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Further evidences on a new diagnostic approach for monitoring human Leishmania (L.) infantum chagasi infection in Amazonian Brazil

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Abstract

This was a prospective study carried out during a period over 2 years (May/2006–September/2008) with a cohort of 1,099 individuals of both genders, aged 1 year old and older, from an endemic area of American visceral leishmaniasis (AVL) in Pará state, Brazil. The object was to analyze the prevalence and incidence of human Leishmania (L.) infantum chagasi infection as well as the dynamics evolution of its clinical-immunological profiles prior identified: (1) asymptomatic infection (AI); (2) symptomatic infection (SI = AVL); (3) sub-clinical oligosymptomatic infection (SOI); (4) sub-clinical resistant infection (SRI) and; (5) indeterminate initial infection (III). The infection diagnosis was performed by using both the indirect fluorescent antibody test and leishmanin skin test with amastigotes and promastigotes antigens of L. (L.) i. chagasi, respectively. A total of 187 cases of infection were recorded in the prevalence (17%), 117 in the final incidence (6.9%), and 304 in the accumulated prevalence (26.7%), which provided the following distribution into the clinical-immunological profiles: AI, 51.6%; III, 22.4%; SRI, 20.1%; SOI, 4.3%; and SI (=AVL), 1.6%. The major finding regarding the dynamics evolution of infection was concerned to III profile, from which the cases of infection evolved to either the resistant profiles, SRI (21 cases, 30.8%) and AI (30 cases, 44.1%), or the susceptible SI (=AVL; 1 case, 1.5%); the latter 16 cases remained as III till the end of the study. These results provided the conclusion that this diagnostic approach may be useful for monitoring human L. (L.) i. chagasi infection in endemic area and preventing the high morbidity of severe AVL cases.

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References

  • Ali A, Ashford RW (1993) Visceral leishmaniasis in Ethiopia. I. Cross-sectional leishmanin skin test in an endemic locality. Ann Trop Med Parasitol 87:157–161

    CAS  PubMed  Google Scholar 

  • Awasthi A, Mathur RK, Saha B (2004) Immune response to Leishmania infection. Indian J Med Res 119:238–258

    CAS  PubMed  Google Scholar 

  • Ayres M, Ayres M Jr, Ayres D, Santos AS (2004) Bioestat 4.0: Aplicações estatísticas nas áreas das Ciências Biológicas e Médicas. Sociedade Civil Mamirauá-Brasília CNPq. Belém, Pará, Brasil

  • Bacellar O, Barral-Neto M, Badaró R, Carvalho EM (1991) Gamma interferon production by lymphocytes from children infected with L. chagasi. Braz J Med Biol Res 24:791–795

    CAS  PubMed  Google Scholar 

  • Bacellar O, D’Oliveira A Jr, Jerônimo S, Carvalho EM (2000) IL-10 and IL-12 are the main regulatory cytokines in visceral leishmaniasis. Cytokine 12:1228–1231

    Article  CAS  PubMed  Google Scholar 

  • Badaró R, Jones TC, Lorenço R, Cerf BJ, Sampaio D, Carvalho EM, Rocha H, Teixeira R, Johnson WD Jr (1986a) A prospective study of visceral leishmaniasis in an endemic area of Brazil. J Infect Dis 154:639–649

    PubMed  Google Scholar 

  • Badaró R, Jones TC, Carvalho EM, Sampaio D, Reed SG, Barral A, Teixeira R, Johnson WD Jr (1986b) New perspectives on a subclinical form of visceral leishmaniasis. J Infect Dis 154:1003–1012

    PubMed  Google Scholar 

  • Blackwell JM, Mohamed HS, Ibrahim ME (2004) Genetics and visceral leishmaniasis in the Sudan: seeking a link. Trend Parasitol 6:268–274

    Article  Google Scholar 

  • Brasil (2003) Ministério da Saúde. Secretaria de Vigilância em Saúde. Departamento de Vigilância Epidemiológica. Manual de Vigilância e Controle da Leishmaniose Visceral. Brasília-DF, Ministério da Saúde, pp 1–120

  • Costa SR, D’Oliveira A Jr, Bacellar O, Carvalho EM (1999) T cell response of asymptomatic Leishmania chagasi infected subjects to recombinant leishmania antigens. Mem Inst Oswaldo Cruz 94:367–370

    CAS  PubMed  Google Scholar 

  • Crescente JAB, Silveira FT, Lainson R, Gomes CMC, Laurenti MD, Corbett CEP (2009) A cross-sectional study on the clinical and immunological spectrum of human Leishmania (L.) infantum chagasi infection in the Brazilian Amazon region. Trans Roy Soc Trop Med Hyg. doi:10.1016/j.trstmh.2009.06.010

    PubMed  Google Scholar 

  • Davies CR, Mazloumi Gavgani AS (1999) Age, acquired immunity and the risk of visceral leishmaniasis: a prospective study in Iran. Parasitol 119:247–257

    Article  Google Scholar 

  • Gama MEA, Costa JML, Gomes CMC, Corbett CEP (2004) Sub-clinical form of the American visceral leishmaniasis. Mem Inst Oswaldo Cruz 99:889–893

    Article  PubMed  Google Scholar 

  • Holaday BJ, Pompeu MM, Evans T, Braga DN, Texeira MJ, Sousa AQ, Sadick MD, Vasconcelos AW, Abrams JS, Pearson RD (1993) Correlates of Leishmania-specific immunity in the clinical spectrum of infection with Leishmania chagasi. J Infect Dis 167:411–417

    CAS  PubMed  Google Scholar 

  • Instituto Brasileiro de Geografia e Estatística (2004) Contagem nacional de populações. Superintendência de estudos geográficos e sócio-econômicos. Rio de Janeiro, RJ, Brasil

  • Jamieson SE, Miller EM, Peacock CS, Fakiola M, Wilson ME, Bales-Holst A, Shaw MA, Silveira F, Shaw JJ, Jerônimo SM, Blackwell JM (2007) Geome-wide scan for visceral leishmaniasis susceptibility genes in Brazil. Genes Immun 8:84–90

    Article  CAS  PubMed  Google Scholar 

  • Jeronimo SMB, Teixeira MV, de Queiroz Sousa A, Thielking P, Pearson RD, Evans TG (2000) Natural history of Leishmania (Leishmania) chagasi infection in Northeastern Brazil: Long-term follow-up. Clin Infec Dis 30:608–609

    Article  CAS  Google Scholar 

  • Jeronimo SMB, Holst AK, Jamieson SE, Francis R, Bezerra FL, Ettinger NA, Nascimento ET, Monteiro GR, Lacerda HG, Miller EN, Cordell HJ, Duggal P, Beaty TH, Blackwell JM, Wilson ME (2007) Genes at human chromosome 5q31.1 regulate delayed-type hypersensitivity responses associated with Leishmania chagasi infection. Genes Immun 8:539–551

    Article  CAS  PubMed  Google Scholar 

  • Lainson R, Rangel EF (2003) Ecologia das leishmanioses: Lutzomyia longipalpis e a eco-epidemiologia da leishmaniose visceral americana (LVA) no Brasil. In: Rangel EF, Lainson R (eds) Flebotomíneos no Brasil. Fiocruz, Rio de Janeiro, pp 311–336

    Google Scholar 

  • Lainson R, Rangel EF (2005) Lutzomyia longipalpis and the eco-epidemiology of American visceral leishmaniasis, with particular reference to Brazil—a review. Mem Inst Oswaldo Cruz 100:811–827

    PubMed  Google Scholar 

  • Lainson R, Shaw JJ (2005) Leishmaniasis in the New World. In: Collier L, Balows A, Sussman M (eds) Topley & Wilson’s microbiology and microbial infections, vol 5, Parasitology, 10th edn. Arnold, London, pp 313–349

    Google Scholar 

  • Lima LVR, de Souza AAA, Jennings YL, Corrêa Z, de Jesus R, Everdosa D, Ayres M, Silveira FT (2003) Comparison of the reactivity between antigens of Leishmania (L.) chagasi, L. (L.) amazonensis e Leishmania sp. (Bio-Manguinhos) in the sero-diagnosis of visceral leishmaniasis by the indirect fluorescent antibody test (IFAT). Rev Inst Med Trop São Paulo 45(Supl 13):147

    Google Scholar 

  • Pampiglione S, Manson-Bahr PEC, La Placa M, Borgatti MA, Musumeci S (1975) Studies in Mediterranean leishmaniasis: 3. The leishmanin in skin test kala-azar. Trans Roy Soc Trop Med Hyg 69:60–68

    Article  CAS  PubMed  Google Scholar 

  • Pearson RD, Souza AQ (1996) Clinical spectrum of leishmaniasis. Clin Inf Dis 22:1–13

    CAS  Google Scholar 

  • Silveira FT, Lainson R, Shaw JJ, de Souza AA, Ishikawa EAI, Braga RR (1991) Cutaneous leishmaniasis due to Leishmania (Leishmania) amazonensis in Amazonian Brazil, and the significance of a negative Montenegro skin-test in human infections. Trans R Soc Trop Med Hyg 85:735–738

    Article  CAS  PubMed  Google Scholar 

  • Silveira FT, Shaw JJ, Bichara CNC, Costa JML (1997) Leishmaniose visceral americana. In RNG Leão, Doenças Infecciosas e Parasitárias: Enfoque Amazônico, Belém, PA, CEJUP, pp 631–644

  • Silveira FT, Blackwell JM, Ishikawa EA, Braga RR, Shaw JJ, Quinnell RJ, Soong L, Kima P, McMahon-Pratt D, Black GF, Shaw M-A (1998) T cell responses to crude and defined leishmanial antigens in patients from the lower Amazon region of Brazil infected with different species of Leishmania of the subgenera Leishmania and Viannia. Parasite Immunol 20:19–26

    CAS  PubMed  Google Scholar 

  • Silveira FT, Lainson R, Pereira EA, de Souza AAA, Campos MB, Chagas EJ, Gomes CMC, Laurenti MD, Corbett CEP (2009a) A longitudinal study on the transmission dynamics of human Leishmania (L.) infantum chagasi-infection in Amazonian Brazil, with special reference to its prevalence and incidence. Parasitol Res 20:19–26

    Google Scholar 

  • Silveira FT, Lainson R, de Souza AAA, Crescente JAB, Campos MB, Gomes CMC, Laurenti MD, Corbett CEP (2009b) A prospective study on the dynamics of clinical and immunological evolution of human Leishmania (L.) infantum chagasi-infection in the Brazilian Amazon region. Trans Roy Soc Trop Med Hyg 104(1)

  • Vinhas V, Freire M, Bacellar O, Cunha S, Rocha H, Carvalho EM (1994) Characterization of T cell responses to purified leishmania antigens in subjects infected with Leishmania chagasi. Braz J Med Biol Res 27:1199–1205

    CAS  PubMed  Google Scholar 

  • Zijlstra EE, El-Hassan AM, Ismael A, Ghalib HW (1994) Endemic kala-azar in eastern Sudan: a longitudinal study on the incidence of clinical and subclinical infection and post-kala-azar dermal leishmaniasis. Am J Trop Med Hyg 51:826–836

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We are grateful for the research technician team of the leishmaniasis laboratory of Evandro Chagas Institute (Health Ministry, Brazil).

Founding

This research was supported by Evandro Chagas Institute (Health Ministry, Brazil); Tropical Medicine Institute (Federal University of Pará state, Brazil); Wellcome Trust (London); Laboratório de Investigação Médica (LIM)-50 (Hospital de Clínicas (HC)-Faculdade de Medicina (FM)-Universidade de São Paulo (USP, Brazil), and Fundação de Amparo à Pesquisa do estado de São Paulo (FAPESP: 06/56319-1, Brazil).

Ethical approval

This study was approved by the Ethics Committee in human research of Evandro Chagas Institute (Health Ministry, Brazil), protocol number 16/2003, and the Ethics Committee of research programs, Medicine School of São Paulo University, São Paulo state, Brazil, protocol number 0255/07.

Conflicts of interest statement

The authors have no conflicts of interest concerning the work reported in this paper.

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Authors and Affiliations

  1. Parasitology Department, Evandro Chagas Institute (Surveillance Secretary of Health, Ministry of Health), Belém, Pará, Brazil

    Fernando Tobias Silveira, Ralph Lainson, Adelson Alcimar Almeida De Souza, Marliane Batista Campos, Liliane Almeida Carneiro, Luciana Vieira Rego Lima & Patrícia Karla Santos Ramos

  2. Tropical Medicine Institute, Federal University of Pará, Belém, Pará, Brazil

    Fernando Tobias Silveira

  3. Pathology Department, Medical School of São Paulo University, São Paulo, São Paulo, Brazil

    Cláudia Maria de Castro Gomes, Marcia Dalastra Laurenti & Carlos Eduardo Pereira Corbett

Authors
  1. Fernando Tobias Silveira
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  2. Ralph Lainson
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  3. Adelson Alcimar Almeida De Souza
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  4. Marliane Batista Campos
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  5. Liliane Almeida Carneiro
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  6. Luciana Vieira Rego Lima
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  7. Patrícia Karla Santos Ramos
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  8. Cláudia Maria de Castro Gomes
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  9. Marcia Dalastra Laurenti
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  10. Carlos Eduardo Pereira Corbett
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Corresponding author

Correspondence to Fernando Tobias Silveira.

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Silveira, F.T., Lainson, R., De Souza, A.A.A. et al. Further evidences on a new diagnostic approach for monitoring human Leishmania (L.) infantum chagasi infection in Amazonian Brazil. Parasitol Res 106, 377–386 (2010). https://doi.org/10.1007/s00436-009-1672-x

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  • DOI: https://doi.org/10.1007/s00436-009-1672-x

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