Epidemiologic Aspects of an Emerging Focus of Visceral Leishmaniasis in Tbilisi, Georgia

BackgroundOver the last 15 years, visceral leishmaniasis (VL) has emerged as a public health concern in Tbilisi, the capital of Georgia. Methodology/Principal FindingsSeroepidemiological surveys were conducted to determine the prevalence and incidence of infection in children and dogs within the main focus of VL, and to identify risk factors associated with human infection. Of 4,250 children investigated, 7.3% were positive by direct agglutination test in a baseline survey; an apparent incidence rate of 6.0% was estimated by one year follow-up. None of the seropositive children progressed to VL during the survey. Increased seropositivity at one year was predicted by presence at baseline of clustered flying insects (OR = 1.49; P = 0.001), perceived satisfactory sanitation (OR = 1.65; POR = 1.33; P = 0.023), and by persistent fever during the 6 months prior to baseline survey (OR = 14.2; PLeishmania 70 kDa heat-shock protein (HSP70) gene as Leishmania infantum. Conclusions/SignificanceThere is an active focus of L. infantum transmission in Tbilisi with a high prevalence of human and canine infections.