Further studies of the complement fixation test using homologous parasite antigen in an endemic area for visceral leishmaniasis have showed that 82% of individuals with proven visceral leishmaniasis were positive initially whilst 92% were positive at some stage during their illness. Titres fell slowly following effective treatment and anticomplementary activity, confined to confirmed visceral leishmaniasis, was usually lost during treatment.Individuals with alternative causes of hepatosplenomegaly from the same population were negative apart from those with a presumptive diagnosis of visceral leishmaniasis but without parasitological confirmation.Less than 1% of people in the same endemic area without visceral leishmaniasis were positive, suggesting that preliminary serodiagnostic investigation would limit the need for invasive investigation under field conditions.

A complement fixation test for visceral leishmaniasis using homologous parasite antigen I.

Further studies of the complement fixation test using homologous parasite antigen in an endemic area for visceral leishmaniasis have showed that 82% of individuals with proven visceral leishmaniasis were positive initially whilst 92% were positive at some stage during their illness. Titres fell slowly following effective treatment and anticomplementary activity, confined to confirmed visceral leishmaniasis, was usually lost during treatment. Individuals with alternative causes of hepatosplenomegaly from the same population were negative apart from those with a presumptive diagnosis of visceral leishmaniasis but without parasitological confirmation. Less than 1% of people in the same endemic area without visceral leishmaniasis were positive, suggesting that preliminary serodiagnostic investigation would limit the need for invasive investigation under field conditions.

A complement fixation test for visceral leishmaniasis using homologous parasite antigen II. Results in an endemic area in Kenya.

Visceral leishmaniasis is a notifiable parasitic disease that had increased in incidence in our region on the past few years. It is common in children. In adults, it occurs more on a background of immunodeficiency, and frequently with incomplete clinical manifestations, making the diagnosis complicated. The aim of our study is to reveal different features of visceral leishmaniasis in adults, through the analysis of its epidemiological, clinical and biological parameters, in a group of 26 patients. No one was infected with HIV or under immunosuppressive therapy Clinical presentation was generally conservative, but there was few differences in adults compared to children, concerning both the clinical symptoms and the laboratory parameters. Diagnosis was provided by direct examination of bone marrow smears in 24 cases (sensitivity 92%), and anti-leishmanial serology in the others. We should think to the diagnosis of VL even if the patient is not known immunocompromised, and even if the clinical is incomplete, to avoid a delay of care which can lead to serious complications.

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Dunan S

Papers

[Immunological diagnosis of visceral leishmaniasis (10 years' experience].

Mediterranean visceral leishmaniasis and its immunologic diagnosis