Sensitivity of an immunoenzymatic test for detection of ant-L. brasiliensis antibodies compared to other tests used for the diagnosis of American cutaneous leishmaniasis

Abstract

SUMMARYThe diagnosis of American cutaneous leishmaniasis (ACL) is frequently based on clinical and epidemiological data associated with the results of laboratory tests. Some laboratory methods are currently being applied for the diagnosis of ACL, among them the indirect immunofluorescence reaction (IIFR), the Montenegro skin test (MST), histopathological examination, and the polymerase chain reaction (PCR). The performance of these methods varies in a considerable proportion of patients. After the standardization of an immunoenzymatic test (ELISA) for the detection of IgG in the serum of patients with ACL using a crude Leishmania braziliensis antigen, the results obtained were compared to those of other tests routinely used for the diagnosis. The tests revealed the following sensitivity, when analyzed separately: 85% for ELISA IgG, 81% for PCR, 64.4% for MST, 58.1% for IIFR, and 34% for the presence of parasites in the biopsy. ELISA was positive in 75% of patients with ACL presenting a negative MST, in 84.8% of ACL patients with negative skin or mucous biopsies for the presence of the parasite, and in 100% of cases with a negative PCR. Thus, ELISA presented a higher sensitivity than the other tests and was useful as a complementary method for the diagnosis of ACL.

Serological and Molecular Investigation of Cutaneous Leishmaniasis in Healthy Individuals from an American Cutaneous Leishmaniasis-Endemic Region

“…However, parasite DNA was not detected in the blood of individuals analyzed in this study. An analysis of patients with a clinical history of ACL conducted by Ferreira et al (2006) did not reveal the presence of parasite DNA; however, the results of the ELISA conducted by Ferreira et al (2006) were in agreement with those obtained in this study. Conversely, Camera et al (2006) successfully detected parasite DNA in samples obtained from individuals (with no prior history of ACL) living in endemic regions.…”

“…The results of IIF were not in agreement with those obtained by ELISA, which may be a consequence of the higher sensitivity of the latter (Szargiki et al, 2009). Some studies have shown that IIF-negative samples could test positive for ACL in ELISA (Ferreira et al, 2006), including the subclinical cases (Arraes et al, 2008). Thus, the use of different antigens in sensitive techniques, such as ELISA, can provide more specific diagnosis.…”

“…Several authors have described the detection of Leishmania (Viannia) DNA in peripheral blood as an appropriate tool for the diagnosis of ACL (Ferreira et al, 2006;Venazzi et al, 2007;Martins et al, 2010). However, parasite DNA was not detected in the blood of individuals analyzed in this study.…”

Mapping B-Cell Epitopes for the Peroxidoxin of Leishmania (Viannia) braziliensis and Its Potential for the Clinical Diagnosis of Tegumentary and Visceral Leishmaniasis

“…In endemic areas, the MST is a decisive method for diagnosing older cutaneous lesions and mucosal lesions, when the number of parasites is low and therefore, difficult to detect [40]. For L. braziliensis infection , a low sensitivity value has been previously described by MST when compared with serological methods [41]. The high positive predictive value observed in r Peroxidoxin ELISA may represents an alternative complementary assay for TL diagnosis, as well as in the development of a new rapid immunochromatographic test [42].…”

Estudo da transmissão da leishmaniose tegumentar americana no Distrito Federal

“…O diagnóstico de leishmaniose foi feito pela história, exame dermatológico e pela positividade de, pelo menos, dois exames diagnósticos específicos 3 .…”