MONITORING OF LEISHMANIA TRANSMISSION IN THE PERI-ELIMINATION PHASE: THE POTENTIAL OF SEROLOGICAL SURVEYS

Intro: Elimination of visceral leishmaniasis (VL) as a public health problem on the Indian subcontinent is within reach. With VL cases coming to an all-time low, monitoring of infection rather than disease might provide a sensitive method to pick-up resurgence of transmission. We therefore evaluated...

Full description

Bibliographic Details
Main Authors: O.P. Singh, K. Cloots, T.K. Rai, V.D. Tiwari, A.K. Singh, E. Hasker, S. Sundar
Format: Article
Language:English
Published: Elsevier 2023-05-01
Series:International Journal of Infectious Diseases
Online Access:http://www.sciencedirect.com/science/article/pii/S1201971223001819
_version_ 1797824549752930304
author O.P. Singh
K. Cloots
T.K. Rai
V.D. Tiwari
A.K. Singh
E. Hasker
S. Sundar
author_facet O.P. Singh
K. Cloots
T.K. Rai
V.D. Tiwari
A.K. Singh
E. Hasker
S. Sundar
author_sort O.P. Singh
collection DOAJ
description Intro: Elimination of visceral leishmaniasis (VL) as a public health problem on the Indian subcontinent is within reach. With VL cases coming to an all-time low, monitoring of infection rather than disease might provide a sensitive method to pick-up resurgence of transmission. We therefore evaluated to what extent serological surveys allow to distinguish between presence and absence of Leishmania donovani transmission. Methods: Seven villages were selected within Bihar and Uttar Pradesh state, based on their reported VL case load in last 20 years, and categorized as either currently endemic (VL cases reported in each of the last three years), previously endemic (VL cases reported until four years ago), or non-endemic (no VL cases in last 15 years). All inhabitants aged ≥2 years were requested to provide blood sample for rK39 Rapid Diagnostic Test, Direct Agglutination Test (DAT;cut-off ≥1:3,200), and rK39 ELISA (cut-off pp=18). Findings: A total of 3,959 households (population: 20,325) were visited in seven clusters, of whom 15,468 (76%) provided a blood sample. Seroprevalence with rK39 RDT was 0.42% (95%CI 0.26 – 0.62%), 0.26% (95%CI 0.15– 0.43%) and 0.00% (95%CI 0.00 – 0.10%) in currently endemic (CE), previously endemic (PE) and non-endemic (NE) clusters respectively. DAT seroprevalence was 0.51% (95%CI 0.34– 0.75%), 1.62% (95%CI 0.32 – 1.98%) and 0.05% (95%CI 0.01– 0.19%) in CE, PE and NE clusters respectively. ELISA results provided a significant difference between all three settings, with 5.21% (95%CI 4.62 – 5.84%) seroprevalence in CE clusters, 1.55% (95%CI 1.25 – 1.89%) in PE clusters, and 0.13% (95%CI 0.04 – 0.30%) in NE clusters. Among children aged <10 years, ELISA was able to differentiate between clusters with (CE) or without (PE and NE) transmission. Conclusion: Our study suggests that serological surveys are able to differentiate between villages with and without ongoing transmission, and can be a useful tool for monitoring of transmission.
first_indexed 2024-03-13T10:40:39Z
format Article
id doaj.art-08f06d315ccd45fda92e3da8bba3bd06
institution Directory Open Access Journal
issn 1201-9712
language English
last_indexed 2024-03-13T10:40:39Z
publishDate 2023-05-01
publisher Elsevier
record_format Article
series International Journal of Infectious Diseases
spelling doaj.art-08f06d315ccd45fda92e3da8bba3bd062023-05-18T04:38:04ZengElsevierInternational Journal of Infectious Diseases1201-97122023-05-01130S22MONITORING OF LEISHMANIA TRANSMISSION IN THE PERI-ELIMINATION PHASE: THE POTENTIAL OF SEROLOGICAL SURVEYSO.P. Singh0K. Cloots1T.K. Rai2V.D. Tiwari3A.K. Singh4E. Hasker5S. Sundar6Banaras Hindu University, Department of Biochemistry, Varanasi, IndiaInstitute of Tropical Medicine, Public Health, Antwerp, BelgiumBanaras Hindu University, Department of Medicine, Institute of Medical Sciences, Varanasi, IndiaBanaras Hindu University, Department of Medicine, Institute of Medical Sciences, Varanasi, IndiaBanaras Hindu University, Department of Medicine, Institute of Medical Sciences, Varanasi, IndiaInstitute of Tropical Medicine, Public Health, Antwerp, BelgiumBanaras Hindu University, Department of Medicine, Institute of Medical Sciences, Varanasi, IndiaIntro: Elimination of visceral leishmaniasis (VL) as a public health problem on the Indian subcontinent is within reach. With VL cases coming to an all-time low, monitoring of infection rather than disease might provide a sensitive method to pick-up resurgence of transmission. We therefore evaluated to what extent serological surveys allow to distinguish between presence and absence of Leishmania donovani transmission. Methods: Seven villages were selected within Bihar and Uttar Pradesh state, based on their reported VL case load in last 20 years, and categorized as either currently endemic (VL cases reported in each of the last three years), previously endemic (VL cases reported until four years ago), or non-endemic (no VL cases in last 15 years). All inhabitants aged ≥2 years were requested to provide blood sample for rK39 Rapid Diagnostic Test, Direct Agglutination Test (DAT;cut-off ≥1:3,200), and rK39 ELISA (cut-off pp=18). Findings: A total of 3,959 households (population: 20,325) were visited in seven clusters, of whom 15,468 (76%) provided a blood sample. Seroprevalence with rK39 RDT was 0.42% (95%CI 0.26 – 0.62%), 0.26% (95%CI 0.15– 0.43%) and 0.00% (95%CI 0.00 – 0.10%) in currently endemic (CE), previously endemic (PE) and non-endemic (NE) clusters respectively. DAT seroprevalence was 0.51% (95%CI 0.34– 0.75%), 1.62% (95%CI 0.32 – 1.98%) and 0.05% (95%CI 0.01– 0.19%) in CE, PE and NE clusters respectively. ELISA results provided a significant difference between all three settings, with 5.21% (95%CI 4.62 – 5.84%) seroprevalence in CE clusters, 1.55% (95%CI 1.25 – 1.89%) in PE clusters, and 0.13% (95%CI 0.04 – 0.30%) in NE clusters. Among children aged <10 years, ELISA was able to differentiate between clusters with (CE) or without (PE and NE) transmission. Conclusion: Our study suggests that serological surveys are able to differentiate between villages with and without ongoing transmission, and can be a useful tool for monitoring of transmission.http://www.sciencedirect.com/science/article/pii/S1201971223001819
spellingShingle O.P. Singh
K. Cloots
T.K. Rai
V.D. Tiwari
A.K. Singh
E. Hasker
S. Sundar
MONITORING OF LEISHMANIA TRANSMISSION IN THE PERI-ELIMINATION PHASE: THE POTENTIAL OF SEROLOGICAL SURVEYS
International Journal of Infectious Diseases
title MONITORING OF LEISHMANIA TRANSMISSION IN THE PERI-ELIMINATION PHASE: THE POTENTIAL OF SEROLOGICAL SURVEYS
title_full MONITORING OF LEISHMANIA TRANSMISSION IN THE PERI-ELIMINATION PHASE: THE POTENTIAL OF SEROLOGICAL SURVEYS
title_fullStr MONITORING OF LEISHMANIA TRANSMISSION IN THE PERI-ELIMINATION PHASE: THE POTENTIAL OF SEROLOGICAL SURVEYS
title_full_unstemmed MONITORING OF LEISHMANIA TRANSMISSION IN THE PERI-ELIMINATION PHASE: THE POTENTIAL OF SEROLOGICAL SURVEYS
title_short MONITORING OF LEISHMANIA TRANSMISSION IN THE PERI-ELIMINATION PHASE: THE POTENTIAL OF SEROLOGICAL SURVEYS
title_sort monitoring of leishmania transmission in the peri elimination phase the potential of serological surveys
url http://www.sciencedirect.com/science/article/pii/S1201971223001819
work_keys_str_mv AT opsingh monitoringofleishmaniatransmissionintheperieliminationphasethepotentialofserologicalsurveys
AT kcloots monitoringofleishmaniatransmissionintheperieliminationphasethepotentialofserologicalsurveys
AT tkrai monitoringofleishmaniatransmissionintheperieliminationphasethepotentialofserologicalsurveys
AT vdtiwari monitoringofleishmaniatransmissionintheperieliminationphasethepotentialofserologicalsurveys
AT aksingh monitoringofleishmaniatransmissionintheperieliminationphasethepotentialofserologicalsurveys
AT ehasker monitoringofleishmaniatransmissionintheperieliminationphasethepotentialofserologicalsurveys
AT ssundar monitoringofleishmaniatransmissionintheperieliminationphasethepotentialofserologicalsurveys