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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.
Financial support: This study was supported by Japan Society for the Promotion of Science (JSPS) Grant-in-Aid for Scientific Research for JSPS Postdoctoral Fellowship for Foreign Researchers 1604227, Grant-in-Aid for Scientific Research (B) 15406018, and Grant-in-Aid for Scientific Research (B) 18406013. This work was also supported by the Special Coordination Funds for Promoting Science and Technology of Ministry of Education, Culture, Sports, Science and Technology (MEXT), Japan (1200015).
Authors' addresses: Mohammad Zahidul Islam, Makoto Itoh, Hidekazu Takagi, Atsuhide Takesue, and Eisaku Kimura, Department of Parasitology, Aichi Medical University School of Medicine, Nagakute, Aichi-ken, Japan, E-mails: firstname.lastname@example.org, email@example.com, firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org. Present address of Mohammad Zahidul Islam, Department of Biology, The Catholic University of America, Washington, DC. Md. Anwar Ul Islam and Md. Ajijur Rahman, Department of Pharmacy, University of Rajshahi, Rajshahi, Bangladesh, E-mails: email@example.com and firstname.lastname@example.org. A. R. M. Saifuddin Ekram, Department of Medicine, Rajshahi Medical College, Rajshahi, Bangladesh, E-mail: email@example.com. Yoshihisa Hashiguchi, Prometeo Project, Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador and Department of Parasitology, Kochi Medical School, Kochi University, Nankoku City, Kochi, Japan, E-mail: firstname.lastname@example.org.
Reprint requests: Makoto Itoh, Department of Parasitology, Aichi Medical University School of Medicine, Nagakute, Aichi-ken 480-1195, Japan, E-mail: email@example.com.