ArticlePLoS neglected tropical diseases2019
Determinants for progression from asymptomatic infection to symptomatic visceral leishmaniasis: A cohort study.
Article in PLoS neglected tropical diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diagnosis of visceral and cutaneous leishmaniasis using loop-mediated isothermal amplification (LAMP) protocols: a systematic review and meta-analysis.Parasites & vectors · 2022Pooled it
- Systematic suppression of Leishmania (Leishmania) amazonensis-mediated delayed-type hypersensitivity response in American cutaneous leishmaniasis.Parasites & vectors · 2025Article
- Immune-Pathological Correlates of Disease Severity in New-World Kala-Azar: The Role of Parasite Load and Cytokine Profiles.Pathogens (Basel, Switzerland) · 2025Article
- The potential ofMicrobiology spectrum · 2025Article
- T-cell activation and senescence in asymptomatic HIV/Leishmania infantum co-infection.PLoS neglected tropical diseases · 2025Article
- Assessment of asymptomaticFrontiers in medicine · 2025Article
- Article
- Monitoring of Leishmania transmission in the postelimination phase: The potential of serological surveys.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2024Article
- Challenges for maintaining post elimination phase of visceral leishmaniasis control programme in India: A field-based study.PLoS neglected tropical diseases · 2024Article
- Immune response to viscerotropicFrontiers in immunology · 2024Review
- Wuchereria bancrofti infection is associated with progression to clinical visceral leishmaniasis in VL- endemic areas in Muzaffarpur, Bihar, India.PLoS neglected tropical diseases · 2023Article
- Gene Signatures of Symptomatic and Asymptomatic Clinical-Immunological Profiles of Human Infection byMicroorganisms · 2023Article
- Livestock and rodents within an endemic focus of Visceral Leishmaniasis are not reservoir hosts for Leishmania donovani.PLoS neglected tropical diseases · 2022Article
- Identification of asymptomatic Leishmania infections: a scoping review.Parasites & vectors · 2022Article
- A Multi-Country, Single-Blinded, Phase 2 Study to Evaluate a Point-of-Need System for Rapid Detection of Leishmaniasis and Its Implementation in Endemic Settings.Microorganisms · 2021Article
- Leishmaniasis in the United States: Emerging Issues in a Region of Low Endemicity.Microorganisms · 2021Review
- Precision Medicine in Control of Visceral Leishmaniasis Caused byFrontiers in cellular and infection microbiology · 2021Review
- Revival of Leishmanization and Leishmanin.Frontiers in cellular and infection microbiology · 2021Review
- Diagnostic accuracy of direct agglutination test, rK39 ELISA and six rapid diagnostic tests among visceral leishmaniasis patients with and without HIV coinfection in Ethiopia.PLoS neglected tropical diseases · 2020Article
- Xenodiagnosis to address key questions in visceral leishmaniasis control and elimination.PLoS neglected tropical diseases · 2020Review
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21 authors.
Funding
Abstract
backgroundAsymptomatic Leishmania donovani infections outnumber clinical presentations, however the predictors for development of active disease are not well known. We aimed to identify serological, immunological and genetic markers for progression from L. donovani infection to clinical Visceral Leishmaniasis (VL).
methodsWe enrolled all residents >2 years of age in 27 VL endemic villages in Bihar (India). Blood samples collected on filter paper on two occasions 6-12 months apart, were tested for antibodies against L. donovani with rK39-ELISA and DAT. Sero converters, (negative for both tests in the first round but positive on either of the two during the second round) and controls (negative on both tests on both occasions) were followed for three years. At the start of follow-up venous blood was collected for the following tests: DAT, rK39- ELISA, Quantiferon assay, SNP/HLA genotyping and L.donovani specific quantitative PCR.
resultsAmong 1,606 subjects enrolled,17 (8/476 seroconverters and 9/1,130 controls) developed VL (OR 3.1; 95% CI 1.1-8.3). High DAT and rK39 ELISA antibody titers as well as positive qPCR were strongly and significantly associated with progression from seroconversion to VL with odds ratios of 19.1, 30.3 and 20.9 respectively. Most VL cases arose early (median 5 months) during follow-up.
conclusionWe confirmed the strong association between high DAT and/or rK39 titers and progression to disease among asymptomatic subjects and identified qPCR as an additional predictor. Low predictive values do not warrant prophylactic treatment but as most progressed to VL early during follow-up, careful oberservation of these subjects for at least 6 months is indicated.
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