Kala-azar: a comparative study of parasitological methods and the direct agglutination test in diagnosis

Zijlstra, E.E.; Ali, Mohamed S.; Elhassan, Ahmed M.; Eltoum, Isam A.; Satti, Mohamed; Ghalib, H. W.; Kager, Piet A.

doi:10.1016/0035-9203(92)90086-r

Cited by 168 publications

(152 citation statements)

References 7 publications

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“…One of them was diagnosed with a liver abscess and the other a pulmonary abscess. DAT, despite being one of the cheapest, simplest and most sensitive for diagnosing VL 14 , does not differentiate between past and recent infections 35 . The DAT test was not a diagnost criterion for co-infection study.…”

Section: Discussionmentioning

confidence: 99%

Diagnosing visceral leishmaniasis and HIV/AIDS co-infection: a case series study in Pernambuco, Brazil

Cavalcanti

Medeiros

Lopes

et al. 2012

Rev. Inst. Med. trop. S. Paulo

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HIV/AIDS-associated visceral leishmaniasis may display the characteristics of an aggressive disease or without specific symptoms at all, thus making diagnosis difficult. The present study describes the results of diagnostic tests applied to a series of suspected VL cases in HIV-infected/AIDS patients admitted in referral hospitals in Pernambuco, Brazil. From a total of 14 eligible patients with cytopenias and/or fever of an unknown etiology, and indication of bone marrow aspirate, 10 patients were selected for inclusion in the study. Diagnosis was confirmed by the following examinations: Leishmania detection in bone marrow aspirate, direct agglutination test, indirect immunofluorescence, rK39 dipstick test, polymerase chain reaction and latex agglutination test. Five out of the ten patients were diagnosed with co-infection. A positive direct agglutination test was recorded for all five co-infected patients, the Leishmania detection and latex agglutination tests were positive in four patients, the rK39 dipstick test in three, the indirect immunofluorescence in two and a positive polymerase chain reaction was recorded for one patient. This series of cases was the first to be conducted in Brazil using this set of tests in order to detect co-infection. However, no consensus has thus far been reached regarding the most appropriate examination for the screening and monitoring of this group of patients.

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Section: Discussionmentioning

confidence: 99%

Diagnosing visceral leishmaniasis and HIV/AIDS co-infection: a case series study in Pernambuco, Brazil

Cavalcanti

Medeiros

Lopes

et al. 2012

Rev. Inst. Med. trop. S. Paulo

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“…22 Zijlstra and others found a sensitivity of 93.1%, 67.8%, and 56.3% for splenic, bone marrow, and lymph node aspiration, respectively, in a study of 91 hospital patients. 23 In an extensive community survey in Bangladesh, only 29 (23%) of 125 clinically suspected persons were parasitologically proven, and all responded favorably to treatment. 24 Although response to treatment is probably the best methodologic option in establishing a gold standard for VL, few related studies have been reported.…”

Section: Discussionmentioning

confidence: 99%

Operational validation of the direct agglutination test for diagnosis of visceral leishmaniasis.

Boelaert¹,

Safi²,

Jacquet

et al. 1999

The American Journal of Tropical Medicine and Hygiene

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Abstract. The validity of the direct agglutination test (DAT) for visceral leishmaniasis (VL) was studied with a standardized field kit on 148 clinically suspected persons and 176 healthy controls recruited between 1993 and 1994 from an endemic area in Gedaref State, Sudan. A sensitivity of 95.9% and a specificity of 99.4% were found at a 1: 8,000 cut-off titer when parasitologically confirmed cases were compared with healthy controls. While corroborating previously reported sensitivity and specificity estimates of this serodiagnostic test, this study examined the bias generated by commonly used test validation procedures. The fundamental methodologic problem in VL test validation is the absence of a reliable gold standard. Moreover, any operational guideline on DAT use has to consider the critical dependency of the predictive values of the test on VL prevalence rates. The DAT diagnostic cut-off titer depends upon many external factors, among which the prevalence of disease in the area and the case mix seem the most important.

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“…These tests still remain the gold standard (GS) because of high specificity. 7,8 The aspiration materials result in a suboptimal sensitivity ranging from 93.1-98.7% for spleen aspirates to 52-85% for bone marrow and 52-58% for lymph node aspirates. However, these methods are invasive, risky, and painful; they require skilled personnel, and they are not readily available in disease-endemic regions.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of rK-39 Strip Test Using Urine for Diagnosis of Visceral Leishmaniasis in an Endemic Region of India

Singh

Pandey

Das

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. The definitive diagnosis of visceral leishmaniasis (VL) requires invasive procedures for demonstration of parasites in tissue smear or culture. These procedures need expertise and laboratory supports and cannot be performed in the field. The aim of the present study was to evaluate the existing rK-39 immunochromatographic nitrocellulose strips test (ICT) with some modification in human urine for diagnosis of VL. The test was performed on both sera and urine samples on the same 786 subjects (365 confirmed VL and 421 control subjects). The sensitivity of the rK-39 ICT in serum was 100%, whereas the specificity was 93.8%, 100%, and 96.2% in healthy controls from endemic, non-endemic, and other infectious diseases, respectively. However, in urine samples, the test showed 96.1% sensitivity and 100% specificity. Considering sensitivity and feasibility of the test in the field, rK-39 ICT using urine samples can be an alternative to conventional invasive VL diagnosis.

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Kala-azar: a comparative study of parasitological methods and the direct agglutination test in diagnosis

Cited by 168 publications

References 7 publications

Diagnosing visceral leishmaniasis and HIV/AIDS co-infection: a case series study in Pernambuco, Brazil

Diagnosing visceral leishmaniasis and HIV/AIDS co-infection: a case series study in Pernambuco, Brazil

Operational validation of the direct agglutination test for diagnosis of visceral leishmaniasis.

Evaluation of rK-39 Strip Test Using Urine for Diagnosis of Visceral Leishmaniasis in an Endemic Region of India

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