Volume 75, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


The results of five serologic tests (ELISA using promastigote antigen [ELISAp] and recombinant K39 [ELISArK39] and K26 [ELISArK26] antigens, indirect immunofluorescence test using promastigote antigen [IIFT], and immunochromatographic tests using the rK39 antigen [TRALd]) and of the Montenegro skin test (MST) were analyzed in 41 individuals treated for kala-azar and living in Porteirinha, Minas Gerais, Brazil. The tests were carried out 1 week to 12 years after specific treatment. All MSTs during the 8 months after treatment were negative, whereas after 1 year, 28 (84.8%) were positive. Negativity in all serologic tests was observed for 11 (26.8%) of the 41 individuals, whereas positivity in at least one test was observed for 70.3% of subjects evaluated ≥ 2 years after treatment. With respect to each exam, positivity was 38.0% for TRALd, 61.9% for ELISA rK39, 47.6% for ELISA rK26, 38.0% for ELISAp, and 40.5% for IIFT. None of the individuals presented recurrence of the disease during the 4 years of follow-up. The tests were repeated in 24 of the 41 individuals, after some time, and the results were the same in 33.3% of the cases. We conclude that serological tests for kala-azar might continue to be positive after treatment of the disease, although this does not indicate a poor prognosis or a poor therapeutic response.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Bern C, Jha SN, Joshi AB, Thakur GD, Bista MB, 2000. Use of the recombinant K39 dipstick test and the direct agglutination test in a setting endemic for visceral leishmaniasis in Nepal. Am J Trop Med Hyg 63 : 153–157. [Google Scholar]
  2. Kaul P, Malla N, Kaur S, Mahajan RC, Ganguly NK, 2000. Evaluation of a 200-kDa amastigote-specific antigen of L. donovani by enzyme-linked immunosorbent (ELISA) for the diagnosis of visceral leishmaniasis. Trans R Soc Trop Med Hyg 94 : 173–175. [Google Scholar]
  3. Singh S, Gilman-Sachs A, Chang KP, Reed SG, 1995. Diagnostic and prognostic value of K39 recombinant antigen in indian leishmaniasis. J Parasitol 81 : 1000–1003. [Google Scholar]
  4. Singh S, Kumari V, Singh N, 2002. Predicting kala-azar disease manifestation in asymptomatic patients with latent Leishmania donovani infection by detection of antibody against recombinant k39 antigen. Clin Diagn Lab Immunol 9 : 568–572. [Google Scholar]
  5. Singh S, Sivakumar R, 2003. Recent advances in the diagnosis of leishmaniasis. J Postgrad Med 49 : 55–66. [Google Scholar]
  6. Sundar S, Rai M, 2002. Laboratory diagnosis of visceral leishmaniasis. Clin Diagn Lab Immunol 9 : 951–958. [Google Scholar]
  7. Hailu A, 1990. Pre- and post-treatment antibody levels in visceral leishmaniasis. Trans R Soc Trop Med Hyg 84 : 673–675. [Google Scholar]
  8. Oskam L, Niewenhuijs JL, Hailu A, 1999. Evaluation of the direct agglutination test (DAT) using freeze-dried antigen for the detection of anti-Leishmania antibodies in stored sera from various groups in Ethiopia. Trans R Soc Trop Med Hyg 93 : 275–277. [Google Scholar]
  9. Badaró R, Carvalho EM, Orge MGO, Teixiera RS, Rocha H, 1985. Imunidade humoral e celular em indivíduos curados de leishmaniose visceral. Rev Soc Bras Med Trop 18 : 77–83. [Google Scholar]
  10. Zerpa O, Ulrich M, Banitez M, Avila C, Rodríguez V, Centeno M, Belizario D, Reed SG, Convit J, 2002. Epidemiological and immunological aspects of human visceral leishmaniasis on Margarita Island, Venezuela. Mem Inst Oswaldo Cruz 97 : 1079–1083. [Google Scholar]
  11. Zijlstra EE, Daifalla NS, Kager PA, Khalil EAG, El-Hassan AM, Reed SG, Ghalib HW, 1998. rK39 enzyme-linked immunosorbent assay for diagnosis of Leishmania donovani infection. Clin Diagn Lab Immunol 5 : 717–720. [Google Scholar]
  12. Pampiglione S, Manson-Bahr PEC, Placa M, Borgatti MA, Musumeci S, 1975. Studies on Mediterranean leishmaniasis. 3. The leishmanin skin test in kala-azar. Trans R Soc Trop Med Hyg 69 : 447–453. [Google Scholar]
  13. Prata A, 1957. Quadro Clínico e Laboratorial do Calazar. Arquivos Brasileiros de Medicina Naval. 65 : 11–26. [Google Scholar]
  14. Levy L, Mendes E, 1981. Impaired cell-mediated immunity in patients with Kala-azar. Allergol Immunopathol (Madr) 9 : 109–112. [Google Scholar]
  15. Manson-Bahr PEC, Southgate BA, 1964. Recent research on Kala Azar in East Africa. J Trop Med Hyg 67 : 79–84. [Google Scholar]
  16. Southgate BA, Oriedo VEB, 1967. Studies in the epidemiology of East African Leishmaniasis. 3. Immunity as a determinant of geographical distribution. J Trop Med Hyg 70 : 1–4. [Google Scholar]
  17. Southgate BA, Manson-Bahr PEC, 1967. Studies in the epidemiology of East African Leishmaniasis. 4. The significance of the positive leishmanin test. J Trop Med Hyg 70 : 29–33. [Google Scholar]
  18. Shido SA, Akuffo HO, Mohamed AA, Huldt G, Nilsson LA, Ouchterlony O, Thorstensson R, 1995. Visceral leishmaniasis in Somalia: Prevalence of leishmanin-positive and seropositive inhabitants in an endemic area. Trans R Soc Trop Med Hyg 89 : 21–24. [Google Scholar]
  19. Badaro R, Jones TC, Carvalho EM, Sampaio D, Reed SG, Barral A, Teixeira R, Johnson WD, 1986. A prospective study of visceral leishmaniasis in an endemic area of Brazil. J Infect Dis 154 : 639–649. [Google Scholar]
  20. D’Oliveira A, Costa SRM, Barbosa AB, Orge MGO, Carvalho EM, 1997. Asymptomatic Leishmania chagasi infection in relatives and neighbors of patients with visceral leishmaniasis. Mem Inst Oswaldo Cruz 92 : 15–20. [Google Scholar]
  21. Marzochi KBF, Marzochi MCA, Schubach AO, 1999. Leishmaniose visceral: interação hospedeiro-parasito e determinismo das formas clínicas. Rev Soc Bras Med Trop 32 (Suppl 2): 59. [Google Scholar]
  22. Melo MN, Mayrink W, Costa CA, Magalhães PA, Dias M, Williams P, Araújo FG, Coelho MV, Batista SM, 1977. Padronização do antígeno de Montenegro. Rev Inst Med Trop Sao Paulo 19 : 161–164. [Google Scholar]
  23. Sokal JE, 1975. Editorial: Measurement of delayed skin-test response. N Engl J Med 293 : 501–502. [Google Scholar]
  24. Badaró R, Reed SG, Barral A, Orge MGO, Jones TC, 1986. Evaluation of micro enzyme-linked immunosorbent assay (ELISA) for antibodies in American visceral leishmaniasis: Antigen selection for detection of infection-specific response. Am J Trop Med Hyg 35 : 72–78. [Google Scholar]
  25. Hommel M, Peters W, Ranque J, Quilici M, Lanotte G, 1978. The micro-ELISA technique in the serodiagnosis of visceral leishmaniasis. Ann Trop Med Parasitol 72 : 213–218. [Google Scholar]
  26. Voller A, Bidwell DE, Bartlett A, 1976. Enzyme immunoassay in diagnostic medicine. Theory and practice. Bull World Health Organ 53 : 55–65. [Google Scholar]
  27. Camargo ME, 1966. Fluorescent antibody test for the serodiagnosis of American trypanosomiasis. Technical modification employing preserved culture forms of Trypanosoma cruzi in a slide test. Rev Inst Med Trop Sao Paulo 8 : 227–234. [Google Scholar]
  28. Hailu A, Menon JN, Berhe N, Gedamu L, Hassard TH, Kager PA, Olobo J, Bretscher PA, 2001. Distinct immunity in patients with visceral leishmaniasis from that in subclinically infected and drug-cured people: Implications for the mechanism underlying drug cure. J Infect Dis 184 : 112–115. [Google Scholar]
  29. Prata A, 1957. Cura parasitológica do calazar. Hospital (Rio J) 51 : 571–577. [Google Scholar]
  30. Alvar J, Canavate C, Gutiérrez-Solar B, Jiménez M, Laguna F, López-Vélez R, Molina R, Moreno J, 1997. Leishmania and human immunodeficiency virus coinfection: The first 10 years. Clin Microbiol Rev 10 : 298–391. [Google Scholar]

Data & Media loading...

  • Received : 15 Nov 2005
  • Accepted : 12 Jun 2006

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error