blood parasite load was the strongest predictor for VL. Compared to VL, nodular PKDL was more likely and macular PKDL less likely to result in positive xenodiagnosis, but neither difference reached statistical significance. Conclusions: Nodular and macular PKDL, and VL, can be infectious to sand flies. Active PKDL case detection and prompt treatment should be instituted and maintained as an integral part of VL control and elimination programs. | es_ES |
dc.description.sponsorship | This work was supported by the World Health Organization Special Programme for Research and Training in Tropical Diseases, Switzerland; the Spanish Foundation for International Cooperation, Health and Social Affairs; and International Centre for Diarrhoeal Disease Research, Bangladesh core donors. | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Oxford University Press | es_ES |
dc.type.hasVersion | VoR | es_ES |
dc.rights.uri | http://creativecommons.org/licenses/by-nc-nd/4.0/ | * |
dc.subject | Post-kala-azar dermal leishmaniasis | es_ES |
dc.subject | Transmission | es_ES |
dc.subject | Visceral leishmaniasis | es_ES |
dc.subject | Xenodiagnosis | es_ES |
dc.subject.mesh | Disease Reservoirs | es_ES |
dc.subject.mesh | Disease Transmission, Infectious | es_ES |
dc.subject.mesh | Adult | es_ES |
dc.subject.mesh | Animals | es_ES |
dc.subject.mesh | Female | es_ES |
dc.subject.mesh | Humans | es_ES |
dc.subject.mesh | Insect Vectors | es_ES |
dc.subject.mesh | Leishmania donovani | es_ES |
dc.subject.mesh | Leishmaniasis, Cutaneous | es_ES |
dc.subject.mesh | Leishmaniasis, Visceral | es_ES |
dc.subject.mesh | Male | es_ES |
dc.subject.mesh | Middle Aged | es_ES |
dc.subject.mesh | Psychodidae | es_ES |
dc.title | Quantifying the Infectiousness of Post-Kala-Azar Dermal Leishmaniasis Toward Sand Flies | es_ES |
dc.type | journal article | es_ES |
dc.rights.license | Attribution-NonCommercial-NoDerivatives 4.0 Internacional | * |
dc.identifier.pubmedID | 30357373 | es_ES |
dc.format.volume | 69 | es_ES |
dc.format.number | 2 | es_ES |
dc.format.page | 251-258 | es_ES |
dc.identifier.doi | 10.1093/cid/ciy891 | es_ES |
dc.contributor.funder | Agencia Española de Cooperación Internacional para el Desarrollo | es_ES |
dc.contributor.funder | International Centre for Diarrhoeal Disease Research, Bangladesh (India) | es_ES |
dc.contributor.funder | World Health Organization (WHO/OMS) | es_ES |
dc.description.peerreviewed | Sí | es_ES |
dc.identifier.e-issn | 1537-6591 | es_ES |
dc.relation.publisherversion | https://doi.org/10.1093/cid/ciy891 | es_ES |
dc.identifier.journal | Clinical Infectious Diseases : An official publication of the Infectious Diseases Society of America | es_ES |
dc.repisalud.centro | ISCIII::Centro Nacional de Microbiología | es_ES |
dc.repisalud.institucion | ISCIII | es_ES |
dc.rights.accessRights | open access | es_ES |