Prevalence of and Factors Associated with Negative Microscopic Diagnosis of Cutaneous Leishmaniasis in Rural Peru
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Autor
Rosales, Luis AngelLescano, Andres G.
Smith, Edward
Perez, Erika
Alves, Clark
Lamm, Ryan
Sanchez, Juan F.
Messina, Catherine
Murphy, Meagan
Valdivia, Hugo
Ballard, Sarah-Blythe
Perrotta, Grace
Fuhrer, Jack
Fecha de publicación
2018xmlui.metadata.dc.contributor.email
[email protected]
Metadatos
Mostrar el registro completo del ítemJournal
American Journal of Tropical Medicine and HygieneDOI
10.4269/ajtmh.17-0909Enlaces adicionales
http://www.ajtmh.org/content/journals/10.4269/ajtmh.17-0909Resumen
Cutaneous leishmaniasis is endemic to South America where diagnosis is most commonly conducted via microscopy. Patients with suspected leishmaniasis were referred for enrollment by the Ministry of Health (MoH) in Lima, Iquitos, Puerto Maldonado, and several rural areas of Peru. A 43-question survey requesting age, gender, occupation, characterization of the lesion(s), history of leishmaniasis, and insect-deterrent behaviors was administered. Polymerase chain reaction (PCR) was conducted on lesion materials at the Naval Medical Research Unit No. 6 in Lima, and the results were compared with those obtained by the MoH using microscopy. Factors associated with negative microscopy and positive PCR results were identified using χ2 test, t-test, and multivariate logistic regression analyses. Negative microscopy with positive PCR occurred in 31% (123/403) of the 403 cases. After adjusting for confounders, binary multivariate logistic regression analyses revealed that negative microscopy with positive PCR was associated with patients who were male (adjusted odds ration [OR] = 1.93 [1.06-3.53], P = 0.032), had previous leishmaniasis (adjusted OR = 2.93 [1.65-5.22], P < 0.0001), had larger lesions (adjusted OR = 1.02 [1.003-1.03], P = 0.016), and/or had a longer duration between lesion appearance and PCR testing (adjusted OR = 1.12 [1.02-1.22], P = 0.017). Future research should focus on further exploration of these underlying variables, discovery of other factors that may be associated with negative microscopy diagnosis, and the development and implementation of improved testing in endemic regions.Tipo
info:eu-repo/semantics/articleDerechos
info:eu-repo/semantics/embargoedAccessIdioma
engDescripción
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.ISSN
0002-96371476-1645
ae974a485f413a2113503eed53cd6c53
10.4269/ajtmh.17-0909
Scopus Count
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