Journal of Biostatistics and Epidemiology 2016. 2(3):136-142.

Human visceral leishmaniasis: Seroprevalence survey of asymptomatic adults in an endemic area of Northwestern Iran
Sedigheh Shirmohammad, Mehdi Mohebali, Behnam Mohammadi Ghalehbin, Zabiholah Zarei, Behnaz Akhoundi, Shapoor-Reza Shojaei, Nadia Tayefi Nasrabadi, Zahra Kakooei


Background & Aim: Visceral leishmaniasis (VL) or kala-azar is a protozoan disease caused by some species of Leishmania donovani complex. Mediterranean type of the disease is endemic in various parts of Iran. A cross-sectional study was designed to determine the seroprevalence of VL among asymptomatic adult population in Meshkin-Shahr area from the Northwest of Iran as an endemic focus of VL.
Methods & Materials: Altogether, 180 blood samples were collected from asymptomatic adults’ population throughout 2015. Before sampling, a questionnaire was separately completed for each individual. All the collected blood samples were examined by direct agglutination test (DAT) after plasma separation. Anti-Leishmania infantum antibodies at titers 1:100 to 1:1600 was considered as L. infantum infection, while the cut-off titer of ≥ 1:3200 with specific signs and symptoms was considered as VL.
Results: From 180 collected plasma samples, nine (5%) of them showed anti-Leishmania antibodies at titers 1:400 and higher. Distribution of anti-Leishmania antibodies titers was 1:400 (n = 2), 1:800 (n = 4), and 1:1600 (n = 3). All of the seropositive cases were observed among females. All the seropositive individuals had not a history of kala-azar. The highest seropositivity rate was observed among the age group of 13-23 years old. No changes in titers of anti-Leishmania antibodies observed after collected the seropositive blood samples again and tested by DAT with 1-month interval.
Conclusion: Visceral Leishmania infection is relatively high among adult people reside in Meshkin-Shahr area without any clinical manifestations. Asymptomatic VL infection is very important in immunocompromized individuals such as HIV-positive cases; these patients are at risk to manifesting clinical signs and symptoms of VL. Therefore continuing serological surveillance for detection of visceral Leishmania infection should be recommended in the endemic foci of VL.


Visceral leishmaniasis; Seroprevalence; Direct agglutination test; Adult; Iran

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Desjeux P. Leishmaniasis: current situation and new perspectives. Comp Immunol Microbiol Infect Dis 2004; 27(5): 305-18.

Werneck GL. Visceral leishmaniasis in Brazil: rationale and concerns related to reservoir control. Rev Saude Publica 2014; 48(5): 851-6.

Mohebali M. Visceral leishmaniasis in Iran: review of the epidemiological and clinical features. Iran J Parasitol 2013; 8(3): 348-58.

Ashford RW. The leishmaniases as emerging and reemerging zoonoses. Int J Parasitol 2000; 30(12-13): 1269-81.

D'Oliveira JA, Costa SR, Barbosa AB, Orge Mdl, Carvalho EM. symptomatic Leishmania chagasi infection in relatives and neighbors of patients with visceral leishmaniasis. Mem Inst Oswaldo Cruz 1997; 92(1): 15-20.

Caldas AJ, Costa J, Aquino D, Silva AA, Barral-Netto M, Barral A. Are there differences in clinical and laboratory parameters between children and adults with American visceral leishmaniasis? Acta Trop 2006; 97(3): 252-8.

Cavalcante IJ, Vale MR. Epidemiological aspects of visceral leishmaniasis (kala-azar) in Ceara in the period 2007 to 2011. Rev Bras Epidemiol 2014; 17(4): 911-24.

Elmahallawy EK, Sampedro MA, Rodriguez-Granger J, Hoyos-Mallecot Y, Agil A, Navarro Mari JM, et al. Diagnosis of leishmaniasis. J Infect Dev Ctries 2014; 8(8): 961-72.

Mohebali M, Akhoundi B, Kakooei Z, Zarei Z, Charehdar S, Molaei S. Modification on direct agglutination antigen preparation for simplified sero-diagnosis of human and

canine visceral leishmaniasis. Iran J Parasitol 2015; 10(3): 360-5.

Mahmoudvand H, Mohebali M, Sharifi I, Keshavarz H, Hajjaran H, Akhoundi B, et al. Epidemiological aspects of visceral leishmaniasis in baft district, kerman province, southeast of Iran. Iran J Parasitol 2011; 6(1): 1-11.

Edrissian GH, Hafizi A, Afshar A, Soleiman-Zadeh G, Movahed-Danesh AM, Garoussi A. An endemic focus of visceral leishmaniasis in Meshkin-Shahr, east Azerbaijan province, north-west part of Iran and IFA serological survey of the disease in this area. Bull Soc Pathol Exot Filiales 1988; 81(2): 238-48.

Wikipedia. Meshginshahr [Online]. [cited 2016 Oct 2]; Available from:

el Harith A, Kolk AH, Leeuwenburg J, Muigai R, Huigen E, Jelsma T, et al. Improvement of a direct agglutination test for field studies of visceral leishmaniasis. J Clin Microbiol 1988; 26(7): 1321-5.

Zijlstra EE, Ali MS, el-Hassan AM, el-Toum IA, Satti M, Ghalib HW, et al. Direct agglutination test for diagnosis and sero-epidemiological survey of kala-azar in the Sudan. Trans R Soc Trop Med Hyg 1991; 85(4): 474-6.

Mohebali M, Hajjaran H, Hamzavi Y, Mobedi I, Arshi S, Zarei Z, et al. Epidemiological aspects of canine visceral leishmaniosis in the Islamic Republic of Iran. Vet Parasitol 2005; 129(3-4): 243-51.

Silva ES, Schoone GJ, Gontijo CM, Brazil RP, Pacheco RS, Schallig HD. Application of direct agglutination test (DAT) and fast agglutination screening test (FAST) for sero-diagnosis of visceral leishmaniasis in endemic area of Minas Gerais, Brazil. Kinetoplastid Biol Dis 2005; 4: 4.

Schallig HD, Schoone GJ, Kroon CC, Hailu A, Chappuis F, Veeken H. Development and application of 'simple' diagnostic tools for visceral leishmaniasis. Med Microbiol Immunol 2001; 190(1-2): 69-71.

el Harith A, Slappendel RJ, Reiter I, van Knapen F, de Korte P, Huigen E, et al. Application of a direct agglutination test for


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