The epidemiology of visceral leishmaniasis and asymptomatic leishmanial infection in a highly endemic Bangladeshi village.

Abstract	We examined the epidemiology of kala-azar and asymptomatic leishmanial infection measured by serologic and leishmanin skin test results in a Bangladeshi community. In a subset, we measured serum retinol, zinc and C-reactive protein (CRP). Kala-azar and seroconversion incidence were 15.6 and 63.1 per 1,000 person-years, respectively. Proximity to a previous kala-azar case increased the likelihood of both kala-azar and asymptomatic infection. Bed net use protected against kala-azar (rate ratio = 0.35, P < 0.01), but not subclinical infection (rate ratio = 1.1, P = 0.82). Kala-azar patients were younger (P < 0.001) and reported lower red meat consumption (P < 0.01) than asymptomatic seropositive individuals. Retinol and zinc levels were lower in current kala-azar patients and those who later developed kala-azar compared with uninfected and asymptomatically infected subjects. The CRP levels were higher in kala-azar patients compared with the other two groups. Low red meat intake and poor zinc and retinol status may characterize a group at higher risk of symptomatic disease.
Authors	Caryn Bern, Rashidul Haque, Rajib Chowdhury, Mustakim Ali, Katie M Kurkjian, Louise Vaz, Josef Amann, M A Wahed, Yukiko Wagatsuma, Robert F Breiman, John Williamson, W Evan Secor, James H Maguire
Journal	The American journal of tropical medicine and hygiene (Am J Trop Med Hyg) Vol. 76 Issue 5 Pg. 909-14 (May 2007) ISSN: 0002-9637 [Print] United States
PMID	17488915 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)
Chemical References	Antibodies, Protozoan Antigens, Protozoan Protozoan Proteins Vitamin A C-Reactive Protein K39 antigen, Leishmania Zinc
Topics	Adult Antibodies, Protozoan (analysis, metabolism) Antigens, Protozoan (metabolism) Bangladesh (epidemiology) C-Reactive Protein (analysis) Child Child, Preschool Endemic Diseases (statistics & numerical data) Humans Incidence Leishmaniasis, Visceral (diagnosis, epidemiology) Logistic Models Poisson Distribution Prevalence Protozoan Proteins (metabolism) Risk Factors Time Factors Vitamin A (blood) Zinc (blood)

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