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. 2024 Jul 16;111(3):462-471.
doi: 10.4269/ajtmh.24-0155. Print 2024 Sep 4.

Leishmania Infection among HIV-Infected Patients in a Southern Province of Thailand: A Cross-Sectional Study

Chontida Jundang  1 , Toon Ruang-Areerate  2 , Mathirut Mungthin  2 , Saovanee Leelayoova  2 , Wanna Tinsan  1 , Hussana Kanoknatjamorn  1 , Buntharika Duangkao  1 , Weerayut Bubpamas  1 , Suradej Siripattanapipong  3 , Tawee Naaglor  2 , Nattapong Hongsimakul  2 , Supicha Sroythong  2 , Phakhajee Rattanalertpaiboon  2 , Phunlerd Piyaraj  2
Affiliations

Leishmania Infection among HIV-Infected Patients in a Southern Province of Thailand: A Cross-Sectional Study

Chontida Jundang et al. Am J Trop Med Hyg. .

Abstract

Leishmaniasis, a neglected tropical disease, imposes a notable health burden, especially on immunocompromised individuals such as HIV patients. Recognizing its prevalence and risk factors in specific populations is vital for effective prevention. This study in Satun Province, southern Thailand, aimed to ascertain leishmaniasis prevalence and identify associated risks among HIV-infected patients. A cross-sectional study was conducted among 650 HIV-infected individuals at a tertiary care hospital. Data on demographic characteristics, clinical parameters, and potential risk factors were collected. Individual plasma, buffy coat, and saliva samples were collected. Leishmania infection was determined using the direct agglutination test and nested polymerase chain reaction (nPCR) of nPCR-buffy coat and nPCR-saliva. The association between risk factors and Leishmania infection was assessed with logistic regression analysis. The prevalence of Leishmania infection was 8.61% (56/650). Species was identified among 20 HIV-infected patients as follows: Leishmania orientalis (n = 14), Leishmania martiniquensis (n = 4), and Leishmania donovani complex (n = 2). The factors associated with Leishmania infection included age (adjusted odds ratio [OR] = 1.03), intravenous drug use (adjusted OR = 2.39), CD4 cell count <500 cells/mm3 (adjusted OR = 2.40), and a viral load ≥50 copies/mL (adjusted OR = 5.16). The prevalence of Leishmania infection among HIV-infected patients in Satun Province was considerable. These findings underscore the need for integrated care and targeted interventions to address this infection and improve public health outcomes. Further research and collaborative efforts are warranted to develop effective prevention and control strategies for Leishmania infection in the HIV-infected Thai population.

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Conflict of interest statement

Disclosure: The Ethics Committee of the Royal Thai Army Medical Department approved this study (approval number: S005h/59). All participants provided written informed consent. The collected data were assigned unique identification codes to ensure the confidentiality and anonymity of the participants. The study adhered to the principles outlined in the Declaration of Helsinki.

Authors’ contributions: C. Jundang: conceptualization, investigation, and methodology; T. Ruang-Areerate: investigation and methodology; M. Mungthin: conceptualization, funding acquisition, methodology, supervision, and writing – review and editing; S. Leelayoova: conceptualization, funding acquisition, methodology, supervision, and writing – review and editing; W. Tinsan: investigation and project administration; H. Kanoknatjamorn: investigation; B. Duangkao: investigation; W. Bubpamas: investigation; S. Siripattanapipong: investigation; T. Naaglor: investigation; N. Hongsimakul: investigation; S. Sroythong: investigation; P. Rattanalertpaiboon: investigation; and P. Piyaraj: conceptualization, formal analysis, funding acquisition, methodology, project administration, and writing – original draft preparation.

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