Volume 87, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We reported a highly sensitive and specific enzyme-linked immunosorbent assay (ELISA) that detects immunoglobulin G (IgG) in urine using rKRP42 antigen for the diagnosis of visceral leishmaniasis (VL). The ELISA was applied to study chronological change in antibody titers in five study areas in Rajshahi district, Bangladesh. A total of 585 subjects without a past VL history were examined at least three times in the 30-month follow-up period; of these subjects, 137 (23.4%) subjects became ELISA-positive at least one time during the study. Among the positive cases, 40 (29.2%) subjects developed clinical VL, and 31 (77.5%) of these subjects showed IgG titers of ≥ 1,000 U more than one time in the study period. Considering only the first ELISA results, 22 subjects with IgG titers of ≥ 1,000 U could be found, and 21 (95.5%) of these subjects turned out to be clinical cases. The high urinary IgG titers (≥ 1,000 U) will help predict possible clinical VL cases and thus, identify an outbreak in its earlier stage.


Article metrics loading...

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

Full text loading...



  1. Trouiller P, Olliaro P, Torreele E, Orbinski J, Laing R, Ford N, , 2002. Drug development for neglected diseases: a deficient market and a public health policy failure. Lancet 359: 21882194.[Crossref] [Google Scholar]
  2. Pearson R, Sausa QA, , 1996. Clinical spectrum of leishmaniasis. Clin Infect Dis 22: 113.[Crossref] [Google Scholar]
  3. Desjeux P, , 2004. Leishmaniasis: current situation and new perspectives. Comp Immunol Microbiol Infect Dis 27: 305318.[Crossref] [Google Scholar]
  4. Bern C, Chowdhury R, , 2006. The epidemiology of visceral leishmaniasis in Bangladesh: prospects for improved control. Indian J Med Res 123: 275288. [Google Scholar]
  5. Chowdhur MA, Rafiqueuddin AK, Hossain A, , 1992. Aldehyde test (formol-gel test) in the diagnosis of kala-azar (visceral leishmaniasis). Trop Doct 22: 185186.[Crossref] [Google Scholar]
  6. Sundar S, Rai M, , 2002. Laboratory diagnosis of visceral leishmaniasis. Clin Diagn Lab Immunol 9: 951958. [Google Scholar]
  7. 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: 505507.[Crossref] [Google Scholar]
  8. Ghose AC, Haldar JP, Pal SC, Mishra BP, Mishra KK, , 1980. Serological investigations on Indian kala-azar. Clin Exp Immunol 40: 318326. [Google Scholar]
  9. 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 assay (ELISA) for the diagnosis of visceral leishmaniasis. Trans R Soc Trop Med Hyg 94: 173175.[Crossref] [Google Scholar]
  10. Raj VS, Ghosh A, Dole VS, Madhubala R, Myler PJ, Stuart KD, , 1999. Serodiagnosis of leishmaniasis with recombinant ORFF antigen. Am J Trop Med Hyg 61: 482487. [Google Scholar]
  11. Zijlstra EE, Daifalla NS, Kager PA, Khalil EAG, Hassan AME, Reed SG, Ghalib HW, , 1998. rK39 enzyme-linked immunosorbent assay for diagnosis of Leishmania donovani infection. Clin Diagn Lab Immunol 5: 717720. [Google Scholar]
  12. Harith AE, Kolk AHJ, Leeuwenburg J, Muigai R, Kiugu S, Kiugu S, Laarman JJ, , 1986. A simple and economical direct agglutination test for serodiagnosis and sero-epidemiological studies of visceral leishmaniasis. Trans R Soc Trop Med Hyg 80: 583587.[Crossref] [Google Scholar]
  13. Harith AE, Kolk AHJ, Leeuwenburg J, Muigai R, Huigen E, Jelsma T, Kager PA, , 1988. Improvement of a direct agglutination test for field studies of visceral leishmaniasis. J Clin Microbiol 26: 13211325. [Google Scholar]
  14. Burns JM, Shreffler WG, Benson DR, Ghalib HW, Badaro R, Reed SG, , 1993. Molecular characterization of a kinesin-related antigen of Leishmania chagasi that detects specific antibody in African American visceral leishmaniasis. Proc Natl Acad Sci USA 90: 775779.[Crossref] [Google Scholar]
  15. Maalej IA, Chenik M, Louzir H, Salah AB, Bahloul C, Amri F, Dellagi K, , 2003. Comparative evaluation of ELISAs based on ten recombinant or purified leishmania antigens for the serodiagnosis of Mediterranean visceral leishmaniasis. Am J Trop Med Hyg 68: 312320. [Google Scholar]
  16. Islam MZ, Itoh M, Takagi H, Islam AU, Ekram ARMS, Rahman A, Takesue A, Hashiguchi Y, Kimura E, , 2008. Enzyme-linked immunosorbent assay to detect urinary antibody against recombinant rKRP42 antigen made from Leishmania donovani for the diagnosis of visceral leishmaniasis. Am J Trop Med Hyg 79: 599604. [Google Scholar]
  17. CDC, 2010. CDC—Parasites—Leishmaniasis. Resources for Health Professionals. Available at: http://www.cdc.gov/parasites/leishmaniasis/health_professionals/index.html. Accessed December 28, 2011. [Google Scholar]
  18. Ahluwalia IB, Bern C, Costa C, Akter T, Chowdhury R, Ali M, Alam D, Kenah E, Amann J, Islam M, Wagatsuma Y, Haque R, Breiman RF, Maguire JH, , 2003. Visceral leishmaniasis: consequences of a neglected disease in a Bangladeshi community. Am J Trop Med Hyg 69: 624628. [Google Scholar]
  19. Collin S, Davidson R, Ritmeijer K, Keus K, Melaku Y, Kipngetich S, Davies C, , 2004. Conflict and kala-azar: determinants of adverse outcome of kala-azar among patients in Southern Sudan. Clin Infect Dis 38: 612619.[Crossref] [Google Scholar]
  20. Singh S, Kumari V, Singh N, , 2002. Predicting kala-azar disease manifestations in asymptomatic patients with latent Leishmania donovani infection by detection of antibody against recombinant rK39 antigen. Clin Diagn Lab Immunol 9: 568572. [Google Scholar]
  21. Islam MZ, Itoh M, Shamsuzzaman SM, Mirza R, Matin F, Ahmed I, Choudhury AKMS, Hossain MA, Qiu XG, Begam N, Furuya M, Leafasia JL, Hashiguchi Y, Kimura E, , 2002. Diagnosis of visceral leishmaniasis by ELISA using urine samples. Clin Diagn Lab Immunol 9: 789794. [Google Scholar]
  22. Islam MZ, Itoh M, Mirza R, Ahmed I, Ekram ARMS, Sarder AH, Shamsuzzaman SM, Hashiguchi Y, Kimura E, , 2004. Direct agglutination test with urine samples for the diagnosis of visceral leishmaniasis. Am J Trop Med Hyg 70: 7882. [Google Scholar]
  23. Attar ZJ, Chance ML, el-Safi S, Carney J, Azazy A, El-Hadi M, Dourado C, Hommel M, , 2001. Latex agglutination test for the detection of urinary antigens in visceral leishmaniasis. Acta Trop 78: 1116.[Crossref] [Google Scholar]
  24. Itoh M, Weerasooriya MV, Qui X-G, Gunawardena NK, Anantaphruti MT, Tesana S, Rattanaxay P, Fujimaki Y, Kimura E, , 2001. Sensitive and specific enzyme-linked immunosorbent assay for the diagnosis of Wuchereria bancrofti infection in urine samples. Am J Trop Med Hyg 65: 362365. [Google Scholar]
  25. Takagi H, Islam MZ, Itoh M, Islam MAU, Ekram ARMS, Hussain HM, Hashiguchi Y, Kimura E, , 2007. Production of recombinant kinesin-related protein of Leishmania donovani and its application in the serodiagnosis of visceral leishmaniasis. Am J Trop Med Hyg 76: 902905. [Google Scholar]
  26. Ahmed BN, , 2004. Report on Outbreak Investigation, Kala azar in Godagari. IEDCR in Action, Series 2. Dhaka, Bangladesh: Institute of Epidemiology, Disease Control & Research. [Google Scholar]
  27. Singh S, Reed SG, Sacks AG, Chang KP, , 1995. Diagnostic and prognostic value of rK39 antigen in Indian leishmaniasis. J Parasitol 81: 10001003.[Crossref] [Google Scholar]
  28. Weerasooriya MV, Itoh M, Islam MZ, Qiu XG, Fujimaki Y, Kimura E, , 2003. Prevalence and levels of filaria-specific urinary IgG4 among children less than five years of age and the association of the antibody positivity between the children and their mothers. Am J Trop Med Hyg 68: 465468. [Google Scholar]

Data & Media loading...

  • Received : 15 Mar 2012
  • Accepted : 16 Jun 2012
  • Published online : 03 Oct 2012

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