Prevalence Of Visceral Leishmaniasis Research Articles

Sex-structured disease transmission model and control mechanisms for visceral leishmaniasis (VL).

Leishmaniasis are a group of diseases caused by more than 20 species of the protozoan that are transmitted through the bite of female sand fly. The disease is endemic to 98 countries of the world. It affects most commonly the poorest of the poor and mainly males. Several research has been conducted to propose disease control strategies. Effective medical care, vector control, environmental hygiene, and personal protection are the mainstays of the current preventative and control methods. The mathematical models for the transmission dynamics of the disease studied so far did not consider the sex-biased burden of the disease into consideration. Unlike the previous VL works, this study introduces a new deterministic sex-structured model for understanding the transmission dynamics of visceral leishmaniasis. Basic properties of the model including basic reproduction number ([Formula: see text]), and conditions for the existence of backward bifurcation of the model are explored. Baseline parameter values were estimated after the model was fitted to Ethiopia's VL data. Sensitivity analysis of the model was performed to identify the parameters that significantly impact the disease threshold. Numerical simulations were performed using baseline parameter values, and scenario analysis is performed by changing some of these parameters as appropriate. The analysis of the model shows that there is a possibility for a backward bifurcation for [Formula: see text], which means bringing [Formula: see text] to less than unity may not be enough to eradicate the disease. Our numerical result shows that the implementation of disease-preventive strategies, as well as effectively treating the affected ones can significantly reduce the disease prevalence if applied for more proportion of the male population. Furthermore, the implementation of vector management strategies also can considerably reduce the total prevalence of the disease. However, it is demonstrated that putting more effort in treating affected reservoir animals may not have any significant effect on the overall prevalence of the disease as compared to other possible mechanisms. The numerical simulation infers that a maximum of 60% of extra preventative measures targeted to only male population considerably reduces the total prevalence of VL by 80%. It is also possible to decrease the total prevalence of VL by 69.51% when up to 50% additional infected males receive treatment with full efficacy. Moreover, applying a maximum of 15% additional effort to reduce the number of vectors, decreases the total VL prevalence by 57.71%. Therefore, in order to reduce the disease burden of visceral leishmaniasis, public health officials and concerned stakeholders need to give more emphasis to the proportion of male humans in their intervention strategies.

Climate Change and Environmental Influence on Prevalence of Visceral Leishmaniasis in West Pokot County, Kenya

Kala-azar is a parasitic disease caused by Leishmania species transmitted by sand fly. In Kenya, kala-azar is endemic in thirty subcounties spread over in eleven counties in the arid zones. Climate change-influenced seasonal weather variability and environmental alterations remain important determinants of many vector-borne diseases. The present study focused on climate change and environmental influence on kala-azar in West Pokot. A descriptive cross-sectional and retrospective research design was adapted. Study area was purposively selected. Locations were randomly selected, and households were systematically selected. Three hundred sixty-three household questionnaires, eleven key informant interviews, and five focus group discussions were undertaken. Secondary data were obtained from Kacheliba subcounty hospital records. Statistical Package for the Social Sciences version 24 was used to analyze quantitative data while qualitative data were analyzed to establish connection for interpretation. Kala-azar cases have been on the rise on aggregate and surge towards the end of dry season and just after the rains. Significant environmental factors included the presence of seasonal rain water pathways and rock piles around houses (AOR = 4.7; 95% CI = (2.3-9.6), p < 0.05 ), presence of acacia trees in and around homesteads (AOR = 8.5; 95% CI = (2.5-28.6), p < 0.05 ), presence of anthills around the homesteads (AOR = 5.2; 95% CI = (1.2-23.4), p < 0.05 ), and presence of animal shed within compound (AOR = 2.8; 95% CI = (0.96-8), p < 0.05 ). Climate change-induced seasonal weather variability, increased temperature and reduced precipitation as well as environmental alterations influence kala-azar occurrence in West Pokot. Community sensitization on disease prevalence, clearing of vector predilection sites, and improving community environmental risk perception are imperative to promote prevention.

AN OVERVIEW OF VISCERAL LEISHMANIASIS IN THE CITY OF GURUPI, SOUTH REGION OF TOCANTINS

Visceral leishmaniasis (VL) is an endemic disease in the region of Gurupi, with higher prevalence in the pediatric age group, aggravated by the high morbidity and low prophylaxis and prevention strategies of this anthropozoonosis. Objective: To characterize the data reported in the municipality of Gurupi - TO in the years 2013 to 2020 and to outline the epidemiological profile of the disease by determining the risk factors for high prevalence of the disease in this locality. Methods: This is a cross-sectional descriptive epidemiological research, retrospective and documental based, extracted from the database of SINAN (Notifiable Diseases Information System) of Gurupi in the interval between 2013 and 2020. Evaluative questionnaires were applied to all patients notified and found, analyzing the variables described in the study and subsequent statistical application of the chi-square test. Results: In the city of Gurupi, the most affected age group was between 2 and 9 years (37.29%); the most affected gender was male (66.10%); the year of highest prevalence was the year 2017 a total of 37.28% of cases in the analyzed period; and the location of highest prevalence in the municipality were the neighborhoods farthest from the city center. As for the probable sites for contamination, most people point to their own home as a source of contamination. Conclusion: The epidemiological cut shows the prevalence of VL in the city of Gurupi and highlights the need for preventive intervention protocols for the prevention of the disease in endemic areas to decrease morbidity and mortality and control the number of cases.

Recurrence and Driving Factors of Visceral Leishmaniasis in Central China

Visceral leishmaniasis (VL) is an important vector-borne zoonosis caused by Leishmania spp. that has been spreading in China. It has been posing a significant risk to public health in central China due to its recurrence in recent decades. Yet, the spatiotemporal patterns and the driving factors of VL in central China remain unclear at present. The purpose of this study was to analyse spatiotemporal distribution, explore driving factors, and provide novel insight into prevention and control countermeasures of the VL spreading in central China. Based on data of human VL cases from 2006 to 2019 obtained from the Chinese Centres for Disease Control and Prevention (CDC), we depicted the map showing the spatiotemporal distribution of VL in central China. We further explored the driving factors contributing to the spread of VL through the general additive model (GAM) by combining maps of environmental, meteorological, and socioeconomic correlates. Most VL cases were reported in Shaanxi and Shanxi provinces, the number of which has been increasing every year in the last 14 years, from 3 new cases in 2006 to 101 new cases in 2019. The results of GAM revealed that environmental (i.e., changes in grasslands/forests), meteorological (i.e., temperature and relative humidity), and socioeconomic (i.e., population density) factors are significantly associated with the prevalence of VL in central China. Our results provide a better understanding regarding the current situation and the driving factors of VL in central China, assisting in developing the disease prevention and control strategies implemented by public health authorities.

A trend prevalence of visceral Leishmaniasis in West Armachiho District, Amhara Region, Northwest Ethiopia

BackgroundVisceral leishmaniasis (VL) is a disease caused by an obligate intracellular protozoan parasite that affects animals and humans. An estimated 3.2 million people are at risk of VL, and 3700–7400 cases occur annually in Ethiopia. The highest numbers of VL cases have been previously reported from the North Western parts of the country, especially in West Armachiho District. The aim of this study was to determine the trend prevalence of VL at the study area.MethodsHealth center based retrospective data were collected to determine the trend prevalence of VL among patients who had blood examination from January 2010 to August 2015. The blood samples were collected by finger pricking and the infections were confirmed by using rK39 antibody test.ResultOf the 9299 VL suspected cases, 1948 (21%) were positive for rK39 antibody test. Of these, 1757 (90.2%) were primary kala-azar cases, 167 (8.6%) were relapse and the remaining 24 (1.2%) were post kala-azar dermal leishmaniasis cases.ConclusionsThe prevalence of VL is still high in the study area. Therefore, early case detection, diagnosis, treatment, and timely analysis are essential.

The Granger causality analysis of the impact of climatic factors on visceral leishmaniasis in northwestern Iran in 1995-2019.

Visceral leishmaniasis (VL) as a vector-borne disease, is an endemic in the northwest and south of Iran and sporadic in other areas in the country. This study was performed to investigate the Granger causality analysis of the impacts of climatic factors on VL in northwestern Iran throughout the period from 1995 to 2019. In a longitudinal study, the epidemiological data of patients suffering from VL were collected from the health centers and hospitals in Meshkinshahr County, Ardabil province, between 1995 and 2019. Moreover, the environmental and climatic data of each location, such as temperature, humidity, rainfall, the number of frost and warm days in the year, were obtained from the meteorological center of the county and put into the Excel software. The incidence rate of VL was modeled by time series analysis and to compare its relationship with other time series covariates, the Granger causality analysis was used. The results of Granger causality analysis showed that some climatic variables including daily mean temperature, absolute minimum temperature, maximum and minimum temperature and maximum humidity were the main factors affecting the prevalence of VL in northwestern Iran. The findings greatly demonstrated that the potential of Granger causality in epidemiologic status of VL in northwestern Iran. Moreover, the results suggest that in addition to patient-related and biological factors, environmental and climatic factors such as temperature and humidity also play a major role in completing the transmittance cycle of VL in an endemic focus.

Prevalence of visceral leishmaniasis in China in 2018

Prevalence of visceral leishmaniasis in China in 2018

Impact of dogs with deltamethrin-impregnated collars on prevalence of visceral leishmaniasis.

Leishmaniasis is a vector borne zoonosis which is classified as a neglected tropical disease. Among the three most common forms of the disease, Visceral Leishmaniasis (VL) is the most threatening to human health, causing 20,000 to 30,000 deaths worldwide each year. Areas where VL is mostly endemic have unprotected dogs in community and houses. The "presence of dogs usually increases VL risk for humans since dogs are the principal reservoir host for the parasite of the disease. Based on this fact, most earlier studies consider culling dogs as a control measure for the spread of VL. A more recent control measure has been the use of deltamethrin-impregnated dog collars (s) to protect both humans and dogs by putting s on dogs neck. The presence of dogs helps to grow the sandfly population faster by offering a more suitable blood-meal source. On the other hand, the presence of s on dogs helps to reduce sandfly population by the lethality of deltamethrin insecticide. This study brings an ecological perspective to this public health concern, aiming to understand the impact of an additional host (here, protected dogs) on disease risk to a primary host (here, humans). To answer this question, we compare two different settings: a community without dogs, and a community with dogs protected with . Our analysis shows the presence of protected dogs can reduce VL infection risk in humans. However, this disease risk reduction depends on dogs’ tolerance for sandfly bites.

Sistematični pregled i metaanaliza humane visceralne leišmanijaze u Iranu

Visceral leishmaniasis (VL) is a protozoan disease caused by some Leishmania donovani complex species and is considered as an endemic zoonotic parasitic disease in Iran. This study was performed to determine the prevalence of human VL in Iran. Data were systematically gathered from 1985 to 2018 in Islamic Republic of Iran from the following electronic databases: PubMed, Google Scholar, Science Direct, Scopus, Web of Science, Magiran, Irandoc, Iranmedex and Scientific Information Database (SID). In total, 29 studies reporting the prevalence of VL from different areas of Iran met our suitability criteria. The Q test and the I2 statistics were applied to determine heterogeneities. The Egger's and Begg's test was used to check the presence of publication bias. The pooled prevalence of VL in Iran measured by random-effects was estimated at 1% (95% CI:1-2) in urban areas, 3% (95% CI:2-4) in rural areas and 2% (95% CI: 2-3) in total. The majority of VL cases during the last 33 years were reported in the northwest and south provinces of Iran. There was a high degree of heterogeneity (I2 = 98.2%, Q test: p = 0.0002) and Begg's (z = 3.62, p < 0.001) and Egger's (bias =5.9, 95% CI = 2.70-9.11) tests were significant for the study of publication bias. After correction, the total prevalence was estimated to be 0.3% (95% CI: 0.2-0.9).The prevalence of VL in Iran was 0.3%, and this rate was much higher in the northwest and south of the country. These results are desirable for managing the control programs of this disease.

Determinant Factors and Spatial Distribution of Visceral Leishmaniasis in North Gondar in Selected Hospitals

Introduction: Visceral Leishmaniasis (VL) is a neglected tropical disease caused by Leishmaniasis protozoa, and transmitted by a sand fly vector. Leishmaniasis is distributed in worldwide and affects millions of peoples. Objective: The objective was to assess the prevalence and spatial distribution of VL in North Gondar. Methodology: 369 patients were selected from records or medical charts retrospectively using stratified and systematic sampling techniques. The study used spatial autocorrelation measures and auto logistic regression model. Result: From 369 patients, 313 (84.8%) were infected by VL. The proportion of VL incidence for those who traveled to endemic areas was (70.2%). Male patients accounted a larger proportion (93.2%) compared to female patients (6.8%). Moran’s scatter plot test revealed there is regional clustering on the VL incidence. Local Moron’s Index value of Gondar Zuria, Dembeya, Quara, Metemma, Tach Armachiho, Gondar Town, West Belesa and Adarakay was positive, this showed places that shared boundaries have similar VL incidence (i.e high-high or low-low). From result of local Getis and Ord statistic, positive standardized Z-values of Adarkay, Gondar Town, Metema, Quara, West Belesa and Dembiya showed the places were hot spot. Similarly negative standardized Z values of Gondar Zuria and Tach Armachiho revealed that places were cold spot. The spatial auto logistic regression result revealed that sex, travel history, BMI, rainfall and elevation were the significant factors of VL at 95% confidence level. Conclusion: The prevalence of VL is still very high (84.8%) in North Gondar Zone. VL clustered on endemic districts that shared common boundaries.

Prevalence of visceral leishmaniasis in A population of free-roaming dogs as determined by multiple sampling efforts: A longitudinal study analyzing the effectiveness of euthanasia

Free-roaming dogs affected by visceral leishmaniasis (VL) contribute to the geographical expansion of the disease and require special attention from health authorities. The objectives of the present study were to determine the prevalences of VL in a population of free-roaming dogs in an endemic region of Brazil, to establish the spatial distribution of infected dogs, and to examine the effectiveness of euthanasia of infected dogs in controlling the disease in this particular population. Dogs were captured every two months during seven sampling efforts. Capture locations were georeferenced and captured dogs were assessed for the presence of anti-Leishmania antibodies using an enzyme-linked immunosorbent assay (ELISA) as a screening test and the indirect fluorescent antibody test (IFAT) as the confirmatory procedure. Dogs that were seropositive by both assays were considered infected and were submitted to immediate euthanasia. After the end of the collection period, stored sera were evaluated with the Dual-Path Platform test (DPP). Animals positive by this method and by ELISA were also considered infected as currently recommended by the Brazilian Ministry of Health. Spatial analysis was performed using the Kernel technique. A total of 328 dogs were captured at least once during the sampling period, 25 (7.6%) of them were seropositive by ELISA and IFAT and 27 (8.2%) by DPP and ELISA. The prevalence of VL showed an overall decreasing trend. However, even with periodical euthanasia, it was not possible to eliminate the infection and increased prevalences were observed in the fourth and seventh samplings. There was a high overall agreement between the two criteria for defining infection. None of the dogs that tested negative by IFAT at the first capture seroconverted in the subsequent captures but a number of dogs exhibited changes in serological status over time. From the three dogs initially tested negative by ELISA and IFAT, but tested positive by the protocol currently adopted in Brazil, two became negative in subsequent recaptures. Spatial analysis revealed that infected animals concentrated in areas with a high density of free-roaming dogs. The existence of VL among homeless dogs may contribute significantly in the persistence of the disease among the human population, despite the practice of periodical euthanasia. The operational and ethical implications associated with euthanasia of free-roaming dogs, and the failure to control the transmission of VL among this particular population, led us to conclude that interventions promoting responsible ownership of pets may be a more effective strategy.

High frequency of subclinical Leishmania infection among HIV-infected patients living in the endemic areas of visceral leishmaniasis in Fars province, southern Iran.

Visceral leishmaniasis (VL) is a major health concern in patients with HIV infection in endemic areas of VL. In these areas, a substantial number of infected individuals are asymptomatic and the risk of acute VL infection in HIV/VL co-infected cases is high. The current study aimed to determine the prevalence of asymptomatic VL infection among HIV-infected patients in Fars province, southern Iran. Subjects of the study were 251 HIV-confirmed patients who all were clinically asymptomatic for leishmaniasis. Blood samples were obtained from each participant. Anti-Leishmania antibodies were detected in the sera using ELISA. DNA was extracted from the buffy coat of each subject and PCR amplified, targeting an ITS-2 gene of Leishmania. PCR products were purified from the gel and were sequenced. Overall, 19 out of 251 (7.6%) HIV-infected patients were found to be infected with Leishmania, using serological or molecular methods. Anti-Leishmania antibodies were detected in 13 (5.2%) patients and leishmanial DNA in 8 (3.2%) of the patients. The sequence analysis of DNA-positive cases revealed the species of the parasite as L. infantum. The high prevalence of VL among the patients with HIV is a serious challenge which demands further attention to improve the prophylaxis and treatment measurements of VL/HIV co-infection and thereby promoting the life expectancy and quality of life of these patients.

Addressing the recent dispersion of urban visceral leishmaniasis in the border of Argentina, Brazil, Paraguay + Uruguay + Bolivia – Project IDRC

The territory located in the border of Argentina, Brazil and Paraguay is endemic for tegumentary leishmaniasis (TL). However, Lutzomyia longipalpis first report in the area was in 2010-Argentina, in 2012-Brazil, and no records in the Paraguayan border despite of reports of human visceral leishmaniasis (VL) cases. Therefore, we developed a research from 2014 to 2017 to study VL in the three-country border at locality level; Uruguay-2015, and Bolivia-2016 joined latter due to the alerts of VL in the Argentinean borders. The space-time distributions of vectors, infected dogs and environmental variables were recorded and associated at three progressive scales, while anthropological surveys were performed. Three scenarios were characterized based on canine VL prevalence, vector presence-abundance and the spatial distribution consistency between them: settled VL, incipient VL, and steady TL with imported canine VL. The vector abundance was clustered in ‘hot spots’ persistent in time that could act as ‘source populations’. The clustering distribution was associated with environmental variables at the different scales studied. Therefore, the vector distribution (proxy of human-dog exposure) could be modeled in recent southern scenarios to focus the surveillance and interventions on predicted ‘hot spots’, in order to increase the effectiveness and efficiency of program activities.

Kala-azar in Darfur: Evidence for indigenous transmission in Al-Malha Locality, North Darfur, western Sudan

BackgroundRecent reports showed high numbers of visceral leishmaniasis cases in North Darfur, western Sudan. Due to a lack of previous studies, no information is available on local transmission of the disease in these areas. Therefore, a pilot entomological and epidemiological study was conducted in Al-Malha Locality during the year 2013, to investigate possibility of local transmission and places and times of the year where and when people contract the infection.MethodsKala-azar incidence data were obtained from records of Ministry of Health, North Darfur; Al-Malha rural hospital; and the Federal Ministry of Health, Division of Communicable and Non-communicable Diseases. Sand flies were collected using sticky paper and rodent burrow traps from five different microhabitats during three different phases of the year. Species identification was undertaken using appropriate taxonomic keys. Data were statistically analyzed to determine the distribution of kala-azar among different age groups and between sexes, and to compare the species richness and distribution of different sandfly species between the different microhabitats.ResultsThe most affected age groups with kala-azar during the period 2013–2016 were children between one and five years old and those under one year. Females were found to be more affected than males. A total of 918 sand fly specimens were collected using sticky paper and rodent burrow traps from five microhabitats. Identified specimens belong to 13 species; 5 Phlebotomus and 8 Sergentomyia. Phlebotomus orientalis, the principal vector of visceral leishmaniasis (VL) in Sudan and other East African countries, was found for the first time in the area. No other known vector of VL was found in the collection. The highest number of sand flies was recorded during the summer season (63%), with S. antennata (48%) and S. schwetzi (24.1%) being the most abundant species. Among Phlebotomus species, P. orientalis showed relatively high density (8.6%). A dry seasonal water course (called “Khor”) seems to be the most preferred habitat for most of the sand fly species since most of the collections (41.2%) were made from this site, followed by the rodent burrows.ConclusionsThe presence of P. orientalis and the high prevalence of VL in infants in the Al-Malha area provide the first evidence for local transmission of the parasite causing kala-azar in Darfur. Transmission is probably occurring during summer near the woodland where a high density of the vector was recorded. As a pre-requisite for designing effective control of VL in North Darfur, large scale entomological and epidemiological studies are recommended.

The Relationship between Climatic Factors and the Prevalence of Visceral Leishmaniasis in North West of Iran

Background Visceral leishmaniasis (VL) is most commonly found among children under the age of 10 in some provinces of Iran including Ardabil. As such, this study set out to determine the relationship between some climatic factors and the prevalence of VL in Northwest of Iran. Materials and Methods In this descriptive-analytic study, data collection was done on some climatic factors including rainfall, temperature, and the number of sunny and snowy days from Apr. 2001 to Sep. 2017 from the weather station in Meshkinshahr County of Ardabil province, Iran, and the related information of the VL patients from the health center. Statistical analysis was done using Excel and SPSS version 23.0 software. Pearson correlation coefficient test was utilized for data analysis. Results Over the course of 17 years, 226 cases of VL occurred in rural and urban areas of Meshkinshahr. The highest prevalence of VL disease was reported in February and March. Climatic factors of temperature and the number of sunny days showed a direct relationship with the prevalence of VL disease (P 0.05). Conclusion In spite of the rather cold and humid climate of Meshkinshahr County during much of the year, based on the findings of present study, there was a significantly direct relationship between VL disease and the hot temperature as well as sunny days. Background Visceral leishmaniasis (VL) is most commonly found among children under the age of 10 in some provinces of Iran including Ardabil. As such, this study set out to determine the relationship between some climatic factors and the prevalence of VL in Northwest of Iran. Materials and Methods In this descriptive-analytic study, data collection was done on some climatic factors including rainfall, temperature, and the number of sunny and snowy days from Apr. 2001 to Sep. 2017 from the weather station in Meshkinshahr County of Ardabil province, Iran, and the related information of the VL patients from the health center. Statistical analysis was done using Excel and SPSS version 23.0 software. Pearson correlation coefficient test was utilized for data analysis. Results Over the course of 17 years, 226 cases of VL occurred in rural and urban areas of Meshkinshahr. The highest prevalence of VL disease was reported in February and March. Climatic factors of temperature and the number of sunny days showed a direct relationship with the prevalence of VL disease (P 0.05). Conclusion In spite of the rather cold and humid climate of Meshkinshahr County during much of the year, based on the findings of present study, there was a significantly direct relationship between VL disease and the hot temperature as well as sunny days.

Prevalence of visceral leishmaniasis, risk factors and associated disorders: Knowledge of inhabitants and professionals in Fulbaria, Mymensingh

A total of 215 cases were recorded from the rural areas of Fulbaria upazila during June 2015 to May 2016. The prevalence of kala-azar was higher in male (51.22%) than female (36.96%). In the area, 10.1 - 20 years age group was the most prevalent group and the prevalence was found to decrease with the increase of age. Post Kala-azar Dermal Leishmaniasis (PKDL) was developed in 38.14% of kala-azar patients of Fulbaria upazila. The prevalence of kala-azar was found 63.89% in mud house dwellers and when living in tin shed house but with earthen floor, the prevalence was 58.79%. On the other hand, 10.31% had single infection with kala-azar, 21.65% had double infection and 68.04% had multiple infection. Living in proximity to prior case, climatic change, racked mud house, humid area, cattle sheds made of cracked mud walls, lack of awareness and knowledge regarding kala azar were the risk factors. Total 45 professionals were interviewed in the Upazila Health Complex and Upazila Sub-Centers of the study area through a preset questionnaire. Of them, 71.11% had the appropriate acquaintance about the agent (Leishmania donovani) of kala-azar and 35.29% professionals had the correct comprehension regarding the reservoir of kala-azar (man). Most of them (91.11%) recommended rK 39 dipstick test as the single most important diagnostic blood test and Miltefosine and Amphotericin B are the most recommended drugs for treatment of kala-azar.Bangladesh J. Zool. 45(1): 73-83, 2017

Identification of Visceral Leishmaniasis-Susceptible Areas using Spatial Modelling in Southern Caucasus.

This study explores the application of spatial modelling techniques to generate susceptibility maps for a neglected zoonotic disease, visceral leishmaniasis (VL), in an endemic area in southern Caucasus that includes Iran, Armenia and Azerbaijan. The social and physical environment of southern Caucasus has been mainly characterized by the presence of several factors that are strongly associated with VL, which has caused a significant number of infections during the past decade. Three popular spatial modelling techniques, consisting of the weights of evidence, logistic regression and fuzzy logic methods, were evaluated and trained using a study area in north-western Iran where an inventory of highly infected areas and high-quality evidential factors was available. Model performance was assessed using the receiver-operating characteristic (ROC) approach. According to the results of these assessments, the fuzzy logic method with γ=0.5 was chosen for the prediction of VL incidence in southern Caucasus. The susceptibility map generated using the fuzzy logic method indicated that VL followed a spatial pattern at the conjunction of the three countries, which suggests that the prevalence of VL in southern Caucasus is socio-ecologically dependent.

Visceral Leishmaniasis: An Update and Literature Review

Context: Leishmania is a pathogen that infects mononuclear phagocytes in which they establish chronic intracellular parasitism and survive for the infected person’s lifetime. Untreated cases of visceral leishmaniasis (VL) could cause death within two years. Along with known complications of VL, co-infection of Leishmania with human immunodeficiency virus (HIV) is becoming more frequent, with important clinical, diagnostic, chemotherapeutic, epidemiologic, and economic implications. This review attempts to provide updated information about diagnosis and treatment of VL.Evidence Acquisition: In this narrative review, recent published sources of information on leishmaniasis consisting of books and articles have been reviewed. This review focuses on VL.Results The outcome of infection depends on the host, the Leishmania species, and co-morbidities or co-infections. Disease manifestation may range from asymptomatic carrier to fatal disease. The development of a sensitive and rapid antigen detection test for relapse detection and also for cure remains an important aspect in diagnosis.Conclusions Development of novel drugs and diagnostic tests has allowed us to better manage VL. Although leishmaniasis is one of the oldest known parasitic infectious diseases, increasing prevalence of VL among specific populations, recent reports of disease reactivation and flare-up in clinically asymptomatic patients after the onset of immunosuppressive therapy, the risk of disease acquisition by tourists in endemic areas (e.g., the Mediterranean eara), and difficulties in prevention and controlling disease (i.e., given the diversity and distribution of vectors and reservoirs), leishmaniasis has again attracted researchers’ attention. Concerning reports of treatment failure and drug resistance are also new challenges in management of this parasitic disease in endemic areas.

Prevalence of Visceral Leishmaniasis in Hospitalized Patients as an increasing Public Health Problem

Introduction: Globally, Visceral Leishmaniasisan increasing public health problem, as evidenced by markedly increasing incidence rates and multiple outbreaks in all continents. Visceral Leishmaniasisis probably the most widespread and prevalent zoonotic disease in the world. World Health Organisation estimates the worldwide prevalence to be approximately 12 million cases, with annual mortality of about 60 000. The size of population at risk is about 350 million. Methods: Sera of 150 patients were analysed by indirect enzyme liked immunosorbent assay (ELISA). Serum was collected from patients with VL before the onset of treatment. Serum was separated from 1mL and stored at -20 °C. Results: For two years from January 2011 to December 2012 in our laboratory were examined 150 cases (hospitalized patients for IgG antibodies. The mean age was 15.44 with minimum 1 and maximum 69, standart deviation 16.577. The city of Durres represents 40.7 % of all cases. The prevalence for antibodies IgG was 17.3%. There was no significant relationship between antibodies IgG and sex, age and residence of patients. Conclusion: The prevalence of Leishmania in our patients is high but was not found an association regarding residence, age’s group and sex.

Prevalence and Associated Factors of Canine Visceral Leishmaniasis in an Endemic Area of Mato Grosso, Brazil

Background: Canine visceral leishmaniasis is a chronic and severe disease of great interest to global public health. In Brazil, the main species causing visceral leishmaniasis is Leishmania chagasi [syn. Leishmania infantum], which is transmitted by sandflies of the species Lutzomyia longipalpis and Lu. cruzi. This study aimed to determine the risk factors and prevalence of visceral leishmaniasis in dogs residing in endemic areas of the municipality of Várzea Grande, Mato Grosso.Material, Methods &amp; Results: The study was conducted in the Várzea Grande neighbourhoods Jardim Eldorado, Parque Sabiá and São Mateus, which are located in the Brazilian Cerrado region and are endemic for visceral leishmaniasis. The Várzea Grande is a mostly commercial and industrial municipality and relies on subsistence farming. To describe the general characteristics of the dog population and housing environment, an interview was carried out with the dog owners in each household. This interview addressed local demographics and the identification of dogs to establish epidemiological aspects of canine illness and risk factors for infection. The dogs were examined and physically restrained for blood collection by jugular venipuncture. For serological testing, a commercial enzyme-linked immunosorbent assay (ELISA) was used. A Chi-square test or Fisher’s exact test was used to identify associations between independent variables and the seroprevalence of dogs with anti-Leishmania antibodies. It were collected blood from 521 animals, including 160 belonging to Jardim Eldorado, 129 to Parque Sabiá and 232 to São Mateus. Of these animals, 120 were reactive by ELISA, with a prevalence of 23.0%. There was no statistically significant difference (P &gt; 0.05) according to gender, age, racial definition, origin, time with family, presence of ectoparasites, or the presence of people with skin wounds at home or on other pets. The major risk factor for canine infection was fur length; dogs with short fur were 2.2 times more likely to be infected than dogs with long fur.Discussion: The prevalence of canine leishmaniasis in endemic areas was found to be similar to studies in Cuiaba, a city in Várzea Grande, which also included neighbourhoods endemic for visceral leishmaniasis as study areas. Other studies have shown prevalence rates that differ from those found in this study. This difference may either be because the neighbourhoods in this study had already experienced outbreaks of the disease or because serum samples were cross-reactive with other trypanosomatids. While infection was more readily detected in dogs with clinical signs, asymptomatic dogs with anti-Leishmania antibodies were found in greater numbers, which is consistent with the literature. Hair length was the only factor associated with canine leishmaniasis in this study; short-haired animals were most at risk of contracting the disease because they had more skin exposure to sandflies during blood feeding. In conclusion, endemic districts of Várzea Grande had high prevalence rates of canine visceral leishmaniasis, and a short length coat was associated with infection.