The Parasitemia has Contributed to the Severity of Cases of Visceral Leishmaniasis

Cássio Marinho Campelo; Andres Christopher Medvedovsky; Pablo Eliak Linhares de Holanda; Denis Francisco Gonçalves de Oliveira; Luiz Carlos de Albuquerque-Pinto; Luciana Magalhães Melo; Lilia Maria Carneiro Câmara

doi:10.1007/s12088-023-01182-6

The Parasitemia has Contributed to the Severity of Cases of Visceral Leishmaniasis

Indian J Microbiol. 2024 Jun;64(2):511-519. doi: 10.1007/s12088-023-01182-6. Epub 2024 Jan 27.

Authors

Cássio Marinho Campelo¹, Andres Christopher Medvedovsky², Pablo Eliak Linhares de Holanda³, Denis Francisco Gonçalves de Oliveira¹, Luiz Carlos de Albuquerque-Pinto¹, Luciana Magalhães Melo⁴, Lilia Maria Carneiro Câmara¹

Affiliations

¹ Department of Pathology and Legal Medicine, Biomedicine Center, Federal University of Ceará/Brazil, Coronel Nunes de Melo Street 1312, Rodolfo Teófilo, Fortaleza, Ceará 60430-270 Brazil.
² TEFL Academy, London, England.
³ São José Hospital of Infectious Disease, Fortaleza, Ceará Brazil.
⁴ Fametro University Center, Fortaleza, Ceará Brazil.

PMID: 39011003
PMCID: PMC11246353 (available on 2025-06-01)
DOI: 10.1007/s12088-023-01182-6

Abstract

Visceral leishmaniasis (VL) occurs due to the evolution, virulence, and adaptation of Leishmania, vector biology, host immune system evasion, and reservoir hosts. Parasitemia can be involved as a warning regarding the clinical severity of VL The present study aims to evaluate the relationship between parasitemia and the prognosis of individuals with VL. Blood and bone marrow samples from individuals with VL were analyzed to identify parasite and quantify or measure parasite burden. Individuals were classified in the clinical score model of risk of death by disease proposed by Coura-Vital et al. (PLoS Negl Trop Dis 8(12): e33742014, 2014). 39/74 individuals presented a better prognosis, and 35/74 individuals presented a worse prognosis. HIV + VL co-infection was present in 32 individuals, of which 12 were considered severe. The group aged 51 to 64 was classified as severe, with a decrease in leukocytes (p-value 0.0295) and neutrophils (p-value 0.0476). L. infantum DNA was identified in blood and bone marrow, in 69 individuals, and not detected in 5 individuals. The quantification of the parasite showed greater parasitemia in bone marrow (P = 0.0003) with an average of 4.70 × 10⁴ Leishmanias/mL about blood, with 0.29 × 10⁴ Leishmanias/mL. Individuals in the age group aged 51 to 64 co-infected with HIV + VL had higher parasitemia (p-value 0.0150) with 2.44 × 10⁴ Leishmanias/mL in blood and bone marrow than in the group aged 20 to 50. Parasitemia, measured by molecular biology in blood and bone marrow, was related to the worst clinical prognosis of VL in the age group aged 51 to 64.

Keywords: Clinical prognosis; Parasitemia; Severity of illness; Visceral leishmaniasis.

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