Showing papers on "Visceral leishmaniasis published in 1989"
TL;DR: The results of this study demonstrate that the DAT is highly suitable for wide-scale epidemiological and ecological field work and could also facilitate diagnosis of leishmaniasis in dogs in veterinary health services.
Abstract: A direct agglutination test (DAT) for detection of visceral leishmaniasis in humans has been developed. In this study, it was evaluated for applicability to detection of infections in dogs, a reservoir species. The reliability of the test was improved by treating the test sera with 0.2 M 2-mercaptoethanol and incubating them at 37 degrees C. Sensitivity was 100% and specificity was 98.9% when the test was used on serum samples from 220 dogs, including 26 with parasitologically confirmed canine leishmaniasis, 12 with suspected but unconfirmed leishmaniasis, and 182 with other conditions. The DAT detected specific antibodies in 10 dogs with canine leishmaniasis diagnosed by case history, clinical signs of leishmaniasis, and seropositivity in an immunofluorescence test using either promastigotes or amastigotes, as well as in 2 dogs suspected of having leishmaniasis. The performance of an antigen prepared from a homologous isolate of Leishmania infantum in the DAT was compared with that of an antigen from a laboratory-adapted strain of L. donovani (sensu lato). The homologous antigen compared favorably with the standard antigen, and the results provided further evidence of the potential of the DAT for detection of Leishmania infection in the canine reservoir host. The results of this study, together with those of our previous studies in human visceral leishmaniasis, demonstrate that the DAT is highly suitable for wide-scale epidemiological and ecological field work. This technique could also facilitate diagnosis of leishmaniasis in dogs in veterinary health services.
166 citations
TL;DR: Visceral leishmaniasis developed before full-blown acquired immunodeficiency syndrome (AIDS) in seven patients and at the same time as or after AIDS in the other two patients.
Abstract: In an 8-month period nine patients with human immunodeficiency virus (HIV) infection were diagnosed as having visceral leishmaniasis; all diagnoses were based on cultures (eight from bone marrow and one from the skin) Visceral leishmaniasis developed before full-blown acquired immunodeficiency syndrome (AIDS) in seven patients and at the same time as or after AIDS in the other two patients Three patients had a history of leishmaniasis Clinical manifestations and laboratory findings were atypical Leishmania species were cultured from samples taken from all patients; however, six patients had an insignificant antileishmanial antibody titer and Leishmania amastigotes were not seen in their bone marrow smears Four isolates were identified by isoenzyme analysis as Leishmania donovani infantum Five patients died, including two patients who had completed at least one 3-week course of therapy with N-methylglucamine antimoniate Screening should be done for visceral leishmaniasis in patients with HIV infection who live or travel in areas where the disease is endemic The diagnosis of visceral leishmaniasis may frequently be missed if cultures are not done
152 citations
TL;DR: The absence of this T cell- and probably lymphokine-dependent mechanism is a likely explanation for treatment failures in immunocompromised patients infected with L. donovani and perhaps other systemic intracellular pathogens as well.
Abstract: Although directly microbicidal, pentavalent antimony has failed as treatment for visceral leishmaniasis in patients who also have AIDS or are receiving immunosuppressive therapy. To define the role of T cells in the successful host response to chemotherapy, we examined the efficacy of pentavalent antimony (sodium stibogluconate, Pentostam) in normal and T cell-deficient BALB/c mice infected with Leishmania donovani. In euthymic (nu/+) mice, single injections of 250 and 500 mg/kg of Pentostam induced the killing of 67% and 89% of intracellular liver amastigotes, respectively. In contrast, in athymic nude (nu/nu) mice, up to three injections of 500 mg/kg achieved no L. donovani killing and did not retard visceral parasite replication. Once nude mice were reconstituted with nu/+ spleen cells, however, Pentostam exerted strong leishmanicidal activity, an effect that appeared to be transferred by either L3T4+ or Lyt-2+ cells. Responsiveness to chemotherapy could also be induced by providing nude mice with either interferon-gamma or interleukin 2 alone. The absence of this T cell- and probably lymphokine-dependent mechanism is a likely explanation for treatment failures in immunocompromised patients infected with L. donovani and perhaps other systemic intracellular pathogens as well.
128 citations
TL;DR: It is concluded that the antigenic specific suppression of lymphocyte proliferation in visceral leishmaniasis is cell mediated.
Abstract: Barral, Aldina Maria Prado. “Documento produzido em parceria ou por autor vinculado a Fiocruz, mas nao consta a informacao no documento”.
124 citations
TL;DR: It is established that visceral leishmaniasis is an opportunistic infection in HIV-infected patients, and it is suggested that in endemic areas it should be considered an indicator disease for the diagnosis of AIDS.
Abstract: In an area endemic for visceral leishmaniasis, 16patients with human immunodeficiency virus (HIV) infection developed the disease. All belonged to populations at risk for AIDS (15 were intravenous drug abusers). Five patients fulfilled the criteria for full-blown AIDS, and two more fulfilled them after diagnosis of leishmaniasis. All presented with the classic manifestations of visceral leishmaniasis, but leishmania serology was negative in 15 patients (93%). Leishmania donovani amastigotes were identified in the bone marrow in all cases. Most patients responded initially to treatment with pentavalent antimonial drugs, but seven (43%) followed a chronic course, with multiple relapses in five, despite alternative treatments. Visceral leishmaniasis occurred in patients with different levels of depression of the CD4 to CD8 lymphocyte ratio. Mortality was 37% (six patients) and was independent of the chronic-relapsing course of the disease. In no case was leishmaniasis the primary cause of death. Our data establish that visceral leishmaniasis is an opportunistic infection in HIV-infected patients, and we suggest that in endemic areas it should be considered an indicator disease for the diagnosis of AIDS. © 1989 by The University of Chicago.
101 citations
TL;DR: The relatively high prevalence of L. chagasi infection found among D. marsupialis captured near human dwellings suggests that these animals may be an important peridomestic reservoir.
Abstract: Epidemiologic studies were conducted during the period 1986–1988 in a small rural community in Colombia (El Callejon) where visceral leishmaniasis is highly endemic. In this community of 185 people, 14 cases of infantile visceral leishmaniasis were diagnosed in the 9 years 1981–1988. Leishmanin skin testing of a sample of the human residents showed that prevalence of Leishmania chagasi infection increased with age; overall, 51.2% of the subjects had a positive reaction. A canine surveillance program was instituted, using introduced sentinel dogs as well as the indigenous dog population. Eleven of 16 sentinel dogs were infected within 8 months of exposure; mean seroconversion time was 4.4 months. Eleven of 25 seronegative local dogs were also infected during the 26 month period; mean seroconversion time was 8 months. Parasites identified by isozyme electrophoresis as L. chagasi were recovered from 18 of 22 seropositive dogs. Collections of wild animals using baited live traps yielded mainly the neotropical opossum, Didelphis marsupialis. Leishmania chagasi was recovered from 12 of 37 (32.4%) opossums. Six of 681 female Lutzomyia longipalpis collected in the community had flagellates in their guts; cultures from 4 were identified as L. chagasi. These data confirmed that active parasite transmission occurred. The relatively high prevalence of L. chagasi infection found among D. marsupialis captured near human dwellings suggests that these animals may be an important peridomestic reservoir.
100 citations
Journal Article•
TL;DR: It seems that appearance of autoantibodies to ribonucleoproteins in sera of patients infected with Leishmania is not only due to simply polyclonal activation of lymphocytes, but is also the result of a molecular mimicry between leishmanial antigens and ribon nucleoprotein.
Abstract: Sera from 29 patients with visceral leishmaniasis and 14 patients with cutaneous leishmaniasis were tested against a panel of nine nuclear antigens employing an enzyme-linked immunosorbent assay (ELISA). Anti- Sm, RNP, SS-A and SS-B antibodies were present in high titres in 83, 86, 36 and 73 per cent of the patients with visceral leishmaniasis and in 7, 14, 25 and 25 per cent of the patients with cutaneous leishmaniasis. One serum from a patient with visceral leishmaniasis which reacted strongly with Sm, RNP, SS-A and SS-B was examined by immunoblotting on extractable nuclear antigen from Hela cells. This serum binds to nine different antigenic bands (16, 23, 29, 30, 40, 50, 58, 100 and 115 kD). These same antigens were recognized by serum from a patient with systemic lupus erythematosus. The binding of visceral leishmaniasis serum antibodies to ribonucleoproteins was inhibited by prior incubation of serum with either leishmanial membrane antigens, from four different species of Leishmania, or intact cells of Leishmania donovani, implying molecular resemblance between common leishmanial antigens and ribonuclear antigens. It seems that appearance of autoantibodies to ribonucleoproteins in sera of patients infected with Leishmania is not only due to simply polyclonal activation of lymphocytes, but is also the result of a molecular mimicry between leishmanial antigens and ribonucleoproteins.
76 citations
TL;DR: These are the first reported cases of visceral leishmaniasis (kala-azar) caused by L. tropica in Africa; these cases were refractory to sodium stibogluconate.
Abstract: We report the characterization of 6 Leishmania tropica isolates from 2 patients with visceral leishmaniasis who were unresponsive to treatment with sodium stibogluconate. The Leishmania isolates, MHOM/KE/81/NLB-029A, -029XIB, and -029XIC and MHOM/KE/81/NLB-030I, -030B, and -030XXA, all from splenic aspirates, were characterized by cellulose acetate electrophoresis using 11 enzymes: malate dehydrogenase, malic enzyme, phosphogluconate dehydrogenase, glucose-6-phosphate dehydrogenase, superoxide dismutase, glutamate-oxaloacetate transaminase, adenylate kinase, nucleoside hydrolase, mannose phosphate isomerase, glucose phosphate isomerase, and phosphoglucomutase. Isozyme migration patterns were indistinguishable from those of 2 WHO reference strains of Leishmania tropica (MHOM/SU/60/LRC-L39, NLB-305 and MHOM/IQ/OO/LRC-L36, NLB-067). These are the first reported cases of visceral leishmaniasis (kala-azar) caused by L. tropica in Africa; these cases were refractory to sodium stibogluconate.
70 citations
TL;DR: The involvement of the lung in 13 cases of human visceral leishmaniasis was studied and all 10 interstitial pneumonitis cases showed PAP-positive material using specific L. donovani (MHOM/BR/72/LD 46) antiserum.
Abstract: The involvement of the lung in 13 cases of human visceral leishmaniasis was studied. Interstitial pneumonitis with mononuclear cells was found in 76.8% of the cases; 53.8% also had foci of septal fibrosis. Leishmania were seen within macrophages in 3 cases only. However, all 10 interstitial pneumonitis cases showed PAP-positive material using specific L. donovani (MHOM/BR/72/LD 46) antiserum. 3 cases with no interstitial pneumonitis were PAP-negative. A short discussion about clinical aspects and the course of the disease is presented.
55 citations
01 Jan 1989
TL;DR: In this paper, the application of measures aimed at controlling canine leishmaniasis should represent the main strategy to prevent human infections, since the antimonial drugs which are successfully used for the treatment of human VL are poorly effective in the radical treatment of canine leischmaniasis.
Abstract: The dog is the domestic reservoir of Mediterranean visceral leishmaniasis (VL). Therefore, the application of measures aimed at controlling canine leishmaniasis should represent the main strategy to prevent human infections. Unfortunately, the antimonial drugs which are successfully used for the treatment of human VL are poorly effective in the radical treatment of canine leishmaniasis. Killing of infected dogs is usually considered the only effective measure to control or to prevent epidemics in man (WHO, 1984). However, in Mediterranean foci where a canine leishmaniasis seropositivity prevalence of 15–20% is commonly found (Bettini and Gradoni, 1986), the elimination of all serologically positive dogs is not achievable.
49 citations
TL;DR: The results of this double‐blind study stress the differences that may exist between the natural hosts of Leishmania parasites and experimental animal substitutes.
Abstract: In a double-blind study 393 seronegative dogs, residing in a holoendemic area for Leishmania donovani infantum infection, were randomly assigned to an immunization with a partly purified L.d. infantum-derived preparation, or received adjuvant only. During the first year of the study period the rate of infection was significantly higher in the vaccinated group than in the control one (P less than 0.05), but this difference disappeared during the second year (P = 0.44). Since a similar immunization protocol conferred resistance against experimental murine leishmaniasis, these results stress the differences that may exist between the natural hosts of Leishmania parasites and experimental animal substitutes.
Journal Article•
TL;DR: Sandfly anglesi is a highly exophilic species in this area, a behaviour which could explain the limited impact of the treatment on this sandfly, but these data are difficult to interpret due to the natural seasonal variation in density in this species.
Abstract: After one month of entomological observations to record pretreatment data, a sub Andean village of Yungas, Bolivia (alt. 1500 m) was sprayed at the beginning of the rainy season (January 1987). Houses were treated inside and outside with deltamethrin at 0.025 g/sq.m.; kennels, hen-houses and stacks of adobe were also sprayed in the same way. As a result of the treatment, Lutzomyia longipalpis, the local vector of visceral leishmaniasis, disappeared from houses and animal shelters for 9 and 10 months respectively. The impact of the treatment on the populations of Lu. nuneztovari and anglesi, the presumed vector of tegumentary leishmaniasis, was not obvious. As compared with pretreatment data, the rate of engorged females in houses decreased by two, and their density was also reduced. But these data are difficult to interpret due to the natural seasonal variation in density in this species. Moreover, the information from the control village did not correspond as expected. Lu. n. anglesi is a highly exophilic species in this area, a behaviour which could explain the limited impact of the treatment on this sandfly.
Journal Article•
TL;DR: A historical review and information about the present status of leishmaniasis in Bangladesh together with control strategies and a proposed plan of operation are presented.
Abstract: Visceral leishmaniasis, which is also known as kala-azar, reappeared in Bangladesh during the 1980s, approximately 7-8 years after large-scale use of DDT had been abandoned by the malaria eradication programme in the country. Pabna, Mymensingh and Rajshahi were the regions most affected with kala-azar. The article presents a historical review and information about the present status of leishmaniasis in Bangladesh together with control strategies and a proposed plan of operation.
01 Jan 1989
TL;DR: Variation in clinical response to treatment of leishmaniasis with pentavalent antimonial compounds with development of in vitro infected macrophage systems has allowed drug sensitivity to be monitored.
Abstract: Variation in clinical response to treatment of leishmaniasis with pentavalent antimonial compounds has been reported on many occasions. It has been assumed that the variations arise from the patient or drug potency since there has previously been no way of checking the sensitivity of the parasites. The development of in vitro infected macrophage systems has allowed drug sensitivity to be monitored (Berman and Wyler, 1980; Neal and Matthews, 1982).
TL;DR: A patient with HIV infection presented with multiple cutaneous Kaposi's sarcomata and further investigations proved the patient to have visceral leishmaniasis (kala azar), a rare presentation in HIV infection.
Abstract: A patient with HIV infection presented with multiple cutaneous Kaposi's sarcomata. Biopsy of one of these showed the presence of amastigotes within an otherwise typical Kaposi's sarcoma. Further investigations proved the patient to have visceral leishmaniasis (kala azar). Visceral leishmaniasis has been reported in HIV infection but it is rare and this presentation is unique. The patient made a good response to a prolonged course of treatment with sodium stibogluconate and allopurinol.
01 Jan 1989
TL;DR: Biochemical techniques like isoenzyme electrophoresis have shown that L. infantum is also the cause of human cutaneous leishmaniasis in wide areas of the Mediterranean regions.
Abstract: Leishmania infantum Nicolle, 1908, has been considered in the past as the aethiological agent of human visceral leishmaniasis (VL) and canine leishmaniasis (CanL) in the Mediterranean basin. Biochemical techniques like isoenzyme electrophoresis, which were developed since the seventies for the identification of Leishmania isolates, have shown that L. infantum is also the cause of human cutaneous leishmaniasis in wide areas of the Mediterranean regions. Furthermore, new mammalian reservoirs of the parasite have been identified, and a number of Phlebotomus species (belonging to subgenus Laroussius) have been definitively incriminated as vectors, having previously been suspected on epidemiological grounds.
TL;DR: Visceral leishmaniasis was highly prevalent in China but since 1958, after a nationwide campaign, it has been brought under control and only sporadic cases occur in the hilly and newly reclaimed desert areas in NW China.
TL;DR: Visceral leishmaniasis in patients infected with human immunodeficiency virus (HIV) is being reported frequently in the Spanish media.
Abstract: Excerpt To the Editor:Visceral leishmaniasis in patients infected with human immunodeficiency virus (HIV) is being reported frequently in the Spanish media (1-3). Berenguer and colleagues (4) recen...
TL;DR: The plasma lipoprotein system of young children with visceral Leishmaniasis (Kala-azar disease) is described and the presence of LP-A-II particles was demonstrated by two-dimensional immunoelectrophoresis in most of the patients' plasma during the acute phase of disease.
TL;DR: Evidence of well preserved parasites within hepatocytes suggest this parasitism as a possible reservoir for recrudescence in liver parenchymal cell parasitism with the amastigotes form of L. donovani.
Abstract: Liver parenchymal cell parasitism with the amastigotes form of L. donovani was detected by electron microscopy in human visceral leishmaniasis. Endocytosis was considered to be the mechanism by which the leishmania entered the cell. Evidence of well preserved parasites within hepatocytes suggest this parasitism as a possible reservoir for recrudescence.
Journal Article•
TL;DR: Considering the low costs involved, easiness in performance and stability of the antigen, the DAT appears to possess high potential for routine application in Sudan.
Abstract: Hawata District (Kassala Province) is one of the known endemic areas for visceral leishmaniasis in Sudan. The co-endemicity with malaria, enteric fever, tuberculosis and brucellosis together with the limited medical laboratory facilities, rendered differential diagnosis of visceral leishmaniasis in this area, rather difficult. Two-hundred and three serum samples, including 49 collected from patients treated earlier as visceral leishmaniasis cases, were tested in a developed direct agglutination test (DAT). 100% concordance was found between the DAT results and the parasitological diagnosis in 40 confirmed cases. In nine unconfirmed, however highly suspected cases, the DAT results indicated visceral leishmaniasis. Significant improvements in the condition of those nine patients was observed during the therapeutic test and later on after a full course of treatment with sodium antimony gluconate (pentostam). DAT titres in the other serum samples (154), collected from patients with malaria, enteric fever, brucellosis and schistosomiasis and from endemic controls were below the cut-off titre (1:3200). Considering the low costs involved, easiness in performance and stability of the antigen, the DAT appears to possess high potential for routine application in Sudan.
Journal Article•
TL;DR: This paper reports the first isolation of leishmanial parasites from a domestic goat, a close associate of man in the vast endemic leish maniasis foci, the first autochthonous case in Eastern Africa.
Abstract: Extensive research has been carried out in Eastern Africa for animal reservoirs of both visceral and cutaneous leishmaniasis. The domestic dog has been the only domestic animal so far implicated as a possible reservoir for visceral leishmaniasis. For cutaneous leishmaniasis caused by Leishmania aethiopica, the hyrax and the giant rat are the proven reservoirs of the disease while several species of rodents have been demonstrated to harbor L. major. Recent studies conducted in domestic animals in West Pokot led to the first isolation of leishmanial parasites from a domestic goat, a close associate of man in the vast endemic leishmaniasis foci. Consequent encounter of a clinical case of the disease is the basis for this paper. It is the first autochthonous case in Eastern Africa. The goat originated from the Western escarpments of the Rift Valley which are known to harbor L. aethiopica. Clinical signs included lesions, indurations, and enlargement of lymph nodes. Parasitological and pathological investigations revealed amastigotes in various tissues. Cultures of the affected tissues produced promastigotes.
01 Jan 1989
TL;DR: Leishmanial parasites were first discovered in the Old World by Cunningham (1885) and with this the first defined cases of leishmaniasis began to be described.
Abstract: Leishmanial parasites were first discovered in the Old World by Cunningham (1885) and with this the first defined cases of leishmaniasis began to be described. By the turn of the century, two distinct leishmaniases were recognized: cutaneous leishmaniasis (CL)(Borovsky,1898, cited and translated by Hoare, 1938; Wright, 1903) and visceral leishmaniasis (VL) (Leishman, 1903; Donovan,1903). This was before the generic name Leishmania was ever applied to the parasites causing them (Ross,1903). Since the clinical manifestations of these two leishmaniases were so distinct, their parasites were named as separate species: L.tropica for those causing CL; L.donovani for those causing VL, despite their similar morphology. So distinct were these in the minds of practitioners that the two species names became synonymous with the two diseases. Even today they are often applied to uncharacterized organisms solely according to clinical condition and the organs in which the parasites are found.
Journal Article•
TL;DR: De nouvelles recherches sont cependant necessaires non seulement a l'interieur meme du foyer d'El Agamy mais plus encore dans les pays voisins.
Abstract: Le caractere original du zymodeme egyptien evoque un foyer autochtone ancien. De nouvelles recherches sont cependant necessaires non seulement a l'interieur meme du foyer d'El Agamy mais plus encore dans les pays voisins. (Arabie Seoudite, Soudan, Yemen, Proche Orient)
Journal Article•
TL;DR: Sera from 289 children residing in 5 endemic localities in AJ&K was tested for Leishmania specific antibodies by IFAT and low levels of these antibodies were detected in 15.4% of the cases.
Abstract: Between January '85 and August '87, 22 cases of VL were seen at National Institute of Health, Islamabad. Three (14.6%) came from the previously known endemic region of Gilgit, 15 (68.1%) from different localities in Azad Jammu and Kashmir (AJ&K), and 4 (17.3%) from neighbouring foci in NWFP and Punjab. Mean age of the patients was 4.2 years, (Range, 10 months to 57 years) median 2.5 years and mode 2 years. High levels of Leishmania antibodies were detected by Indirect Immunofluorescent Antibody Technique (IFAT) in all cases. Leishmania were isolated from bone marrow aspirates of 2 patients and isoenzyme characterization performed in one of these, the organism was typed as Leishmania infantum sensu stricto. Sera from 289 children residing in 5 endemic localities in AJ&K was tested for Leishmania specific antibodies by IFAT and low levels of these antibodies were detected in 15.4% of the cases.
TL;DR: No reactivity to this protein was observed with sera from the other diseases above mentioned indicating that the 60 kD protein may be used in serodiagnosis for ACL.
Abstract: The antigenicity of promastigotes of Leishmania braziliensis braziliensis (L. b.braziliensis) treated with 1% sodium desoxycholate in 10 mM Tris-Hcl pH 8.2 was analysed by immunoblot using as probes sera from American cutaneous leishmaniasis (ACL), American visceral leishmaniasis (AVL), schistosomiasis, malaria and Chagas' disease. The ACL sera reacted constantly with a 60 kD band. No reactivity to this protein was observed with sera from the other diseases above mentioned indicating that the 60 kD protein may be used in serodiagnosis for ACL.
Journal Article•
TL;DR: A sandfly Phlebotomus rossi has emerged as a possible vector of the disease in man and further carefully planned and directed field studies are required in an attempt to identify the reservoir host for human CL.
Abstract: A total of 34 patients with cutaneous leishmaniasis (CL) have been diagnosed in South West Africa/Namibia since 1970. Visceral leishmaniasis has not occurred. So far a sandfly Phlebotomus rossi has emerged as a possible vector of the disease in man. Several aspects of vector incrimination and bionomics still need clarification. Further carefully planned and directed field studies are required in an attempt to identify the reservoir host for human CL.