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

Copyright 2007 The American Society of Tropical Medicine
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2007-04-01
2018-11-16

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References

  1. Chulay JD, Bryceson AD, 1983. Quantitation of amastigotes of Leishmania donovani in smears of splenic aspirates from patients with visceral leishmaniasis. Am J Trop Med Hyg 32 : 475–479.
  2. Kirk R, Sati MH, 1940. Studies in leishmaniasis in the Anglo-Egyptian Sudan II. The skin and lymph glands in kala-azar. Trans R Soc Trop Med Hyg 33 : 501–506.
  3. Zijlstra EE, El-Hassan AM, 2001. Leishmaniasis in Sudan: visceral leishmaniasis. Trans R Soc Trop Med Hyg 95 (Suppl 1): S27–S58.
  4. Siddig M, Ghalib H, Shillington DC, Petersen EA, Khidir S, 1990. Visceral leishmaniasis in Sudan: clinical features. Trop Geogr Med 42 : 107–112.
  5. Zijlstra EE, Ali MS, El-Hassan AM, El-Toum IA, Satti M, Ghalib HW, Sondorp E, Winkler A, 1991. Kala-azar in displaced people from southern Sudan: epidemiological, clinical and therapeutic findings. Trans R Soc Trop Med Hyg 85 : 365–369.
  6. Collin S, Davidson R, Ritmeijer K, Keus K, Melaku Y, Kipngetich S, Davies C, 2004. Conflict and kala-azar: determinants of adverse outcomes of kala-azar among patients in southern Sudan. Clin Infect Dis 38 : 612–619.
  7. Boelaert M, Criel B, Leeuwenburg J, van Damme W, Le Ray D, van der Stuyft P, 2000. Visceral leishmaniasis control: a public health perspective. Trans R Soc Trop Med Hyg 94 : 465–471.
  8. Veeken H, Ritmeijer K, Seaman J, Davidson R, 2003. Comparison of an rK39 dipstick rapid test with direct agglutination test and splenic aspiration for the diagnosis of kala-azar in Sudan. Trop Med Int Health 8 : 164–167.
  9. Chappuis F, Rijal S, Soto A, Menten J, Boelaert M, 2006. A meta-analysis of the diagnostic performance of the direct agglutination test and rK39 dipstick for visceral leishmaniasis. BMJ 333 : 723–726.
  10. El Harith A, Kolk AH, Leeuwenburg J, Muigai R, Huigen E, Jelsma T, Kager P, 1988. Improvement of a direct agglutination test for field studies of visceral leishmaniasis. J Clin Microbiol 26 : 1321–1325.
  11. Victora CG, Huttly SR, Fuchs SC, Olinto MTA, 1997. The role of conceptual frameworks in epidemiological analysis: a hierarchical approach. Int J Epidemiol 26 : 224–227.
  12. Manson-Bahr PEC, Heisch RB, 1956. Studies in leishmaniasis in east Africa.III. Clinical features and treatment. Trans R Soc Trop Med Hyg 50 : 465–471.
  13. Siddig M, Ghalib H, Shillington DC, Peterson EA, 1988. Visceral leishmaniasis in the Sudan: comparative parasitological methods of diagnosis. Trans R Soc Trop Med Hyg 82 : 66–68.
  14. Zijlstra EE, Ali MS, El-Hassan AM, El-Toum IA, Satti M, Ghalib HW, Kager PA, 1992. Kala-azar: a comparative study of parasitological methods and the direct agglutination test in diagnosis. Trans R Soc Trop Med Hyg 86 : 505–507.
  15. Boelaert M, Lynen L, Desjeux P, van der Stuyft P, 1999. Cost-effectiveness of competing diagnostic-therapeutic strategies for visceral leishmaniasis. Bull World Health Organ 77 : 667–674.
  16. UNAIDS, 2004. Report on the Global HIV/AIDS Epidemic: Fourth Global Report. New York: United Nations.
  17. Ritmeijer K, Veeken H, Melaku Y, Leal G, Amsalu R, Seaman J, Davidson RN, 2001. Ethiopian visceral leishmaniasis: generic and proprietary sodium stibogluconate are equivalent; HIV co-infected patients have a poor outcome. Trans R Soc Trop Med Hyg 95 : 668–672.
  18. Hailu A, Berhe N, 2002. The performance of direct agglutination test in the diagnosis of visceral leishmaniasis among Ethiopian patients with HIV co-infection. Ann Trop Med Parasitol 96 : 25–30.
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UTILITY OF LYMPH NODE ASPIRATION IN THE DIAGNOSIS OF VISCERAL LEISHMANIASIS IN SUDAN
The American Journal of Tropical Medicine and Hygiene 76, 689 (2007); https://doi.org/10.4269/ajtmh.2007.76.689
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  • Received : 10 Oct 2006
  • Accepted : 04 Jan 2007

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