Budgetary impact of diagnostic tests for visceral leishmaniasis in Brazil

Assis, Tália Santana Machado de; Azeredo-da-Silva, André Luís Ferreira; Oliveira, Daiana de; Cota, Gláucia; Werneck, Guilherme Loureiro; Rabello, Ana

doi:10.1590/0102-311x00142416

Cited by 5 publications

(3 citation statements)

References 13 publications

(15 reference statements)

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“…DAT which uses whole parasite antigen has proved to be highly specific and sensitive in most of the endemic areas, and certain areas where HIV co-infection is prevalent for example in Spain and other parts of Europe. In fact a recent report claims the performance of DAT to be better than rK39 based RDTs when tested against archived samples in Spain 5 , moreover, it is the most cost effective test in Brazil 9 . Recently a multicentre validation of DAT showed sensitivity ranging from 96·2–99·5% and specificity between 96·2–97·5% 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently immunofluorescent antibody test or IFAT 6 , direct agglutination test or DAT 7,8 and ELISA (enzyme-linked immunosorbent assay) were developed to detect VL. Even though DAT and IFAT perform well in almost all endemic areas 9 they show variations in the antigen preparations and high level of cross reactivity. They are also time consuming, entail expertise and need high-end instruments which restrict them to laboratories.…”

Section: Introductionmentioning

confidence: 99%

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A multicentric evaluation of dipstick test for serodiagnosis of visceral leishmaniasis in India, Nepal, Sri Lanka, Brazil, Ethiopia and Spain

Ejazi

Ghosh

Saha

et al. 2019

Sci Rep

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Visceral leishmaniasis (VL) is one of the leading infectious diseases affecting developing countries. Colloidal gold-based diagnostic tests are rapid tools to detect blood/serum antibodies for VL diagnosis. Lack of uniformity in the performance of these tests in different endemic regions is a hurdle in early disease diagnosis. This study is designed to validate a serum-based dipstick test in eight centres of six countries, India, Nepal, Sri Lanka, Brazil, Ethiopia and Spain with archived and fresh sera from 1003 subjects. The dipstick detects antibodies against Leishmania donovani membrane antigens (LAg). The overall sensitivity and specificity of the test with 95% confidence intervals were found to be 97.10% and 93.44%, respectively. The test showed good sensitivity and specificity in the Indian subcontinent (>95%). In Brazil, Ethiopia, and Spain the sensitivity and specificity of the dipstick test (83.78–100% and 79.06–100%) were better as compared to the earlier reports of the performance of rK39 rapid test in these regions. Interestingly, less cross-reactivity was found with the cutaneous form of the disease in Spain, Brazil, and Sri Lanka demonstrating 91.58% specificity. This dipstick test can therefore be a useful tool for diagnosing VL from other symptomatically similar diseases and against cutaneous form of leishmaniasis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A multicentric evaluation of dipstick test for serodiagnosis of visceral leishmaniasis in India, Nepal, Sri Lanka, Brazil, Ethiopia and Spain

Ejazi

Ghosh

Saha

et al. 2019

Sci Rep

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“…Incidentally, since 2015, the Brazilian Ministry of Health has incorporated rapid test kits for the diagnosis of VL into the SUS , which allowed immediate and accurate results to be obtained using whole blood samples 30 . Nonetheless, it is essential to ensure the continuous supply of these test kits at primary health care centres.…”

Section: Discussionmentioning

confidence: 99%

Where, when, and how the diagnosis of human visceral leishmaniasis is defined: answers from the Brazilian control program

Luz

Carvalho

Naves

et al. 2019

Mem. Inst. Oswaldo Cruz

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BACKGROUND Timely diagnosis is recommended by the Brazilian Visceral Leishmaniasis (VL) Surveillance and Control Program to reduce case fatality. Attempts at assessing this topic in Brazil are scarce. OBJECTIVE This study aimed to describe where, when, and how the diagnosis of VL has been performed in a Brazilian endemic setting. METHODS Data of all autochthonous cases confirmed between 2011 and 2016 (N = 81) were recorded. The care-seeking itinerary until the confirmation of VL diagnosis was assessed among 57 patients. FINDINGS The majority of VL cases (79.1%) were reported by referral hospitals. The patients mainly sought primary health care centres at the onset of symptoms. However, they had to visit seven health services on average to achieve a confirmed diagnosis. The time from the onset of symptoms to the diagnosis of VL (T D) ranged from 1-212 (median, 25) days. The T D was longer among adult patients. There was a direct correlation between the patient's age and T D (r = 0.22; p = 0.047) and a higher occurrence of deaths due to the disease among older patients (p = 0.002). Almost all the patients (98.9%) underwent laboratory investigation, and the VL diagnosis was mainly confirmed based on clinical-laboratory criteria (92.6%). Positive results for the indirect fluorescence antibody test (22.7%) and parasitological examination plus rk39-based immunochromatographic tests (21.3%) were commonly employed. MAIN CONCLUSIONS VL diagnosis was predominantly conducted in hospitals with a long T D and wide application of serology. These findings may support measures focused on early diagnosis, including a greater involvement of the primary health care system. Key words: visceral leishmaniasis-kala-azar-diagnosis-public health-primary health care-Brazil Visceral leishmaniasis (VL), or kala-azar, is a neglected tropical disease caused by protozoa of the genus Leishmania that are transmitted to humans and other mammals via the bite of female phlebotomine sand flies. (1) In humans, the disease is clinically characterised by prolonged fever, weight loss, weakness, hepatosplenomegaly, hypergammaglobulinemia, and pancytopenia. If not treated appropriately, VL can progress to profound cachexia, systemic inflammation, bacterial infection, bleeding, and death. (2) Brazil is one of six countries that share 90% of the VL burden worldwide, in addition to being the main endemic area for the disease in the Americas. (1) Since the 1980s, VL has alarmingly been spreading to Brazilian urban centres as a zoonotic disease caused by Leishmania infantum, transmitted by the phlebotomines Lutzomyia longipalpis and Lutzomyia cruzi, with dogs being the main reservoir host. (3,4) Presently, autochthonous VL

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Proteomics and Leishmaniasis: Potential Clinical Applications

Capelli-Peixoto

Mule

Tano

et al. 2019

Proteomics Clinical Apps

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Leishmaniases are diseases caused by protozoan parasites of the genus Leishmania. They are endemic in 98 countries, affect around 12 million people worldwide and may present several distinct clinical forms. Unfortunately, there are only a few drugs available for treatment of leishmaniasis, which are toxic and not always effective. Different parasite species and different clinical forms require optimization of the treatment or more specific therapies, which are not available. The emergence of resistance is also a matter of concern. Besides, diagnosis can sometimes be complicated due to atypical manifestations and associations with other pathologies. In this review, proteomic data are presented and discussed in terms of their application in important issues in leishmaniasis such as parasite resistance to chemotherapy, diagnosis of active disease in patients and dogs, markers for different clinical forms, identification of virulence factors, and their potential use in vaccination. It is shown that proteomics has contributed to the discovery of potential biomarkers for prognosis, diagnosis, therapeutics, monitoring of disease progression, treatment follow‐up and identification of vaccine candidates for specific diseases. However, the authors believe its capabilities have not yet been fully explored for routine clinical analysis for several reasons, which will be presented in this review.

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Budgetary impact of diagnostic tests for visceral leishmaniasis in Brazil

Abstract: The aim of the present study was to estimate the financial costs of the incorporation and/or replacement of diagnostic tests for human visceral leishmaniasis (VL)

Cited by 5 publications

References 13 publications

A multicentric evaluation of dipstick test for serodiagnosis of visceral leishmaniasis in India, Nepal, Sri Lanka, Brazil, Ethiopia and Spain

A multicentric evaluation of dipstick test for serodiagnosis of visceral leishmaniasis in India, Nepal, Sri Lanka, Brazil, Ethiopia and Spain

Where, when, and how the diagnosis of human visceral leishmaniasis is defined: answers from the Brazilian control program

Proteomics and Leishmaniasis: Potential Clinical Applications

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