Evaluation of the reference value for the Montenegro skin test

Skraba, Cissiara Manetti; Mello, Tatiane França Perles de; Pedroso, Raíssa Bocchi; Ferreira, Érika Cristina; Demarchi, Izabel Galhardo; Aristides, Sandra Mara Alessi; Lonardoni, Maria Valdrinez Campana; Silveira, Thaís Gomes Verzignassi

doi:10.1590/0037-8682-0067-2015

Cited by 18 publications

(13 citation statements)

References 23 publications

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“…This test has been successfully used in several epidemiological studies to assess exposition to the Leishmania parasite and leishmaniasis infection [ 22 – 27 ]. The MST sensitivity and specificity to detect parasite exposure were reported at over 97 and 93%, respectively, which improves with increased exposure time [ 28 – 30 ]. The reaction to MST was measured after 48 h by the ballpoint pen method; if induration was 5 mm or larger, the test was considered positive.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for cutaneous leishmaniasis in the rainforest of Bolivia: a cross-sectional study

et al. 2018

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BackgroundCutaneous leishmaniasis (CL) is an endemic disease in Bolivia, particularly in the rainforest of Cochabamba, in the municipality of Villa Tunari. The precarious, dispersed, and poorly accessible settlements in these farming communities make it difficult to study them, and there are no epidemiological studies in the area. The aim of the present study was to identify the risk factors associated with cutaneous leishmaniasis.MethodsA cross-sectional study was conducted in August 2015 and August 2016 in two communities of Villa Tunari, Cochabamba. The cases were diagnosed through clinical examinations, identification of the parasite by microscopic examination, and the Montenegro skin test. Risk factors were identified through logistic regression.ResultsA total of 274 participants (40.9% female and 59.1% male) were surveyed, of which 43% were CL positive. Sex was the only factor associated with CL with three times more risk for men than for women; this finding suggests a sylvatic mechanism of transmission in the area.ConclusionsIt is advisable to focus on education and prevention policies at an early age for activities related to either leisure or work. Further research is needed to assess the influence of gender-associated behavior for the risk of cutaneous leishmaniasis.

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Section: Methodsmentioning

confidence: 99%

Risk factors for cutaneous leishmaniasis in the rainforest of Bolivia: a cross-sectional study

et al. 2018

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“…Pregnant women, patients receiving immunosuppressive treatments, and patients with comorbities such as diabetes, HIV, HTLV-1 and malignancy, were excluded. VL household contacts with a positive DTH skin test (Montenegro Skin test—Centro de Produção e Pesquisa de Imunobiológicos, Piraquara PR, Brazil) superior to 5 mm induration size [ 22 ], but without symptoms or signs of classical VL, were considered asymptomatic.…”

Section: Methodsmentioning

confidence: 99%

The Severity of Visceral Leishmaniasis Correlates with Elevated Levels of Serum IL-6, IL-27 and sCD14

et al. 2016

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BackgroundVisceral leishmaniasis (VL) is a severe disease caused by infection with protozoa of the genus Leishmania. Classic VL is characterized by a systemic infection of phagocytic cells and an intense activation of the inflammatory response. It is unclear why 90% of infected individuals do not develop the disease while a minority develop the classical form. Furthermore, among those that develop disease, a small group progresses to more severe form that is unresponsive to treatment. The presence of inflammatory mediators in serum could theoretically help to control the infection. However, there is also a release of anti-inflammatory mediators that could interfere with the control of parasite multiplication. In this study, we took advantage of the spectrum of outcomes to test the hypothesis that the immune profile of individuals infected with Leishmania (L.) infantum is associated with the development and severity of disease.Methodology/Principal FindingsSera from patients with confirmed diagnosis of VL were evaluated for the presence of numerous molecules, and levels compared with healthy control and asymptomatic infected individuals.Conclusions/Principal FindingsAlthough differences were not observed in LPS levels, higher levels of sCD14 were detected in VL patients. Our data suggest that L. infantum may activate the inflammatory response via CD14, stimulating a generalized inflammatory response with production of several cytokines and soluble molecules, including IFN-γ, IL-27, IL-10, IL-6 and sCD14. These molecules were strongly associated with hepatosplenomegaly, neutropenia and thrombocytopenia. We also observed that IL-6 levels greater than 200 pg/ml were strongly associated with death. Together our data reinforce the close relationship of IFN-γ, IL-10, IL-6, TNF-α and IL-27 in the immune dynamics of VL and suggest the direct participation of sCD14 in the activation of the immune response against L. infantum.

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“…Semi-quantification of the burden of amastigotes was carried out as follows: negative, no amastigotes on the entire slide; +, 1–10 parasites/ 1000 fields; ++, 1–99 parasites/ 100 fields; +++, ≥10 parasites/ 10 fields. LST was applied by injecting intradermally 0.1 ml of Leishmanin (40μg of protein/ml) into the forearm, and the reaction recorded prior to the initiation of treatment at 48 to 72 hours post application; indurations ≥5mm were considered positive [ 15 ].…”

Section: Methodsmentioning

confidence: 99%

Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina

Krolewiecki

Almazán

Quipildor³

et al. 2017

PLoS Negl Trop Dis

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Leishmania (Viannia) braziliensis is the species most frequently implicated with cutaneous and mucosal leishmaniasis in the Americas; its diagnosis is based on the identification of amastigotes in lesions, which is limited by low parasite burden. Leishmanin Skin Test (LST) is a support tool for diagnosis, based on delayed type hypersensitivity responses to Leishmania antigens injected intradermally, used in endemic areas as a complement to diagnosis. A retrospective analysis of individuals evaluated for their first episode of tegumentary leishmaniasis at a reference center in Argentina during the period 2006-2015 was performed, with the goal of assessing its usefulness as a support tool in the diagnosis of leishmaniasis. Demographic, clinical and diagnostic work-up were analyzed in individuals with clinically compatible lesions, lesion's smear and LST. A total of 733 cases that met the case definition were included in the analysis; 678 (93%) localized cutaneous cases, 50 (7%) with mucosal involvement and 5 (<1%) disseminated. Diagnostic confirmation was reached in 474 (65%) cases through positive smears from skin or mucosal lesions, with only 6 cases among this group having negative LST. Among smear negative cases, 190 were negative also by LST, but in 69 instances LST was positive. Across age groups, similar ratios of sensitivity between smear and LST were calculated. Lesions older than 21 days-old were found to correlate with positive results both for smear and LST significantly more than younger lesions. These findings support the clinical use of LST as a diagnostic complement for American Cutaneous Leishmaniasis across all age groups even in endemic areas. In this analysis, the correlation with smear was high. Standardization of this technique and further research into its most adequate preparation and utilization protocols across different sites will help in the management of suspicious clinical cases. Funding: The author(s) received no specific funding for this work. Competing interests:The authors have declared that no competing interests exist. Author summaryAmerican Cutaneous Leishmaniasis (ACL) is a vector borne Neglected Tropical Disease with skin ulcers as the main clinical manifestation. Diagnosis is suspected when characteristic lesions occur in patients in areas known to be endemic and confirmed with microscopic identification of amastigotes in samples obtained from lesions. The Leishmanin Skin Test (LST) is an aid in the diagnosis based on the elicitation of delayed type hypersensitivity responses upon exposure to Leishmania antigens injected intradermally into the patient´s forearm and measured as the induration size after 48 hours. This analysis of 733 cases, which is the largest series of cases evaluating the role of LST in ACL highlights and establishes the usefulness of this complementary diagnostic tool with a strong correlation with lesion smear and a demonstration that false positive responses due to previous exposure to the parasite are not of concern. The results support the use...

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Evaluation of the reference value for the Montenegro skin test

Cited by 18 publications

References 23 publications

Risk factors for cutaneous leishmaniasis in the rainforest of Bolivia: a cross-sectional study

Risk factors for cutaneous leishmaniasis in the rainforest of Bolivia: a cross-sectional study

The Severity of Visceral Leishmaniasis Correlates with Elevated Levels of Serum IL-6, IL-27 and sCD14

Reappraisal of Leishmanin Skin Test (LST) in the management of American Cutaneous Leishmaniasis: A retrospective analysis from a reference center in Argentina

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