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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.
Authors' addresses: Hussam Ali Osman, Abdelhafeiz Mahamoud, and Abdallah el Harith, Biomedical Research Laboratory, Ahfad University for Women, Omdurman, Sudan, E-mails: email@example.com, firstname.lastname@example.org, and email@example.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: firstname.lastname@example.org. Rubens Riscala Madi, Postgraduate Program in Health and Environment, University of Tiradentes, Aracaju, Sergipe, Brazil, E-mail: email@example.com. Saul J. Semiao-Santos, Department of Medicine and Nursing, University of Tiradentes, Aracaju, Sergipe, Brazil, E-mail: firstname.lastname@example.org.