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- The American Society of Tropical Medicine and Hygiene
- Source: The American Journal of Tropical Medicine and Hygiene, Volume 76, Issue 4, Apr 2007, p. 689 - 693
f UTILITY OF LYMPH NODE ASPIRATION IN THE DIAGNOSIS OF VISCERAL LEISHMANIASIS IN SUDAN
Abstract
We evaluated lymph node aspiration (LNA) as a simple diagnostic procedure for visceral leishmaniasis (VL). Lymph node aspiration was compared with the direct agglutination test (DAT) using a diagnostic titer ≥ 1:6,400 in 7,880 suspected VL patients in eastern Sudan. Compared with DAT, LNA had a sensitivity of 65.1% (95% confidence interval = 63.5–66.6%). Parasite density in LNA correlated strongly with DAT titers (P < 0.0001), and low parasite density accounted for 78.1% of positive LNA results with DAT titers < 1:6,400 (n = 782). Risk factors predictive of a positive LNA result were an age of 1–29 years, male sex, a hemoglobin level < 10.0 g/dL, a DAT titer ≥ 1:800, and a location with a higher prevalence of VL. Lymph node and splenic aspirations were similarly accurate as tests of cure after treatment of 50 VL patients in southern Sudan. Pre-treatment LNA results were negative in 20 cases of severe post kala-azar dermal leishmaniasis.
- 10 Oct 2006
- 04 Jan 2007