Comparative Study of Serologic Tests for the Diagnosis of Asymptomatic Visceral Leishmaniasis in an Endemic Area

• DOI: 10.4269/ajtmh.81.1.27
• Publication Date: 2021-01-04T07:01:20Z
• Authors: Héctor Dardo Romero; Luciana de Almeid...; Mario Leon Silva-...; Virmondes Rodrigues; Roberto Teodoro C...; Sílvio Fernandes ...; Wilson Alecrim; Helio Moraes-Souza; Aluízio Prata
• Keywords: Adult; Aged, 80 and over; Leishmania; Adolescent; Infant; Enzyme-Linked Immunosorbent Assay; Middle Aged; Sensitivity and Specificity; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Child, Preschool; Animals; Humans; Leishmaniasis, Visceral; Serologic Tests; Child; Aged

Serologic tests have been widely used for the diagnosis of asymptomatic visceral leishmaniasis. This study evaluated five serologic infection: enzyme-linked immunosorbent assay (ELISA) using promastigote antigen (ELISAp), ELISA recombinant K39 (ELISA rK39), and K26 rK26) antigens, an indirect immunofluorescence test Leishmania (Leishmania) amazonensis (IIFT), immunochromatographic rK39 (TRALd). As a reference regarding performance tests, patients with classic leishmaniasis originating from Minas Gerais, Brazil (N = 36), were defined as positive group samples healthy individuals nonendemic areas (Argentina) 127) negative controls. Patients other diseases such cutaneous 53) malaria 56) also studied to evaluate chance cross-reactivity in these tests. Finally, subjects area endemic (Porteirinha, northern Gerais) 1241) screened infection Chagas disease. The sensitivity was 50% (18/36), 66.7% (24/36), 69.4% (25/36), 83.3% (30/36), 88.9% (32/36) ELISAp, rK26, rK39, IIFT, TRALd, respectively. Specificity, calculated truly group, 96% (122/127) 97.6% (124/127) ELISAp 100% (127/127) rK26. Positivity at least one employing observed 24 (45%) 47 (82.4%) malaria. In leishmaniasis-endemic area, positivity ranged 3.9% 37.5%. antigens more frequently history exposure human or canine (ELISArK39: 14.6% [149/1017] versus 37.5% [84/224]; rK26: 12.7% [129/1017] 21.4% [48/224], P < 0.001 both). Kappa agreement low, maximum value 0.449 between IIFT. addition, among 112 IIFT-positive subjects, 75 (67%) presented serology conclusion, IIFT TRALd best diagnose cases area. Cross-reactivity disease, leishmaniasis, should be taken into account. However, differences used, together low results, do not permit select infection.