1. The predictive validity of naturally acquired delayed-type hypersensitivity to leishmanin in resistance to Leishmania major-associated cutaneous leishmaniasis.
- Author
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Ben Salah A, Louzir H, Chlif S, Mokni M, Zaatour A, Raouene M, Ismail RB, and Dellagi K
- Subjects
- Adolescent, Animals, Antigens, Protozoan metabolism, Child, Dose-Response Relationship, Immunologic, Female, Humans, Incidence, Leishmania major immunology, Leishmania major metabolism, Leishmaniasis, Cutaneous epidemiology, Leishmaniasis, Cutaneous parasitology, Leishmaniasis, Cutaneous transmission, Male, Predictive Value of Tests, Skin Tests, Tunisia epidemiology, Zoonoses epidemiology, Zoonoses parasitology, Zoonoses transmission, Antigens, Protozoan immunology, Hypersensitivity, Delayed etiology, Leishmania major pathogenicity, Leishmaniasis, Cutaneous immunology
- Abstract
To accurately quantify the different outcomes of Leishmania major infection and to evaluate the fraction of zoonotic cutaneous leishmaniasis (ZCL) cases prevented by naturally acquired leishmanin skin test (LST) reactivity, a cohort of 470 children was followed up in 2 endemic foci, Remada and Dhiba, in southern Tunisia. During May 1997, before the ZCL emergence season, LST was performed, and results were reassessed 12 months later. Active case detection during the ZCL emergence season showed a high incidence of ZCL: 57.0% in Remada and 13.7% in Dhiba. The preventive fraction of ZCL conferred by LST reactivity increased proportionally with the reaction size before the emergence season, revealing a dose-response effect of approximately 70%. In addition, asymptomatic L. major infection appeared to be a significant form of natural immunization, particularly in the context of relatively low transmission. These findings may help in the design and evaluation of vaccines.
- Published
- 2005
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