title: Usefulness of the rK39-immunochromatographic test, direct agglutination test, and leishmanin skin test for detecting asymptomatic Leishmania infection in children in a new visceral leishmaniasis focus in Amhara State, Ethiopia.
abstract: In areas where visceral leishmaniasis is anthroponotic, asymptomatically infected patients may play a role in transmission. Additionally, the number of asymptomatic patients in a disease-endemic area will also provide information on transmission dynamics. Libo Kemkem and Fogera districts (Amhara State, Ethiopia) are now considered newly established areas to which visceral leishmaniasis is endemic. In selected villages in these districts, we conducted a study to assess the usefulness of different approaches to estimate the asymptomatic infection rate. Of 605 participants, the rK39 immunochromatographic test was able to detect asymptomatic infection in 1.5% (9 of 605), direct agglutination test in 5.3% (32 of 605), and leishmanin skin test in 5.6% (33 of 589); the combined use of serologic methods and leishmanin skin test enabled detecting asymptomatic infection in 10.1% (61 of 605). We conclude that the best option to detect asymptomatic infection in this new visceral leishmaniasis-endemic focus is the combined use of the direct agglutination test and the leishmanin skin test.
authors.affiliation: Armauer Hansen Research Institute, Addis Ababa, Ethiopia. endalamawgadisa@yahoo.com
authors.forename: Endalamaw
authors.initials: E
authors.lastname: Gadisa
authors.forename: Estefanía
authors.initials: E
authors.lastname: Custodio
authors.forename: Carmen
authors.initials: C
authors.lastname: Cañavate
authors.forename: Luis
authors.initials: L
authors.lastname: Sordo
authors.forename: Zelalem
authors.initials: Z
authors.lastname: Abebe
authors.forename: Javier
authors.initials: J
authors.lastname: Nieto
authors.forename: Carmen
authors.initials: C
authors.lastname: Chicharro
authors.forename: Abraham
authors.initials: A
authors.lastname: Aseffa
authors.forename: Lawrence
authors.initials: L
authors.lastname: Yamuah
authors.forename: Howard
authors.initials: H
authors.lastname: Engers
authors.forename: Javier
authors.initials: J
authors.lastname: Moreno
authors.forename: Israel
authors.initials: I
authors.lastname: Cruz
mesh_terms: D000293:Adolescent; D000372:Agglutination Tests / Q000379:methods*; D000953:Antigens, Protozoan / Q000276:immunology / Q000302:isolation & purification*; D058345:Asymptomatic Infections / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002846:Chromatography, Affinity / Q000379:methods*; D019353:Endemic Diseases; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007891:Leishmania / Q000302:isolation & purification / Q000472:pathogenicity; D007898:Leishmaniasis, Visceral / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D012882:Skin Tests
chemical_list: D000953:Antigens, Protozoan; C032127:leishmanin