Local Production of a Liquid Direct Agglutination Test as a Sustainable Measure for Control of Visceral Leishmaniasis in Sudan

Hussam Ali Osman Biomedical Research Laboratory, Ahfad University for Women, Omdurman, Sudan; Department of Microbiology, Faculty of Medical Laboratory Sciences, Sudan International University, Khartoum, Sudan; Postgraduate Program in Health and Environment, University of Tiradentes, Aracaju, Sergipe, Brazil; Department of Medicine and Nursing, University of Tiradentes, Aracaju, Sergipe, Brazil

Search for other papers by Hussam Ali Osman in
Current site
Google Scholar
PubMed
Close
,
Abdelhafeiz Mahamoud Biomedical Research Laboratory, Ahfad University for Women, Omdurman, Sudan; Department of Microbiology, Faculty of Medical Laboratory Sciences, Sudan International University, Khartoum, Sudan; Postgraduate Program in Health and Environment, University of Tiradentes, Aracaju, Sergipe, Brazil; Department of Medicine and Nursing, University of Tiradentes, Aracaju, Sergipe, Brazil

Search for other papers by Abdelhafeiz Mahamoud in
Current site
Google Scholar
PubMed
Close
,
Elfadil Mustafa Abass Biomedical Research Laboratory, Ahfad University for Women, Omdurman, Sudan; Department of Microbiology, Faculty of Medical Laboratory Sciences, Sudan International University, Khartoum, Sudan; Postgraduate Program in Health and Environment, University of Tiradentes, Aracaju, Sergipe, Brazil; Department of Medicine and Nursing, University of Tiradentes, Aracaju, Sergipe, Brazil

Search for other papers by Elfadil Mustafa Abass in
Current site
Google Scholar
PubMed
Close
,
Rubens Riscala Madi Biomedical Research Laboratory, Ahfad University for Women, Omdurman, Sudan; Department of Microbiology, Faculty of Medical Laboratory Sciences, Sudan International University, Khartoum, Sudan; Postgraduate Program in Health and Environment, University of Tiradentes, Aracaju, Sergipe, Brazil; Department of Medicine and Nursing, University of Tiradentes, Aracaju, Sergipe, Brazil

Search for other papers by Rubens Riscala Madi in
Current site
Google Scholar
PubMed
Close
,
Saul J. Semiao-Santos Biomedical Research Laboratory, Ahfad University for Women, Omdurman, Sudan; Department of Microbiology, Faculty of Medical Laboratory Sciences, Sudan International University, Khartoum, Sudan; Postgraduate Program in Health and Environment, University of Tiradentes, Aracaju, Sergipe, Brazil; Department of Medicine and Nursing, University of Tiradentes, Aracaju, Sergipe, Brazil

Search for other papers by Saul J. Semiao-Santos in
Current site
Google Scholar
PubMed
Close
, and
Abdallah el Harith Biomedical Research Laboratory, Ahfad University for Women, Omdurman, Sudan; Department of Microbiology, Faculty of Medical Laboratory Sciences, Sudan International University, Khartoum, Sudan; Postgraduate Program in Health and Environment, University of Tiradentes, Aracaju, Sergipe, Brazil; Department of Medicine and Nursing, University of Tiradentes, Aracaju, Sergipe, Brazil

Search for other papers by Abdallah el Harith in
Current site
Google Scholar
PubMed
Close
Restricted access

A prerequisite for the control of visceral leishmaniasis (VL) is the accessibility to reference diagnostics. The high price of the freeze-dried direct agglutination test (FD-DAT) and the short shelf-life time of the rK39 strip test (rK39) have limited the application of these tests in Sudan. An original liquid DAT (LQ-DAT) with high reproducibility compared with the FD-DAT and rK39 has been routinely produced in our laboratory since 1999. In this study, a 3.4-year-old batch (of more than 90 test batches produced to date) was chosen to validate the diagnostic performance of this test against microscopy, FD-DAT, and rK39 in 96 VL and 42 non-VL serum samples. Relatively higher sensitivity (95/96, 99.0%) was recorded for the LQ-DAT than for the FD-DAT (92/96, 95.8%) and rK39 (76/96, 79.2%), probably because of the use of the endemic autochthonous Leishmania donovani isolate as the antigen. Experience with the LQ-DAT, its low cost of production, ease of providing this test, and diagnostic reliability compared with the FD-DAT suggest that widescale implementation of the LQ-DAT can contribute to sustainable VL control in Sudan.

Author Notes

* Address correspondence to Saul J. Semiao-Santos, UNIT, Department of Medicine and Nursing, Av. Murilo Dantas 300 Farolandia Aracaju/SECEP: 4032-490 Brasil. E-mail: saulix@gmail.com

Authors' addresses: Hussam Ali Osman, Abdelhafeiz Mahamoud, and Abdallah el Harith, Biomedical Research Laboratory, Ahfad University for Women, Omdurman, Sudan, E-mails: hussomco@gmail.com, mabdelhafeiz@gmail.com, and abdallah.elharith@gmail.com. Elfadil Mustafa Abass, Biomedical Research Laboratory, Ahfad University for Women, Omdurman, Sudan, and Department of Microbiology, Faculty of Medical Laboratory Sciences, Sudan International University, Khartoum, Sudan, E-mail: elfadil_abass@yahoo.com. Rubens Riscala Madi, Postgraduate Program in Health and Environment, University of Tiradentes, Aracaju, Sergipe, Brazil, E-mail: rrmadi@gmail.com. Saul J. Semiao-Santos, Department of Medicine and Nursing, University of Tiradentes, Aracaju, Sergipe, Brazil, E-mail: saulix@gmail.com.

  • 1.

    Boelaert M, Bhattacharya S, Chappuis F, El Safi SH, Hailu A, Mondal D, Rijal S, Sundar S, Wasunna M, Peeling RW, 2007. Evaluation of rapid diagnostic tests: visceral leishmaniasis. Nat Rev Microbiol 5: S30S39.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Chappuis F, Sundar S, Hailu A, Ghalib H, Rijal S, Peeling RW, Alvar G, Boelaert M, 2007. Visceral leishmaniasis: what are the needs for diagnosis, treatment and control? Nat Rev Microbiol 5: 873882.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    el Harith A, 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.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    el Harith A, el Mutasim M, Mansour D, Mustafa F, Arvidson H, 2003. Use of glycerol as alternative to freeze-drying for long-term preservation of antigen for the direct agglutination test. Trop Med Int Health 8: 10251029.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    el Mutasim M, Mansour D, Abass EM, Hassan WM, el Harith A, 2006. Evaluation of a glycerol-preserved antigen in the direct agglutination test for diagnosis of visceral leishmaniasis at rural level in eastern Sudan. J Med Microbiol 55: 13431347.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    el Harith A, Chowdhury S, Al-Masum A, Semiao-Santos S, Karim E, el-Safi S, Haque I, 1995. Evaluation of cleaving agents other than trypsin in direct agglutination test for further improving diagnosis of visceral leishmaniasis. J Clin Microbiol 33: 19841988.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Sadigursky M, Brodskyn CI, 1986. A new liquid medium without blood and serum for culture of hemoflagellates. Am J Trop Med Hyg 35: 942944.

  • 8.

    Jacquet D, Boelaert M, Seaman J, Rijal S, Sundar S, Menten J, Magnus E, 2006. Comparative evaluation of freeze-dried and liquid antigens in the direct agglutination test for serodiagnosis of visceral leishmaniasis (ITMA-DAT/VL). Trop Med Int Health 11: 17771784.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Abass E, Bollig N, Reinhard K, Camara B, Mansour D, Visektuna A, Lohoff M, Steinhoff U, 2013. rKLO8, a novel Leishmania donovani-derived recombinant immunodominant protein for sensitive detection of visceral leishmaniasis in Sudan. PLoS Negl Trop Dis 7: e2322.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Meredith SE, Kroon NC, Sondorp E, Seaman J, Goris MG, van Ingen CW, Oosting H, Schoone G, Terpstra WJ, Oskam L, 1995. Leish-KIT, a stable direct agglutination test based on freeze-dried antigen for serodiagnosis of visceral leishmaniasis. J Clin Microbiol 33: 17421745.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Mbati PA, Githure JI, Kagai JM, Kirigi G, Kibati F, Wasunna K, Koech DK, 1999. Evaluation of a standardized direct agglutination test (DAT) for the diagnosis of visceral leishmaniasis in Kenya. Ann Trop Med Parasitol 93: 703710.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Oliveira AE, Pedras MJ, De Assis IE, Rabello A, 2009. Improvement of direct agglutination test (DAT) for laboratory diagnosis of visceral leishmaniasis in Brazil. Trans R Soc Trop Med Hyg 103: 12791281.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Islam MZ, Itoh M, Mirza R, Ahmed I, Ekram AR, 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.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Mohebali M, Edrissian GH, Nadim A, Hajjaran H, Akhoundi B, Hooshamand B, Zarei Z, Mirsamadi N, Manoucherhri Naeini K, Mamishi, Sanati AA, Moshfe AA, Charehdar S, Fakhar M, 2006. Application of direct agglutination test (DAT) for the diagnosis and sero-epidemiological studies of visceral leishmaniasis in Iran. Iran J Parasitol 1: 1525.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    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: 3240.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Kuhls K, Keilonat L, Ochsenreither S, Schaar M, Schweynoch C, Presber W, Schönian G, 2007. Multilocus microsatellite typing (MLMT) reveals genetically isolated populations between and within the main endemic regions of visceral leishmaniasis. Microbes Infect 9: 334343.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    Alam MZ, Kuhls K, Schweynoch C, Sundar S, Rijal S, Shamsuzzaman AK, Raju BV, Salotra P, Dujardin JC, Schönian G, 2009. Multilocus microsatellite typing (MLMT) reveals genetic homogeneity of Leishmania donovani strains in the Indian subcontinent. Infect Genet Evol 9: 2431.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    Bhattacharyya T, Duncan EB, El-Safi S, Sundar S, Falconar AK, Singh OP, Kumar R, Ahmed O, Boelaert M, Miles MA, 2014. Significantly lower anti-Leishmania IgG responses in Sudanese versus Indian visceral leishmaniasis. PLoS Negl Trop Dis 8: e2675.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Pattabhi S, Whittle J, Mohamath R, El-Safi S, Moulton GG, Guderian JA, Colombara D, Abdoon AO, Mukhtar MM, Mondal D, Esfandiari J, Kumar S, Chun P, Reed SG, Bhatia A, 2010. Design, development and evaluation of rK28-based point-of-care tests for improving rapid diagnosis of visceral leishmaniasis. PLoS Negl Trop Dis 4: e822.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 99 88 4
Full Text Views 336 12 2
PDF Downloads 70 1 0
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save