Serodiagnosis and epidemiology of visceral leishmaniasis in Turkey.

Abstract

Infantile Mediterranean visceral leishmaniasis (IVL) and anthroponotic cutaneous leishmaniasis (ACL) have long been known to exist in the western and southeastern Turkey, respectively. To further study these and other related diseases, a recombinant antigen (rK39) specific to VL was used in an ELISA for serodiagnosis of selected patients and for screening dog reservoir populations in several endemic sites. Among 24 confirmed VL cases from western Turkey, the rK39 ELISA proved to be more sensitive than a combination of cultivation and microscopy of bone marrow aspirates. The specificity of rK39 for leishmaniasis was demonstrated by its lack of cross-reactivity with sera from other human diseases in the same sites. Interestingly, six of the 83 parasitologically proven ACL cases from southeast Turkey were also rK39 positive. The end point titers of the positive VL and CL cases vary from 10 Ϫ2 to 10 Ϫ5 and from 10 Ϫ2 to 10 Ϫ3 , respectively. The rK39 ELISA was also used to screen 494 apparently healthy dogs from Urfa in southeast Turkey, Manisa/Alasehir near the Aegean Sea, and Karabuk near the Black Sea. Eighteen rK39-positive cases (3.6%), all from the latter two areas, were found to have varying endpoint titers (10 Ϫ2-10 Ϫ4). The high titers predicted increased severity and frequency of the clinical symptoms (i.e., lymphadenopathy, depilation, skin lesion, weight loss and/or death), which were manifested subsequently in 16 of these 18 cases. In addition, more positive canine cases were diagnosed by the rK39 ELISA preclinically than the procedures to detect parasites postsymptomatically in the lymph node aspirates. The use of the rK39 ELISA as a sensitive tool makes it possible to demonstrate coendemicity of canine and human VL, as expected in the case of IVL. The results also point to the possible presence of additional VL types in western Turkey and cutanovisceral type in the southeast part of this country.

Evaluation of antigens from various Leishmania species in a Western blot for diagnosis of American tegumentary leishmaniasis.

“…This method has used soluble extracts, 15,18,20,21,44 purified membrane proteins, 45 or recombinant proteins as antigens. [46][47][48] The immunoblot results obtained with soluble protein extracts of Leishmania species and strain 268T showed a complex reactivity pattern (Figures 1-4), in which most (93%) of the polypeptide fractions of parasites were recognized by at least one serum sample from the individuals tests. Similarly complex profiles were found 15,49 when the human antibody specificity to antigens of L. (V.) braziliensis and L. infantum was analyzed by Western blotting.…”

Leishmania sp. in Visceral Leishmaniasis suspected patients in Kayseri

“…There are an estimated 12 million cases of leishmaniasis worldwide, 2 million new cases occur each year, and 350 million people are at risk (6). VL is still significant public health problems in Turkey, but a decline is observed in the number of cases with both infections in recent years (10). In endemic areas, the disease tends to be relatively chronic, and children are especially affected.…”

Herramientas no invasivas en Venezuela: comparación entre las pruebas inmunoserológicas DAT, rK26 y rK39 en el diagnóstico de leishmaniasis visceral

“…Dichos parámetros se calcularon aplicando las correcciones para la evaluación de pruebas diagnósticas con patrones de referencia imperfectos (16). Como patrón de referencia, en el estudio se usó la prueba ELISA rK39, cuya especificidad y sensibilidad han sido reportadas alrededor de 97% (17)(18)(19)(20)(21)(22)(23). Se determinaron los parámetros de sensibilidad, especificidad, valor diagnóstico positivo y negativo y razón de verosimilitud.…”