title: Comparison of point-of-care tests for the rapid diagnosis of visceral leishmaniasis in East African patients.
abstract: The development of rK39-based rapid diagnostic tests (RDTs) has greatly aided the diagnosis of visceral leishmaniasis, especially in the Indian subcontinent and Brazil, by offering high sensitivity and specificity. However, these tests have been less sensitive and less specific in sub-Saharan Africa. To improve upon the performance of rK39 in Africa, we engineered the fusion molecule rK28, which retained some of the rK39 repeats and combined them with repeat sequences from two additional Leishmania genes. This polyprotein was used in the development of several prototype RDTs by different commercial manufacturers with the goal of assessing relative performance in inexpensive formats. Here, we report field studies showing that the rK28 antigen could be readily adapted to a variety of RDT formats to achieve high sensitivity, generally > 90%, and adequate specificity to aid in the diagnosis of human visceral leishmaniasis in East Africa, Asia, and South America.
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Asrat
authors.initials: A
authors.lastname: Bezuneh
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Maowia
authors.initials: M
authors.lastname: Mukhtar
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Asim
authors.initials: A
authors.lastname: Abdoun
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Tedla
authors.initials: T
authors.lastname: Teferi
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Yegnasew
authors.initials: Y
authors.lastname: Takele
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Ermias
authors.initials: E
authors.lastname: Diro
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Asfaw
authors.initials: A
authors.lastname: Jemaneh
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Welelta
authors.initials: W
authors.lastname: Shiferaw
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Hirut
authors.initials: H
authors.lastname: Wondimu
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Ajay
authors.initials: A
authors.lastname: Bhatia
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Randall F
authors.initials: RF
authors.lastname: Howard
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Hashim
authors.initials: H
authors.lastname: Ghalib
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Gregory C
authors.initials: GC
authors.lastname: Ireton
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington.
authors.forename: Asrat
authors.initials: A
authors.lastname: Hailu
authors.affiliation: Department of Microbiology, Immunology and Parasitology, Addis Ababa University, Addis Ababa, Ethiopia; Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; Leishmaniasis Research and Treatment Centre, Arba-Minch Hospital, Ethiopia; Leishmaniasis Research and Treatment Centre, University of Gondar, Ethiopia; Infectious Disease Research Institute, Seattle, Washington steven.reed@idri.org.
authors.forename: Steven G
authors.initials: SG
authors.lastname: Reed
mesh_terms: D000351:Africa, Eastern; D006801:Humans; D007898:Leishmaniasis, Visceral / Q000175:diagnosis*; D019095:Point-of-Care Systems; D012680:Sensitivity and Specificity