Factors associated to Montenegro skin test positivity in Teresina, Brazil

Gouvêa, Marcus Vinicius; Werneck, Guilherme Loureiro; Costa, Carlos Henrique Nery; Carvalho, Fernando Aécio de Amorim

doi:10.1016/j.actatropica.2007.07.010

Cited by 20 publications

(43 citation statements)

References 28 publications

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“…[23][24][25][26] Second, because education is a proxy for many other variables that might increase peridomestic conditions that favor transmission, such as the ownership of animals, poor household conditions, poverty, and lack of urban services. 6,21,23,[27][28][29][30] It should be noted, however, that findings from profiles 6 and 7 reveal that a higher educational level alone was not able to reduce the risk of infection in settings favorable to the maintenance of the transmission cycle.…”

Section: Discussionmentioning

confidence: 99%

“…16 This result highlights that, in the absence of control measures, a higher educational level would not be able to reduce the risk of infection, particularly in males, who are more exposed to infection during leisure-time activities. 21 Profile 7 shows that highly educated older females who lived in nonintervention areas had a high risk for infection (CI = 57.8%). Women aged 30 years or over would be at higher risk than their younger counterparts, since they would be more exposed to risk factors, considering that phlebotomine sandflies have nocturnal habits.…”

Section: Discussionmentioning

confidence: 99%

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Risk Profiles for Leishmania infantum Infection in Brazil

Alves

Costa

Carvalho

et al. 2016

The American Society of Tropical Medicine and Hygiene

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Abstract. The aim of this study was to characterize risk profiles for Leishmania infantum infection in a population living in an area endemic for visceral leishmaniasis. A cohort study was conducted between January 2004 and December 2006 with the participation of 430 individuals living in the city of Teresina, northeast Brazil, who were initially negative for the Montenegro test. Data analysis was performed using the classification and regression tree method. The cumulative incidence (CI) of Montenegro's test conversion was 35% at 18-month follow-up. Eight different risk profiles for L. infantum infection were identified. The profile with the highest risk (CI = 75%) comprised individuals with less than 4 years of education who had never lived outside Teresina. The profile with the lowest risk (CI = 5%) included highly educated subjects who had owned a dog for 5 years or more and lived in areas that received some type of intervention. These results show that there is a high degree of complexity involved in the risk for L. infantum infection and point out the need of developing new studies to perform a comprehensive analysis focused on investigating the interrelation between risk factors rather than their isolated roles on the determination of infection levels in urban areas.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk Profiles for Leishmania infantum Infection in Brazil

Alves

Costa

Carvalho

et al. 2016

The American Society of Tropical Medicine and Hygiene

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“…Previous studies conducted in other area of Brazil showed similar results. 46 Whether this finding is reflects capacity of males to mount a strong DTH response or whether it reflects differences in parasite burden is not known. In the current study, the frequency of positive serology remained similar in all age groups, whereas the prevalence of a positive LST increased with age.…”

Section: Discussionmentioning

confidence: 99%

“…47 It is also consistent with the disappearance of detectable anti-leishmanial antibodies after spontaneous resolution of asymptomatic infection or successful chemotherapy of VL. 20,46,[48][49][50][51][52][53] In contrast to the transient serologic status, a positive LST may be long lasting in most individuals, 47,54 although it can become negative in some over time (Lacerda H and others, unpublished data).…”

Section: Discussionmentioning

confidence: 99%

Leishmania infantum chagasi in Northeastern Brazil: Asymptomatic Infection at the Urban Perimeter

Lima

Queiroz²,

Lacerda³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Visceral leishmaniasis (VL) is endemic in large cities in Brazil, including Natal. We determined the prevalence of asymptomatic human infection with Leishmania infantum chagasi and associated environmental risks around Natal. Infection was detected by Leishmania skin test (LST) and anti-leishmanial antibodies in humans and anti-leishmanial antibodies in dogs. Amongst 345 humans, 24.6% were seropositive, and 38.6% were LST-positive. Prevalence of positive serology was similar in both sexes and across all ages. However, positive LST responses increased with age, suggesting that LST is long-lasting and cumulative. Multinomial logistic analysis showed that LST response varied with location (P = 0.007) and that males were more frequently LST-positive (P = 0.027). Indicators of lower socioeconomic status associated significantly with human infection. Furthermore, there was geographic coincidence of seropositive humans and dogs (r = 0.7926, P = 0.011). These data suggest that dog and human L. i. chagasi infection are intimately interrelated in environmental conditions associated with low income.

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“…Previous research has characterized income, housing type, dog ownership, population growth index, and illiteracy rates as risk factors for cVL and hVL. 8,19,20,25 In addition, comorbidities and increased likelihood of immune suppression within disadvantaged populations are significant risk factors for VL, including malnutrition, parasitism, aging, immune senescence, concurrent immunosuppressive therapy, and other immunosuppressive coinfections. 8,19,25,26 Not surprisingly, misconceptions about transmission dynamics of L. infantum between dogs, sandflies, and people resulted in an increased risk for canine infection within the household; 83.2% of respondents indicated that sandfly bites led to increased risk for hVL.…”

Section: Discussionmentioning

confidence: 99%

Preventing Zoonotic Canine Leishmaniasis in Northeastern Brazil: Pet Attachment and Adoption of Community Leishmania Prevention

Esch¹,

Pontes²,

Arruda³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. Visceral leishmaniasis (VL), caused by Leishmania infantum chagasi (L.i. chagasi syn. infantum) in northeastern Brazil, was responsible for 51,000 new VL cases from 1980 to 2003. Household presence of L. infantum-infected dogs is a major risk factor for human infection. Despite culling of dogs based on seropositivity, canine L. infantum seroprevalence remains near 20%, suggesting that dog culling is ineffective for preventing VL spread. We administered a cross-sectional survey to 224 households within 300 m of the homes of VL human patients diagnosed within the last year. The goal was to develop a model for voluntary preventative use based on characteristics and motivations of dog owners. We identified that owner knowledge deficiencies regarding canine transmission of L. infantum associated with increased risk of dog infection (odds ratio [OR] = 3.681, confidence interval [CI] = 1.223, 11.08). Higher owner education was associated with decreased levels of dog seropositivity (OR = 0.40, CI = 0.20, 0.81). Pet attachment (P = 0.036) and perception of risk/disease knowledge (P = 0.040) were significantly associated with willingness to voluntarily purchase canine VL prevention. These results highlight the importance of owner attachment to their pet in implementing reservoirtargeted zoonotic VL prevention.

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Factors associated to Montenegro skin test positivity in Teresina, Brazil

Cited by 20 publications

References 28 publications

Risk Profiles for Leishmania infantum Infection in Brazil

Risk Profiles for Leishmania infantum Infection in Brazil

Leishmania infantum chagasi in Northeastern Brazil: Asymptomatic Infection at the Urban Perimeter

Preventing Zoonotic Canine Leishmaniasis in Northeastern Brazil: Pet Attachment and Adoption of Community Leishmania Prevention

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