Mohammad Amin Ghatei; Gholamreza Hatam; Seyed Mohammad Hossein Hosseini; Bahador Sarkari
Volume 6, Issue 4 , December 2009, , Pages 202-207
Abstract
Background: Visceral leishmaniasis (VL) is an endemic disease in some parts of Iran. Many techniques have been used for diagnosis of VL, among which the urine based la-tex agglutination test (KAtex) is a promising one. Objective: To compare three diag-nostic tests of VL including KAtex, ELISA and Direct ...
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Background: Visceral leishmaniasis (VL) is an endemic disease in some parts of Iran. Many techniques have been used for diagnosis of VL, among which the urine based la-tex agglutination test (KAtex) is a promising one. Objective: To compare three diag-nostic tests of VL including KAtex, ELISA and Direct Agglutination Test (DAT) in VL patients and healthy controls in the south west of Iran. Methods: Serum (n = 29) and urine samples (n = 31) were collected from parasitologically confirmed VL patients. Control samples were obtained from healthy individuals (n = 61) and also from patients with infectious diseases other than VL. The collected serum samples were tested by DAT and ELISA using crude antigen from promastigotes of Leishmania infantum and the urine samples were tested by KAtex. Results: Sensitivity and specificity of KAtex for diagnosis of VL was found to be 83.9% and 100%, respectively. Sensitivities of DAT and ELISA were 93.1% and 86.2% and their specificities were 100% and 90.5%, respectively. Conclusion: KAtex yielded a satisfactory sensitivity and specificity in di-agnosis of VL in Iran and can be recommended as a rapid, field applicable and reliable test for diagnosis of VL in this region.
Durria Mansour; Elfadil M. Abass; Abdelhafeiz Mahamoud; Abdallah el Harith
Volume 6, Issue 4 , December 2009, , Pages 208-215
Abstract
Background: Until now, the comparison of the rK39 strip test (RKT) and direct ag-glutination test (DAT) for detection of visceral leishmaniasis (VL) is exclusively based on either positive or negative qualification of the reaction outcome. Objective: In this study, we compared the diagnostic performance ...
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Background: Until now, the comparison of the rK39 strip test (RKT) and direct ag-glutination test (DAT) for detection of visceral leishmaniasis (VL) is exclusively based on either positive or negative qualification of the reaction outcome. Objective: In this study, we compared the diagnostic performance of RKT and DAT for VL both qualitatively and semi-quantitatively. Methods: For comparison based on semi-quantitative grounds, the execution of RKT and DAT was according to the standard procedures. For comparison on semi-qualitative grounds with DAT, the RKT was ap-plied to aliquots from positive samples that were two-fold serially diluted in saline to determine, as for the DAT, the end-point reaction in RKT. Results: While qualita-tively both RKT and DAT demonstrated comparable reliability for VL detection (sen-sitivity = 96% and specificity = 98.7% or 99.3%), no significant correlation (r = 0.13) could be established between intensities of their positive reactions in 25 cases studied. A negative correlation was further determined in those 25 VL cases between the posi-tive intensities of the RKT and antibody levels measured semi-quantitatively with the same procedure (r = -0.36) or the DAT (r = -0.30). Irrespective of the low, moderate or high antibody levels measured with RKT (<1:8 and 1:16-1:32 >1:256) or DAT (< 1:25,600 and 1:51,200- 1:409,600 > 1:3,276,800) in patients with confirmed or uncon-firmed VL infection, exclusively strong positive intensities were obtained with RKT. Conclusion: For further optimizing diagnosis and simultaneously assessing magni-tude of immune response to L. donovani infection in Sudanese patients, the combined application of RKT and DAT is recommended.