Volume 76, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


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 ( < 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.


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  • Received : 10 Oct 2006
  • Accepted : 04 Jan 2007

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