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Leishmania infantum in the Himalayas
Summary
Visceral leishmaniasis (VL) is a growing concern in Pakistan, particularly affecting young children. This study reveals widespread leishmanin skin test positivity, indicating high exposure rates in endemic areas.
Area of Science:
- Medical Entomology
- Parasitology
- Epidemiology
Background:
- Visceral leishmaniasis (VL) has been endemic in Pakistan for over 30 years, with increasing reports across multiple provinces.
- Recent decades show a significant number of cases, predominantly in children under five years old.
Purpose of the Study:
- To assess the epidemiological patterns and transmission dynamics of visceral leishmaniasis in endemic regions of Pakistan.
- To identify the circulating Leishmania species and seroprevalence in affected populations.
Main Methods:
- Cross-sectional study involving leishmanin skin testing of 1938 individuals across 14 villages.
- Serological testing using enzyme-linked immunosorbent assay (ELISA) and direct agglutination test (DAT) on human sera and filter paper blood samples.
- Isolation and characterization of Leishmania parasites from patient samples (bone marrow, skin, spleen).
Main Results:
- A high leishmanin skin test positivity rate of 27.4% was observed, increasing with age, suggesting widespread exposure.
- Leishmanin positivity clustered within households, unlike clinical VL cases, indicating distinct transmission dynamics.
- Parasite typing identified Leishmania infantum zymodeme LON-49 (MON-1) as the causative agent in the studied areas.
- Serological data indicated varying endemic patterns, with some foci suggesting interrupted transmission.
Conclusions:
- The study highlights significant exposure to Leishmania parasites in Pakistani communities, with a high prevalence in young children.
- Leishmania infantum is the primary species responsible for VL in these regions.
- Understanding transmission patterns is crucial for effective control strategies against visceral leishmaniasis.