- INTRODUCTION
- METHODS
- RESULTS
- Sensitivity of rK39 test and DAT in parasitologically confirmed VL patients.
- Specificity of the rK39 test in DAT-negative patients and in DAT-negative controls.
- Comparison of the rK39 test to the combination of the DAT and splenic aspiration.
- Proposed algorithm for rK39 test use for patients suspected of having VL in Ethiopia.
- Quality control.
- DISCUSSION
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1
Ritmeijer K, Dejenie A, Assefa Y, Hundie TB, Mesure J, Boots G, den Boer M, Davidson RN, 2006. A comparison of miltefosine and sodium stibogluconate for treatment of visceral leishmaniasis in an Ethiopian population with high prevalence of HIV infection. Clin Infect Dis 43 :357–364.
-
2
Zijlstra EE, Ali MS, el-Hassan AM, el-Toum IA, Satti M, Ghalib HW, Kager PA, 1991. Direct agglutination test for diagnosis and sero-epidemiological survey of kala-azar in the Sudan. Trans R Soc Trop Med Hyg 85 :474–476.
-
3
Babiker ZO, Davidson R, Mazinda C, Kipngetich S, Ritmeijer K, 2007. Utility of lymph node aspiration in the diagnosis of visceral leishmaniasis in Sudan. Am J Trop Med Hyg 76 :689–693.
-
4
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.
-
5
Ritmeijer K, Davidson RN, 2003. Royal Society of Tropical Medicine and Hygiene joint meeting with Médecins Sans Frontières at Manson House, London, 20 March 2003: field research in humanitarian medical programmes. Médecins Sans Frontières interventions against kala-azar in the Sudan, 1989–2003. Trans R Soc Trop Med Hyg 97 :609–613.
-
6
Medrano FJ, Canavate C, Leal M, Rey C, Lissen E, Alvar J, 1998. The role of serology in the diagnosis and prognosis of visceral leishmaniasis in patients coinfected with human immunodeficiency virus type-1. Am J Trop Med Hyg 59 :155–162.
-
7
World Health Organization, 2000. Leishmania/HIV Co-infection in South-Western Europe 1990–1998: Retrospective Analysis of 965 Patients. Geneva: World Health Organization, WHO/LEISH/2000.42.
-
8
Hailu A, Berhe N, 2002. The performance of direct agglutination tests (DAT) in the diagnosis of visceral leishmaniasis among Ethiopian patients with HIV co-infection. Ann Trop Med Parasitol 96 :25–30.
-
9
Ritmeijer K, Melaku Y, Mueller M, Kipngetich S, O’Keeffe C, Davidson RN, 2006. Evaluation of a new recombinant K39 rapid diagnostic test for Sudanese visceral leishmaniasis. Am J Trop Med Hyg 74 :76–80.
-
10
Chappuis F, Mueller Y, Nguimfack A, Rwakimari JB, Couffignal S, Boelaert M, Cavailler P, Loutan L, Piola P, 2005. Diagnostic accuracy of two rK39 antigen-based dipsticks and the formol gel test for rapid diagnosis of visceral leishmaniasis in northeastern Uganda. J Clin Microbiol 43 :5973–5977.
-
11
Sundar S, Maurya R, Singh RK, Bharti K, Chakravarty J, Parekh A, Rai M, Kumar K, Murray HW, 2006. Rapid, noninvasive diagnosis of visceral leishmaniasis in India: comparison of two immunochromatographic strip tests for detection of anti-K39 antibody. J Clin Microbiol 44 :251–253.
-
12
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.
-
13
Diro E, Techane Y, Tefera T, Assefa Y, Kebede T, Genetu A, Kebede Y, Tesfaye A, Ergicho B, Gebre-Yohannes A, Mengistu G, Engers H, Aseffa A, Desjeux P, Boelaert M, Hailu A, 2007. Field evaluation of FD-DAT, rK39 dipstick and KATEX (urine latex agglutination) for diagnosis of visceral leishmaniasis in northwest Ethiopia. Trans R Soc Trop Med Hyg 101 :908–914.
-
14
Boelaert M, El-Safi S, Hailu A, Mukhtar M, Rijal S, Sundar S, Wasunna M, Aseffa A, Mbui J, Menten J, Desjeux P, Peeling RW, 2008. Diagnostic tests for kala-azar: a multi-centre study of the freeze-dried DAT, rK39 strip test and KAtex in East Africa and the Indian subcontinent. Trans R Soc Trop Med Hyg 102 :32–40.
-
15
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.
-
16
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.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 2080 | 1960 | 63 |
| Full Text Views | 351 | 10 | 0 |
| PDF Downloads | 125 | 15 | 2 |
Field Evaluation of rK39 Test and Direct Agglutination Test for Diagnosis of Visceral Leishmaniasis in a Population with High Prevalence of Human Immunodeficiency Virus in Ethiopia
Rachel ter Horst
Rachel ter Horst
Médecins Sans Frontières, Humera, Ethiopia; Kahsay Abera Hospital, Humera, Ethiopia; Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom; Médecins Sans Frontières, Amsterdam, The Netherlands
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Tewodros Tefera
Tewodros Tefera
Médecins Sans Frontières, Humera, Ethiopia; Kahsay Abera Hospital, Humera, Ethiopia; Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom; Médecins Sans Frontières, Amsterdam, The Netherlands
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Gessesse Assefa
Gessesse Assefa
Médecins Sans Frontières, Humera, Ethiopia; Kahsay Abera Hospital, Humera, Ethiopia; Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom; Médecins Sans Frontières, Amsterdam, The Netherlands
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Abdurazik Z. Ebrahim
Abdurazik Z. Ebrahim
Médecins Sans Frontières, Humera, Ethiopia; Kahsay Abera Hospital, Humera, Ethiopia; Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom; Médecins Sans Frontières, Amsterdam, The Netherlands
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Robert N. Davidson
Robert N. Davidson
Médecins Sans Frontières, Humera, Ethiopia; Kahsay Abera Hospital, Humera, Ethiopia; Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom; Médecins Sans Frontières, Amsterdam, The Netherlands
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Koert Ritmeijer
Koert Ritmeijer
Médecins Sans Frontières, Humera, Ethiopia; Kahsay Abera Hospital, Humera, Ethiopia; Ethiopian Health and Nutrition Research Institute, Addis Ababa, Ethiopia; Department of Infection and Tropical Medicine, Northwick Park Hospital, Harrow, United Kingdom; Médecins Sans Frontières, Amsterdam, The Netherlands
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Accuracy of an rK39 rapid diagnostic test (DiaMed-IT-Leish ®) for visceral leishmaniasis (VL) was compared with splenic aspiration and the direct agglutination test (DAT) in a population with a high prevalence of infection with human immunodeficiency virus (HIV) in Ethiopia. There were 699 patients clinically suspected of having VL (153 parasitologically confirmed, 482 DAT confirmed, and 130 DAT negative), and 97 DAT-negative controls. A total of 84% were tested for HIV and 34% were HIV positive. Sensitivity of the rK39 test in parasitologically confirmed VL patients was 84% (77% in HIV positive and 87% in HIV negative; P = 0.25). Sensitivity of the DAT was higher (94%; P = 0.01), 89% in HIV-positive patients and 95% in HIV-negative patients; P = 0.27). Specificity of the rK39 test was 99% in DAT-negative controls and 92% in DAT-negative patients clinically suspected of having VL. A diagnostic algorithm combining DAT and the rK39 test had a sensitivity of 98% in HIV-positive VL patients and 99% in HIV-negative VL patients. Despite the lower sensitivity in a population with a high prevalence of HIV, the DiaMed-IT-Leish ® rK39 test enables decentralization of diagnosis. Patients clinically suspected of having VL who show negative results on the rK39 antigen test should undergo follow-up DAT testing, especially if they are HIV positive.
Author Notes
- INTRODUCTION
- METHODS
- RESULTS
- Sensitivity of rK39 test and DAT in parasitologically confirmed VL patients.
- Specificity of the rK39 test in DAT-negative patients and in DAT-negative controls.
- Comparison of the rK39 test to the combination of the DAT and splenic aspiration.
- Proposed algorithm for rK39 test use for patients suspected of having VL in Ethiopia.
- Quality control.
- DISCUSSION
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1
Ritmeijer K, Dejenie A, Assefa Y, Hundie TB, Mesure J, Boots G, den Boer M, Davidson RN, 2006. A comparison of miltefosine and sodium stibogluconate for treatment of visceral leishmaniasis in an Ethiopian population with high prevalence of HIV infection. Clin Infect Dis 43 :357–364.
-
2
Zijlstra EE, Ali MS, el-Hassan AM, el-Toum IA, Satti M, Ghalib HW, Kager PA, 1991. Direct agglutination test for diagnosis and sero-epidemiological survey of kala-azar in the Sudan. Trans R Soc Trop Med Hyg 85 :474–476.
-
3
Babiker ZO, Davidson R, Mazinda C, Kipngetich S, Ritmeijer K, 2007. Utility of lymph node aspiration in the diagnosis of visceral leishmaniasis in Sudan. Am J Trop Med Hyg 76 :689–693.
-
4
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.
-
5
Ritmeijer K, Davidson RN, 2003. Royal Society of Tropical Medicine and Hygiene joint meeting with Médecins Sans Frontières at Manson House, London, 20 March 2003: field research in humanitarian medical programmes. Médecins Sans Frontières interventions against kala-azar in the Sudan, 1989–2003. Trans R Soc Trop Med Hyg 97 :609–613.
-
6
Medrano FJ, Canavate C, Leal M, Rey C, Lissen E, Alvar J, 1998. The role of serology in the diagnosis and prognosis of visceral leishmaniasis in patients coinfected with human immunodeficiency virus type-1. Am J Trop Med Hyg 59 :155–162.
-
7
World Health Organization, 2000. Leishmania/HIV Co-infection in South-Western Europe 1990–1998: Retrospective Analysis of 965 Patients. Geneva: World Health Organization, WHO/LEISH/2000.42.
-
8
Hailu A, Berhe N, 2002. The performance of direct agglutination tests (DAT) in the diagnosis of visceral leishmaniasis among Ethiopian patients with HIV co-infection. Ann Trop Med Parasitol 96 :25–30.
-
9
Ritmeijer K, Melaku Y, Mueller M, Kipngetich S, O’Keeffe C, Davidson RN, 2006. Evaluation of a new recombinant K39 rapid diagnostic test for Sudanese visceral leishmaniasis. Am J Trop Med Hyg 74 :76–80.
-
10
Chappuis F, Mueller Y, Nguimfack A, Rwakimari JB, Couffignal S, Boelaert M, Cavailler P, Loutan L, Piola P, 2005. Diagnostic accuracy of two rK39 antigen-based dipsticks and the formol gel test for rapid diagnosis of visceral leishmaniasis in northeastern Uganda. J Clin Microbiol 43 :5973–5977.
-
11
Sundar S, Maurya R, Singh RK, Bharti K, Chakravarty J, Parekh A, Rai M, Kumar K, Murray HW, 2006. Rapid, noninvasive diagnosis of visceral leishmaniasis in India: comparison of two immunochromatographic strip tests for detection of anti-K39 antibody. J Clin Microbiol 44 :251–253.
-
12
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.
-
13
Diro E, Techane Y, Tefera T, Assefa Y, Kebede T, Genetu A, Kebede Y, Tesfaye A, Ergicho B, Gebre-Yohannes A, Mengistu G, Engers H, Aseffa A, Desjeux P, Boelaert M, Hailu A, 2007. Field evaluation of FD-DAT, rK39 dipstick and KATEX (urine latex agglutination) for diagnosis of visceral leishmaniasis in northwest Ethiopia. Trans R Soc Trop Med Hyg 101 :908–914.
-
14
Boelaert M, El-Safi S, Hailu A, Mukhtar M, Rijal S, Sundar S, Wasunna M, Aseffa A, Mbui J, Menten J, Desjeux P, Peeling RW, 2008. Diagnostic tests for kala-azar: a multi-centre study of the freeze-dried DAT, rK39 strip test and KAtex in East Africa and the Indian subcontinent. Trans R Soc Trop Med Hyg 102 :32–40.
-
15
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.
-
16
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.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 2080 | 1960 | 63 |
| Full Text Views | 351 | 10 | 0 |
| PDF Downloads | 125 | 15 | 2 |