title: A community-based, comparative evaluation of direct agglutination and rK39 strip tests in the early detection of subclinical Leishmania donovani infection.
abstract: In the Indian state of Bihar, the sensitivities and specificities of direct agglutination tests (DAT) and rK39 test strips for the detection of Leishmania donovani infection in humans were explored and found to be generally good (92%-100%). When 172 asymptomatic individuals [16 'case-contacts' who lived in the same households as past or current, confirmed cases of visceral leishmaniasis (VL) and 156 other subjects from neighbouring households] were tested, the same 36 (21%) individuals, including all 16 'case-contacts', were found seropositive using each type of test. When followed-up after 3 months, 18 of the individuals who had been found seropositive in the baseline survey remained seropositive, and eight (44%) of these had developed symptomatic VL, with amastigotes in their splenic aspirates. Seven (44%) of the 16 'case-contacts' but only one (5%) of the other 20 subjects found seropositive at baseline went on to develop VL within 3 months. Although the strip test appeared slightly better than DAT for predicting the development of VL in the 172 subjects, either type of test may be very useful for the early detection of asymptomatic L. donovani infection and thus the identification of those at relatively high risk of developing VL.
authors.affiliation: Rajendra Memorial Research Institute of Medical Sciences, Agamkuan, Patna - 800 007, Bihar, India. pksinha18@yahoo.com
authors.forename: P K
authors.initials: PK
authors.lastname: Sinha
authors.forename: S
authors.initials: S
authors.lastname: Bimal
authors.forename: K
authors.initials: K
authors.lastname: Pandey
authors.forename: S K
authors.initials: SK
authors.lastname: Singh
authors.forename: A
authors.initials: A
authors.lastname: Ranjan
authors.forename: N
authors.initials: N
authors.lastname: Kumar
authors.forename: C S
authors.initials: CS
authors.lastname: Lal
authors.forename: S B
authors.initials: SB
authors.lastname: Barman
authors.forename: R B
authors.initials: RB
authors.lastname: Verma
authors.forename: A
authors.initials: A
authors.lastname: Jeyakumar
authors.forename: P
authors.initials: P
authors.lastname: Das
authors.forename: M
authors.initials: M
authors.lastname: Bhattacharya
authors.forename: D
authors.initials: D
authors.lastname: Sur
authors.forename: S K
authors.initials: SK
authors.lastname: Bhattacharya
mesh_terms: D000372:Agglutination Tests; D000818:Animals; D000953:Antigens, Protozoan / Q000276:immunology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D007194:India; D007893:Leishmania donovani / Q000276:immunology*; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000276:immunology; D008297:Male; D015800:Protozoan Proteins / Q000276:immunology; D011934:Reagent Strips; D012423:Rural Health; D012680:Sensitivity and Specificity; D013154:Spleen / Q000469:parasitology
chemical_list: D000953:Antigens, Protozoan; D015800:Protozoan Proteins; D011934:Reagent Strips; C079253:K39 antigen, Leishmania