Transmission of Leishmania donovani in the hills of eastern Nepal, an outbreak investigation in Okhaldhunga and Bhojpur districts

26Citations
Citations of this article
63Readers
Mendeley users who have this article in their library.

Abstract

Background: In the Indian subcontinent, Visceral leishmaniasis is endemic in a geographical area coinciding with the Lower Gangetic Plain, at low altitude. VL occurring in residents of hill districts is therefore often considered the result of Leishmania donovani infection during travel. Early 2014 we conducted an outbreak investigation in Okhaldhunga and Bhojpur districts in the Nepal hills where increasing number of VL cases have been reported. Methodology/Principal Findings: A house-to-house survey in six villages documented retrospectively 35 cases of Visceral Leishmaniasis (VL). Anti-Leishmania antibodies were found in 22/23 past-VL cases, in 40/ 416 (9.6%) persons without VL and in 12/155 (7.7%) domestic animals. An age- and sexmatched case-control study showed that exposure to known VL-endemic regions was no risk factor for VL, but having a VL case in the neighbourhood was. SSU-rDNA PCR for Leishmania sp. was positive in 24 (5%) of the human, in 18 (12%) of the animal samples and in 16 (14%) bloodfed female Phlebotomus argentipes sand flies. L. donovani was confirmed in two asymptomatic individuals and in one sand fly through hsp70-based sequencing. Conclusions/Significance: This is epidemiological and entomological evidence for ongoing local transmission of L. donovani in villages at an altitude above 600 meters in Nepal, in districts considered hitherto non-endemic for VL. The VL Elimination Initiative in Nepal should therefore consider extending its surveillance and control activities in order to assure VL elimination, and the risk map for VL should be redesigned.

Cite

CITATION STYLE

APA

Ostyn, B., Uranw, S., Bhattarai, N. R., Das, M. L., Rai, K., Tersago, K., … Rijal, S. (2015). Transmission of Leishmania donovani in the hills of eastern Nepal, an outbreak investigation in Okhaldhunga and Bhojpur districts. PLoS Neglected Tropical Diseases, 9(8). https://doi.org/10.1371/journal.pntd.0003966

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free