In the recording of biomedical signals, a significant noise component is introduced by the electrode. The magnitude of this noise is considerably higher than the equivalent thermal noise from the electrode impedance. As the noise in surface electrodes limits the resolution of biopotential recordings, it is important to understand its origin. It was found that the noise mainly originates in the electrolyte-skin interface and that it is highly dependent on the electrode gel used and the skin properties of the test subject. Depending on skin treatment, magnitudes between 1 and 20 microVrms were measured among subjects. When the metal-electrolyte interface was allowed time to stabilise, electrodes of different metals measured face to face all showed a negligibly small noise magnitude (< 1 microVrms). In pre-gelled electrodes, where the metal-electrolyte interface has stabilised, no difference in noise properties was found between Ag-AgCl electrodes and other metals when measured on the skin. In subjects at rest, the contribution of EMG signals to the total noise level was shown to be negligibly small compared with the noise contribution of the electrolyte-skin interface. The magnitude of the noise of electrodes appeared to be inversely proportional to the square root of the area of the electrode on the skin.

To increase the potential for the wide-scale application of our direct agglutination test for visceral leishmaniasis, modifications in the components and procedures were introduced. Supplementation with 0.056 M citrate of the suspension medium stabilized the antigen for 9 weeks at 3rC. To circumvent the need for cooling systems in the field, 0.2% (wt/vol) gelatin was added to the serum diluent instead of fetal bovine serum, with reliable results. Specificity and sensitivity were improved by the incorporation of 0.1 M 2-mercaptoethanol in samples with borderline titers. The test could be performed on samples of whole blood; thus the difficulties of preparation and storage of serum, plasma, or filter paper blood are avoided. For mass screening programs, a single serum dilution of 1:6,400 could be employed, contributing to a further reduction in test expenses. Sera from different geographical areas showed equal reactivities in this direct agglutination test despite the nonhomologous Leishmania donovani antigens used.

A direct agglutination test (DAT) for detection of visceral leishmaniasis in humans has been developed. In this study, it was evaluated for applicability to detection of infections in dogs, a reservoir species. The reliability of the test was improved by treating the test sera with 0.2 M 2-mercaptoethanol and incubating them at 37°C. Sensitivity was 100% and specificity was 98.9% when the test was used on serum samples from 220 dogs, including 26 with parasitologically confirmed canine leishmaniasis, 12 with suspected but unconfirmed leishmaniasis, and 182 with other conditions. The DAT detected specific antibodies in 10 dogs with canine leishmaniasis diagnosed by case history, clinical signs of leishmaniasis, and seropositivity in an immunofluorescence test using either promastigotes or amastigotes, as well as in 2 dogs suspected of having leishmaniasis. The performance of an antigen prepared from a homologous isolate of Leishmania infantum in the DAT was compared with that of an antigen from a laboratory-adapted strain of L. donovani (sensu lato). The homologous antigen compared favorably with the standard antigen, and the results provided further evidence of the potential of the DAT for detection of Leishmania infection in the canine reservoir host. The results of this study, together with those of our previous studies in human visceral leishmaniasis, demonstrate that the DAT is highly suitable for wide-scale epidemiological and ecological field work. This technique could also facilitate diagnosis of leishmaniasis in dogs in veterinary health services.

An improved direct agglutination test (DAT) is assessed for the detection of Leishmania infantum antibodies in man and in the canine reservoir in Southern France. The test performance in 32 human visceral leishmaniasis patients was in agreement with the parasitological diagnosis and the immunofluorescence (IFAT) results. In six patients diagnosed earlier as kala-azar cases, both DAT and IFAT revealed negative results. The specificity of the DAT was reproduced in this study by the absence of cross-reactions with sera from other patients. In the dog reservoir, the DAT results were compared with those obtained by IFAT, the enzyme-linked immunosorbent assay (ELISA), cross-over electrophoresis and the latex agglutination test. All 34 dogs with parasitologically positive lymph node aspirates also had positive DAT titres (less than or equal to 1:640); the sensitivity in the other four tests was relatively low. Positive DAT and IFAT results were found in 16 unconfirmed cases of canine leishmaniasis, most probably due to prepatent L. infantum infections.