Urine as a promising sample for Leishmania DNA extraction in the diagnosis of visceral leishmaniasis – a review

Noninvasive Biological Samples to Detect and Diagnose Infections due to Trypanosomatidae Parasites: A Systematic Review and Meta-Analysis

“…Tubulointerstitial involvement and glomerulonephritis are the main causative agents of the proteinuria disorder, which is common in most patients with a clinical episode of leishmaniasis [125][126][127]. In infected individuals, urine represents a fluid from which parasite DNA is easily extracted for detection and species identification [128], which has been probed in the urine of patients [109,121,129,130] and in animal reservoirs [131,132]. These searches were performed in VL caused by L. infantum [109,120,121,133]; in CL and VL-HIV+ patients infected by L. martiniquensis [134]; in CL due to L. major or L. tropica [109]; in South American cutaneous and mucocutaneous leishmaniasis caused by L. braziliensis, L. guyanensis, or L. peruviana [130]; and in canine visceral leishmaniasis [131,132,135].…”

Urine-Based Molecular Diagnostic Tests for Leishmaniasis Infection in Human and Canine Populations: A Meta-Analysis

“…Gold standard methods for diagnosis comprise the microscopic examination of lesion samples (for CL), or spleen aspiration, bone marrow or lymphoid node biopsy (for VL) smears or cultures of the samples. Although these methods show high specificity, sensitivity varies and cannot discriminate distinct species of the parasite [2,9,10]. Other conventional diagnostic methods include immunological tools for diagnostic tests both in serum and urine samples, such as an immunefluorescent antibody test (IFAT) [11], a direct agglutination test (DAT) [12], antigen-capture ELISA [13], latex agglutination test (KATEX) [14], antibody-capture ELISA, and dip-stick test [15].…”

“…Other conventional diagnostic methods include immunological tools for diagnostic tests both in serum and urine samples, such as an immunefluorescent antibody test (IFAT) [11], a direct agglutination test (DAT) [12], antigen-capture ELISA [13], latex agglutination test (KATEX) [14], antibody-capture ELISA, and dip-stick test [15]. However, despite their high diagnostic accuracy, serological methods present some limitations in their use because the identification of antibodies in cured persons cannot distinguish between immunity and an ongoing infection in an asymptomatic individual; thus, they cannot always help in decisions for treatment [9].…”

“…With the advent of many Leishmania species genomes, PCR-based methods can help diagnosis to discriminate between Leishmania subgenera, complexes, and species, and help in the epidemiological studies of zoonotic, anthroponotic and anthropozoonotic species, and in species-specific prognosis and treatment [2]. Several biological samples have been used, including blood, bone marrow, spleen, lymph nodes, skin lesions, conjunctival swabs, and urine [9,16,17]. Despite the large variety of sample options, most of them require special procedures either for sampling or for laboratory diagnosis and can entail risk and discomfort for both patients or diseased pets and healthcare providers.…”

“…Many studies have been performed with urine samples using PCR-based methods and yielded a broad range of sensitivities. It seems that before such a method is widely used, many issues have yet to be solved, such as DNA extraction methods [9]. The present meta-analysis is an effort to quantitatively estimate the effect of several methodological aspects in PCR-based methods applied to urine samples of Leishmania-infected subjects in terms of diagnostic accuracy and validity.…”