Heterogeneity of Leishmania donovani parasites complicates diagnosis of visceral leishmaniasis: comparison of different serological tests in three endemic regions.
Elfadil Abass,Cholho Kang,Franjo Martinković,Saul J. Semião-Santos,Shyam Sundar,Peter Walden,Renaud Piarroux,Abdallah el Harith,Michael Lohoff,Ulrich Steinhoff +9 more
TLDR
Overall, rKLO8- and rK39 ELISA were most sensitive in immunocompetent patients from all endemic regions (96–100%) and the sensitivity was reduced to 81.8% in HIV co-infected patients from France.Abstract:
Diagnostic tests for visceral leishmaniasis that are based on antigens of a single Leishmania strain can have low diagnostic performance in regions where heterologous parasites predominate. The aim of this study was to investigate and compare the performance of five serological tests, based on different Leishmania antigens, in three endemic countries for visceral leishmaniasis. A total number of 231 sera of symptomatic and asymptomatic cases and controls from three endemic regions of visceral leishmaniasis in East Sudan, North India and South France were evaluated by following serological tests: rKLO8- and rK39 ELISA, DAT (ITMA-DAT) and two rapid tests of rK39 (IT LEISH) and rKE16 (Signal-KA). Overall, rKLO8- and rK39 ELISA were most sensitive in immunocompetent patients from all endemic regions (96–100%) and the sensitivity was reduced to 81.8% in HIV co-infected patients from France. Sera of patients from India demonstrated significantly higher antibody responses to rKLO8 and rK39 compared with sera from Sudan (p<0.0001) and France (p<0.0037). Further, some Indian and Sudanese patients reacted better with rKLO8 than rK39. Sensitivity of DAT (ITMA-DAT) was high in Sudan (94%) and India (92.3%) but low in France being 88.5% and 54.5% for VL and VL/HIV patients, respectively. In contrast, rapid tests displayed high sensitivity only in patients from India (96.2%) but not Sudan (64–88%) and France (73.1–88.5% and 63.6–81.8% in VL and VL/HIV patients, respectively). While the sensitivity varied, all tests showed high specificity in Sudan (96.7–100%) and India (96.6%).Heterogeneity of Leishmania parasites which is common in many endemic regions complicates the diagnosis of visceral leishmaniasis. Therefore, tests based on homologous Leishmania antigens are required for particular endemic regions to detect cases which are difficult to be diagnosed with currently available tests.read more
Citations
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Laboratory diagnosis of human visceral leishmaniasis.
TL;DR: Quantitative polymerase chain reaction (qPCR) has been shown to be superior than conventional PCR for the differentiation between active VL and asymptomatic infections, such as for the detection of VL-HIV coinfection.
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An interactive database of Leishmania species distribution in the Americas.
Giovanny Herrera,Natalia Barragán,Nicolás Luna,David Martínez,Frasella De Martino,J. J. Medina,Sergio Niño,Luisa Páez,Angie Ramírez,Laura Vega,Valeria Velandia,Michelle Vera,María Fernanda Zúñiga,Marius Bottin,Juan David Ramírez +14 more
TL;DR: A systematic review of Leishmania parasite species circulating in the countries of the American continent, together with complementary information on epidemiology and geospatial distribution is presented.
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Validation of rK39 immunochromatographic test and direct agglutination test for the diagnosis of Mediterranean visceral leishmaniasis in Spain.
Mathieu Bangert,María Flores-Chávez,Ivonne Pamela Llanes-Acevedo,Carolina Arcones,Carmen Chicharro,Emilia García,Sheila Ortega,Javier Nieto,Israel Cruz +8 more
TL;DR: Though rK39-ICT and DAT exhibited acceptable sensitivity and specificity a combination with other tests is required for highly sensitive diagnosis of VL cases in Spain, which can help inform the choice of serological test to be used when screening or diagnosing VL in a European Mediterranean setting.
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A spotlight on the diagnostic methods of a fatal disease Visceral Leishmaniasis
TL;DR: This review gathers the comprehensive information on diagnostics methods of VL under a single umbrella that could be the prominent tools for the development of rapid, accurate and cost‐effective diagnostic kits for VL which can be used in field conditions.
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Laboratory Diagnosis of Cutaneous and Visceral Leishmaniasis: Current and Future Methods
TL;DR: Main methods used for the detection and identification of leishmaniasis that can be performed by demonstration of the parasite in biological samples from the patient through microscopic examination, by in vitro culture or animal inoculation, or by immunological methods through the detection of parasite antigens that may be present in urine.
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