Diagnostic accuracy of two rK39 antigen-based dipsticks and the formol gel test for rapid diagnosis of visceral leishmaniasis in northeastern Uganda.

Details

Ressource 1Download: 2005_JCM_rk39_VL.pdf (68.53 [Ko])
State: Public
Version: Final published version
Serval ID
serval:BIB_5293F3440317
Type
Article: article from journal or magazin.
Collection
Publications
Title
Diagnostic accuracy of two rK39 antigen-based dipsticks and the formol gel test for rapid diagnosis of visceral leishmaniasis in northeastern Uganda.
Journal
Journal of clinical microbiology
Author(s)
Chappuis F., Mueller Y., Nguimfack A., Rwakimari J.B., Couffignal S., Boelaert M., Cavailler P., Loutan L., Piola P.
ISSN
0095-1137 (Print)
ISSN-L
0095-1137
Publication state
Published
Issued date
12/2005
Peer-reviewed
Oui
Volume
43
Number
12
Pages
5973-5977
Language
english
Notes
Publication types: Comparative Study ; Evaluation Studies ; Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
The development of an accurate, practical, and affordable diagnostic test is essential to improve the management of visceral leishmaniasis (VL) in remote health centers. We evaluated the Formol Gel test (FGT) and two rK39 antigen-based dipsticks, the DUAL-IT L/M, and the Kalazar Detect for VL diagnosis in Amudat Hospital in Uganda. The DUAL-IT L/M was also evaluated for the diagnosis of malaria. All patients clinically suspect of VL were prospectively included in the study between October 2003 and March 2004. The gold standard used to define a VL case was a positive spleen aspirate or a direct agglutination test titer of >1:12,800 with an appropriate clinical response to antileishmanial therapy. A total of 131 VL and 112 non-VL patients were included in the analysis. The DUAL IT L/M was found to be more sensitive than the Kalazar Detect: 97% (95% confidence interval [95%CI] = 92 to 99%) versus 82% (95%CI = 74 to 87%). The Kalazar Detect and the DUAL IT L/M were highly specific (99% [95%CI = 95 to 100%] and 97% [95%CI = 92 to 99%], respectively). The FGT lacked both sensitivity (66% [95%CI = 57 to 73%]) and specificity (90% [95%CI = 83 to 94%]). The sensitivity of the DUAL IT L/M for malaria was only 57% (95%CI = 37 to 76%). The two rK39 dipsticks can be used for diagnostic confirmation of VL in this region. The DUAL-IT L/M without its malaria diagnostic component (DiaMed-IT LEISH) will be adopted as first-line test for VL in Uganda.

Keywords
Adolescent, Adult, Animals, Antibodies, Protozoan/blood, Antigens, Protozoan, Child, Child, Preschool, Female, Humans, Leishmaniasis, Visceral/diagnosis, Male, Protozoan Proteins, Reagent Kits, Diagnostic, Recombinant Proteins, Sensitivity and Specificity, Time Factors, Uganda
Pubmed
Open Access
Yes
Create date
23/02/2016 18:14
Last modification date
20/08/2019 14:07
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