Prevalence of and Factors Associated with Negative Microscopic Diagnosis of Cutaneous Leishmaniasis in Rural Peru

Perrotta, Grace; Smith, Edward; Alves, Clark; Rosales, Luis Angel; Lescano Guevara, Andres Guillermo; Ballard, Sarah-Blythe; Fuhrer, Jack; Valdivia, Hugo; Murphy, Meagan; Perez, Erika; Lamm, Ryan; Sanchez, Juan F.; Messina, Catherine

dc.contributor.author	Lamm, Ryan
dc.contributor.author	Alves, Clark
dc.contributor.author	Perrotta, Grace
dc.contributor.author	Murphy, Meagan
dc.contributor.author	Messina, Catherine
dc.contributor.author	Sanchez, Juan F.
dc.contributor.author	Perez, Erika
dc.contributor.author	Rosales, Luis Angel
dc.contributor.author	Lescano Guevara, Andres Guillermo
dc.contributor.author	Smith, Edward
dc.contributor.author	Valdivia, Hugo
dc.contributor.author	Fuhrer, Jack
dc.contributor.author	Ballard, Sarah-Blythe
dc.date.accessioned	2018-11-30T22:50:36Z
dc.date.available	2018-11-30T22:50:36Z
dc.date.issued	2018
dc.identifier.uri	https://hdl.handle.net/20.500.12866/4157
dc.description.abstract	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.	en_US
dc.language.iso	eng
dc.publisher	American Society of Tropical Medicine and Hygiene
dc.relation.ispartofseries	American Journal of Tropical Medicine and Hygiene (ASTMH Journal)
dc.rights	info:eu-repo/semantics/restrictedAccess
dc.subject	Negative Microscopic Diagnosis	en_US
dc.subject	Cutaneous Leishmaniasis	en_US
dc.subject	Rural	en_US
dc.subject	Peru	en_US
dc.title	Prevalence of and Factors Associated with Negative Microscopic Diagnosis of Cutaneous Leishmaniasis in Rural Peru	en_US
dc.type	info:eu-repo/semantics/article
dc.identifier.doi	https://doi.org/10.4269/ajtmh.17-0909
dc.subject.ocde	https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn	1476-1645