| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
We compared the validity of pancytopenia, the formol-gel test (FGT), the indirect fluorescence antibody test (IFAT), the direct agglutination test (DAT), and the rK39 dipstick test as diagnostic criteria for visceral leishmaniasis (VL) in Nepal. Between September 2000 and January 2002, 310 clinical suspects had a bone marrow aspirate, and if negative, a spleen aspirate smear examined for Leishmania donovani. Sensitivity and specificity of all tests were determined compared with parasitology and by latent class analysis (LCA). Compared with parasitology, the sensitivities of the other tests were as follows: pancytopenia = 16.3% (95% confidence interval [CI] = 11.3–22.5%), FGT = 39.9% (95% CI = 32.7–47.4%), IFAT = 28.4% (95% CI = 22.0–35.5%), DAT = 95.1% (95% CI = 90.8–97.7%), and the rK39 dipstick test = 87.4% (95% CI = 81.7–91.9%). Sensitivity estimates obtained by LCA were similar, but specificity estimates were substantially higher (DAT = 93.7% versus 77.8%; rK39 dipstick test = 93.1% versus 77.0%). The DAT or the rK39 dipstick test can replace parasitology as the basis of a decision to treat VL in Nepalese peripheral health services.
Received August 6, 2003. Accepted for publication September 12, 2003.
Acknowledgments: We thank the nursing and laboratory staff of BPKIHS for taking care of patients and laboratory work.
Financial support: This study was supported by the Flemish Fund for Scientific Research (FWO).
Authors’ addresses: Marleen Boelaert, Unit of Epidemiology, Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium, Telephone: 32-3-2476283, Fax: 32-3-2476258, E-mail: boelaert{at}itg.be. Suman Rijal and Sudhir Regmi, Department of Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal, Telephone : 977-25-25668 ,Fax: 977-25-20251 , E - mails : sumanrijal2{at}yahoo.com and sudhirregmi{at}yahoo.com. Rupa Singh, Department of Pediatrics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal, Telephone: 977-25-25555, Fax: 977-25-20251, E-mail: rupasingh{at}hotmail.com. Balmansingh Karki, Department of Microbiology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal, Telephone: 977-25-25555, Fax: 977-25-20251 , E-mail : bmskarki{at}hotmail.com. Diane Jacquet, Protozoology Unit, Department of Parasitology, Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium, Telephone: 32-3-2476351, Fax: 32-3-2476359, E-mail: djacquet{at}proto.itg.be. François Chappuis, Travel and Migration Medicine Unit, Department of Community Medicine, Geneva University Hospital, 1211 Geneva 14, Switzerland, Telephone: 41-22-3729620, Fax: 41-22-3729626, E-mail: francois.chappuis{at}hcuge.ch. Lenea Campino, Unidade de Leishmanioses, Instituto de Higiene e Medicina Tropical, Lisbon, Portugal, Telephone: 351-1-3652600, Fax: 351-1-3632105, E-mail: campino{at}ihmt.unl.pt. Philippe Desjeux, Communicable Disease Surveillance and Response, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland, Telephone: 41-22-7913870, Fax: 41-22-7910746, E-mail: desjeuxp{at}who.int. Dominique Le Ray, Protozoology Unit, Department of Parasitology, Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium, Telephone: 32-3-2476352, Fax: 32-3-2476359, E-mail: dleray{at}proto.itg.be. Shekhar Koirala, B.P. Koirala Institute of Health Sciences, Dharan, Nepal, Telephone: 977-25-20802, Fax: 977-25-20251, E-mail:shekharkoirala{at}hotmail.com. Patrick Van der Stuyft, Unit of Epidemiology, Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium, Telephone: 32-3-2476255, Fax: 32-3-2476258, E-mail: pvds{at}itg.be.
Reprint requests: Marleen Boelaert, Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, 2000 Antwerp, Belgium.
This article has been cited by other articles:
|
|
 |
|
  J. Mandal, S. Khurana, M. L. Dubey, P. Bhatia, N. Varma, and N. Malla Evaluation of Direct Agglutination Test, rk39 Test, and ELISA for the Diagnosis of Visceral Leishmaniasis Am J Trop Med Hyg, July 1, 2008; 79(1): 76 - 78. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Porrozzi, M. V. Santos da Costa, A. Teva, A. Falqueto, A. L. Ferreira, C. D. dos Santos, A. P. Fernandes, R. T. Gazzinelli, A. Campos-Neto, and G. Grimaldi Jr. Comparative Evaluation of Enzyme-Linked Immunosorbent Assays Based on Crude and Recombinant Leishmanial Antigens for Serodiagnosis of Symptomatic and Asymptomatic Leishmania infantum Visceral Infections in Dogs Clin. Vaccine Immunol., May 1, 2007; 14(5): 544 - 548. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. T. M. Roberts Current understandings on the immunology of leishmaniasis and recent developments in prevention and treatment Br. Med. Bull., July 17, 2006; 75-76(1): 115 - 130. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L. Croft, S. Sundar, and A. H. Fairlamb Drug Resistance in Leishmaniasis Clin. Microbiol. Rev., January 1, 2006; 19(1): 111 - 126. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Sundar, R. Maurya, R. K. Singh, K. Bharti, J. Chakravarty, A. Parekh, M. Rai, K. Kumar, and H. W. Murray Rapid, Noninvasive Diagnosis of Visceral Leishmaniasis in India: Comparison of Two Immunochromatographic Strip Tests for Detection of Anti-K39 Antibody J. Clin. Microbiol., January 1, 2006; 44(1): 251 - 253. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. RITMEIJER, Y. MELAKU, M. MUELLER, S. KIPNGETICH, C. O'KEEFFE, and R. N. DAVIDSON EVALUATION OF A NEW RECOMBINANT K39 RAPID DIAGNOSTIC TEST FOR SUDANESE VISCERAL LEISHMANIASIS Am J Trop Med Hyg, January 1, 2006; 74(1): 76 - 80. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Chappuis, Y. Mueller, A. Nguimfack, J. B. Rwakimari, S. Couffignal, M. Boelaert, P. Cavailler, L. Loutan, and P. Piola Diagnostic Accuracy of Two rK39 Antigen-Based Dipsticks and the Formol Gel Test for Rapid Diagnosis of Visceral Leishmaniasis in Northeastern Uganda J. Clin. Microbiol., December 1, 2005; 43(12): 5973 - 5977. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. M. Kurkjian, L. E. Vaz, R. Haque, C. Cetre-Sossah, S. Akhter, S. Roy, F. Steurer, J. Amann, M. Ali, R. Chowdhury, et al. Application of an Improved Method for the Recombinant K39 Enzyme-Linked Immunosorbent Assay To Detect Visceral Leishmaniasis Disease and Infection in Bangladesh Clin. Vaccine Immunol., December 1, 2005; 12(12): 1410 - 1415. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. N. SARIDOMICHELAKIS, M. E. MYLONAKIS, L. S. LEONTIDES, A. F. KOUTINAS, C. BILLINIS, and V. I. KONTOS EVALUATION OF LYMPH NODE AND BONE MARROW CYTOLOGY IN THE DIAGNOSIS OF CANINE LEISHMANIASIS (LEISHMANIA INFANTUM) IN SYMPTOMATIC AND ASYMPTOMATIC DOGS Am J Trop Med Hyg, July 1, 2005; 73(1): 82 - 86. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
