title: Evaluation of the direct agglutination test as an immunodiagnostic tool for kala-azar in India.
abstract: The direct agglutination test (DAT) has been assessed as a diagnostic procedure for visceral leishmaniasis. Fifty-six of 58 sera (96.5%) from confirmed cases of visceral leishmaniasis, whose bone marrow aspirates contained Leishmania donovani amastigotes, had agglutinating antibodies above the cut-off titre of 1:800. None of the sera from healthy control subjects from non-endemic or endemic areas had anti-leishmanial antibodies. Similarly, none of the sera obtained from cases of malaria or tuberculosis had agglutinating antibodies above the cut-off titre. A significant decline in agglutinating antibody titre in 3 cases following antileishmanial chemotherapy appeared to correlate with regression of clinical symptoms and the absence of amastigotes from bone marrow aspirates. One of 3 cases developed post-kala-azar dermal lesions and sera from this subject had an elevated agglutinating antibody titre. It is concluded that the DAT is a sensitive and specific test to confirm visceral leishmaniasis. As the formalin-fixed promastigotes, stained with Coomassie blue, which are used as antigen could be stored at 4 degrees C for 6 months without any loss of ability to detect anti-leishmanial antibodies, the DAT is recommended for use under field conditions.
authors.affiliation: Department of Experimental Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: N
authors.initials: N
authors.lastname: Singla
authors.forename: G S
authors.initials: GS
authors.lastname: Singh
authors.forename: S
authors.initials: S
authors.lastname: Sundar
authors.forename: V K
authors.initials: VK
authors.lastname: Vinayak
mesh_terms: D000372:Agglutination Tests / Q000379:methods / Q000592:standards; D000818:Animals; D000909:Antibodies, Helminth / Q000032:analysis; D006801:Humans; D007893:Leishmania donovani / Q000276:immunology / Q000302:isolation & purification*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis*; D012680:Sensitivity and Specificity
chemical_list: D000909:Antibodies, Helminth