Abstract
During a visceral leishmaniasis outbreak in an area of Madrid, Spain, the incidence of disease among solid organ transplant recipients was 10.3% (7/68). Being a black person from sub-Saharan Africa, undergoing transplantation during the outbreak, and residing <1,000 m from the epidemic focus were risk factors for posttransplant visceral leishmaniasis.
Highlights
During a visceral leishmaniasis outbreak in an area of Madrid, Spain, the incidence of disease among solid organ transplant recipients was 10.3% (7/68)
A large population of Lepus granatensis hares, which serve as a reservoir for Leishmania infantum, was present in the area [7,8], and the Phlebotomus perniciosus sand fly in Spain can act as a vector and take blood meals from these hares [6,8,9]
Black sub-Saharan African solid organ transplant (SOT) recipients were more likely than other recipients to become affected by Visceral leishmaniasis (VL) (Table 1)
Summary
Distance from patient’s residence to park, m, median (IQR) 1,220 [849–1,865] 399 [261–985] 1,370 [974–1,880] 0.001. All 7 episodes of VL occurred in patients who underwent transplantation during the outbreak period (Figure 1). The median distance between the place of residence and the park was significantly shorter for recipients with VL (399 m) than for those without (1,370 m; p = 0.001) (Figure 2; online Technical Appendix Figure 2). At 4 years, a lower percentage of the SOT recipients living 1,000 m away (61.0% vs 98%; p = 0.001 by log-rank test) (online Technical Appendix Figure 3). Our findings suggest that environmental factors might be crucial in modulating the incidence of VL in immunocompromised hosts, such as SOT recipients; the distance from the patient’s residence to the focus of the outbreak [6,7] emerged as a key risk factor.
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
